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Network Adequacy

Streamline and automate compliance for federal and state network adequacy requirements

Medicare Advantage, Medicaid, and many QHP markets require that health plans verify network adequacy to remain in compliance with federal and state regulations. However, even the information from government sites is not always current or accurate. Although some solutions and products try to fill this need on a limited basis, they often force payers into a one-size-fits-all approach that doesn’t address each health plan’s unique network adequacy needs.

Network Adequacy gives health plans the rapid, accurate proof they need to document that networks fully meet federal and state adequacy requirements – without requiring up-front IT expense or large staff investments.

Fast, Automated Network Adequacy Designed for Real People

HealthLink Dimensions’ Network Adequacy preloads provider information from CMS, then analyzes this data to identify potential adequacy issues for contact information, time, distance, and other mandatory categories. Network Adequacythen filters for false positives and provides suggestions for providers that fill any remaining gaps using HealthLink Dimensions’ industry-leading multi-source provider data assets.

This Cloud-based solution provides 24/7, secure availability. Its unmatched flexibility enables easy-to-use customized inputs across time, distance, and provider types to facilitate state-level client RFP responses. Internal teams receive the network adequacy insights they need, presented in clear, straightforward visuals, map overlays, and reports. Compliance, sales, and network management staff all work more efficiently, receiving essential adequacy assistance in a format that doesn’t require detailed technical knowledge to use or interpret.

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