Health care access: How to deliver quality and value via network management

In every market it operates, Aetna International is committed to keeping costs down whilst ensuring access to high quality care.

Understanding medical network management and why it’s important

Network management exists to ensure international private medical insurance plan holders have access to quality health care at a competitive price. Private health and wellness benefits providers like Aetna International maintain robust network management strategies to tackle the challenges of medical cost inflation and delivering the best health care outcomes. These challenges include:

• Skyrocketing health care costs borne by individuals, employers and governments alike make it increasingly difficult for people to access quality, timely care — and that results in poorer health outcomes.
• Without strong network management, inappropriate provider treatment and billing can impede efforts to ensure patients get the right care at the right cost.

What you’ll discover in this report:

1.    How effective network management makes a difference

Network management is an on-going process. By analysing utilisation rates (how often care services are accessed) and addressing unit cost (how much is paid for care at the point of service), health care benefits providers can implement cost containment strategies to the benefit of everyone: individual plan holders or members; employers; health care providers themselves and insurers.

2.     How Aetna’s network management addresses international network challenges 

Quarterly, Aetna International analyses regional medical trends to assess the state of individual providers, customers and members. In their research, one country* stood out when it came to claims data in comparison to others. Aetna International worked with its network connections to address the issues it discovered.

The case study included in the report highlights the corrective measures put in place to:

• Ensure members weren’t getting and paying for any unnecessary procedures
• Significantly reduce medical expenditure for groups in this country and future premium for these groups.
• Drive towards year-over-year premium reductions, which in this case amounted to $1M U.S.

Read the free report — Making networks work — here

Further reading:

Read the fraud, waste and abuse report and case study here
Bending the curve: Addressing rising costs in health care

Getting in touch

Employers and brokers can find out more about our services by contacting an expert advisor in their region.

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