Integration has become the new buzzword in the medical community today. Emphasis on initiatives like population management and disease management work towards improving the health of communities at large. The success of such programs depends mainly on the synchronous functioning of various specialists which can be achieved through a well-connected physician network. A stable and well-functioning network has a common platform supporting all levels of the health care delivery system. All members, therefore, operate within this unified framework, making it easier for them to coordinate and produce favorable results. On the other hand, an ill-conceived and poorly established network can easily make a mess of any health improvement enterprise due to ineffective communication and a lack of proper leadership. There is a list of pros and cons associated with a physician network that should be kept in mind while either joining such an establishment or trying to set one up. Here are some examples:
Advantages Of A Network:
- A network serves as an intermediary between its affiliated providers and insurance plans. It, helps providers understand and stay compliant with the requirements of Federal statutes like Star Ratings, Care Management, and Quality Management.
- A network shields its providers from adverse business climate or forces and helps streamline processes like contracting, claims management, and utilization management.
- Working as part of a network may increase profitability for providers due to the reduction of losses, additional returns from ancillary testing, and administrative fees, as well as negotiating better contracts.
- A network ensures higher efficiency as any redundancies are nipped at the bud, therefore, lowering wastage of resources and improving utilization.
Disadvantages Of A Network:
- Since most networks run large-scale health initiatives, any failure on their part causes a tremendous negative impact on the lives of many patients at once.
- Physician networks can be labor intensive.
- When working as a collective, it becomes easy to lose focus. Making decisions may also become a tough task as a result of many varying viewpoints. Unifying such a diverse crowd and making them work toward a common goal can prove to be challenging
- The need for an elaborate infrastructure makes setting up a network an expensive affair.
- Lack of expertise concerning how a network should be operated is also a problem that most establishments grapple with.
Ideally, for a network to produce high-quality results, it should be compact and focused. Narrowing down the target population and implementing a few key health measures is a much better approach than chasing numbers. Taking steps to reduce provider turnover is also essential to ascertain success. Aside from this, adaptability, innovation, and a high focus on quality and compliance are features of a sustainable physician network.
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