Network Management

The following statements are about factors that health plans should consider as they develop provider networks in rural and urban markets. Three of the statemen...

Lakesha Frazier, a member of a health plan in a rural area, had been experiencing heart palpitations and shortness of breath. Ms. Frazier's primary care provide...

A population's demographic factors--such as income levels, age, gender, race, and ethnicity--can influence the design of provider networks serving that populati...

In developing a provider network in a large city with a high concentration of young families, the Gypsum Health Plan has set goals focused on the needs of that...

The Gardenia Health Plan has a national reputation for quality care. When Gardenia entered a new market, it established a preferred provider organization (PPO),...