Understanding how members are currently utilizing networks, physicians, hospitals, and other plan
resources can be invaluable in managing a health plan. Without understanding how the patients are
currently utilizing plan resources, it is difficult to craft solutions that can lead to better health outcomes
and better cost performance. Appropriate use of high cost settings can improve health and patient
satisfaction as well as impact cost. The appropriate mix of place of service settings can profoundly
impact the plan cost.
Network performance metrics can assist a plan in devising strategies that improve care and reduce cost.