Provider Network Development Specialists

We build High Performing Provider Networks with a speed to market approach delivering results on time and on budget

Let us do the work for you. With a roster of over 75consultants ready to deploy, EHS designs a market expansion strategy to meet client’s needs within their competitive landscape.

Essential HealthCare Solutions’ network development professionals provide quality support for the development of local, regional, and multi-state network provider networks including specialty networks such as vision, dental, DD/DI, LTSS and behavioral health.

Call Us Now (850) 375-4488

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Developing High-performing Networks With Essential

Our proven network expansion strategies, market knowledge, and innovation approach allows the necessary foundation for our clients to manage cost while developing high performing networks on time and on budget without the burden of hiring and training additional staff or increasing salary wages and benefits

Who we support:

Health Plans
Start-Up Health Plans
Commercial HMOs
Commercial PPOs
Managed Medicaid Plans
ACA Exchange Plans
Medicare Advantage Plans
Provider Organizations
ACOs
Large Self-Insured Provider Networks
IPAs
Clinically Integrated Network

The Value of Working With EHS

Analyze industry trends
Provider Network Market Analysis – We provide comprehensive market analysis to our clients to enhance network development strategy. Our analysis includes utilizing our internal provider and hospital database to provide our clients with healthcare commercial intelligence that untangles the web of data to identify high preforming providers, healthcare systems, and other healthcare organizations for any type of provider network
Support the negotiation of complex, value-based payor agreements
Manage provider risk pool settlements
Develop Optimal Network Performance
Manage risk adjustment methodologies and financial impact for commercial and Medicare Advantage population
Transition to from FFS to Value Based Contracts

Vast understanding of medical cost trends that drive gains and losses across risk pool
In-depth knowledge in value-based contract methodologies
Vast knowledge in at-risk contract methodologies
Improve terms for quality measures
Data Support to provided additional resources for reporting and network analysis
Provider Network Operations Support – Provider training, contracting data integrity and workflow
Provider Credentialing Support
Provider Claims Adjudication and Claims Auditing Support
Provider Directory Accuracy and Provider Data Validation

Past Performance

Get in Touch With Our Solution Team, Today!