By Jeff Bernhard via Linkedin
What is amazing to me in the Large Employer self-funded healthcare purchasing space is that an RFP will ask for things like a “network discount” but ask nothing around what the TPA/Carrier does to ensure that members only see the top 10% quality providers for every surgeon and speciality in every area of the Country.
Quality of care delivered by each specialist and surgeon is not a constant. As an example there are 160 orthopedic specialists that do spinal surgery in Houston, Texas, yet only 10 of them are rated at 90% or higher from the Gold standard Quantros Risk adjusted CMS data. Yes, only 10, yet all 160 are in every large carrier network. Many of them below 40 % quality/safety ratings. You would never know.
Why would you want to see any provider rated less than 90% from an objective, credible database to operate on you? You wouldn’t. This is your body and your health overall.
Quality is not a constant in these networks, period. Consumers deserve to know the highest quality ranked doctors, by specialty.
We are doing better. This is TopCare. This is Continental.
Jeff Bernhard – President of Continental Benefits