Quest Analytics

“It’s helping the contracting teams identify where there are gaps of access for members, and then close those gaps via the tool. It identifies potential providers to fill any sort of access gaps. “And having this mechanism to continuously monitor adequacy, we’re addressing gaps more quickly than we would have in the past. We’re catching things quickly. And we’re able to be more proactive about maintaining our networks versus reactive. That’s important.”

“It creates a central source of truth, so to speak. Instead of having multiple areas [of the company] assessing network adequacy, you have one central location that people can refer to, and you know the results are consistent. It also provides an opportunity for anyone to view whatever areas are relevant to their work. It’s allowed us to partner more closely with the local markets to help them with our end goal of building these provider networks. You build more trust with your partners.”

“We just did 15-plus health plan expansions and new implementations in a very short amount of time. There is no way we could have done it without QES.”

“We update our source files monthly. Our leadership can look at our network status in QES at any time and see our network adequacy is improving.”

“To be able to dive into a county in, say, New York, and see right on the screen which provider will fill a gap 100%. I mean, before Quest Analytics that would have been an hour’s worth of work. QES is just so head-and-shoulders above what we were doing before that nobody can even believe it’s real.”

“The constant validation of provider data by Quest Analytics reduces our workload significantly. We can focus our attention on other network measurement and strategy activities that we need to do. For example, identifying gaps in our network and then working with the appropriate team members on action. We’re proactive rather than simply keeping the data up to date.”

“We’re getting the validated data back in a format that enables us to batch flow changes into the system. These efficiencies are a huge leap forward in getting our data to an acceptable standard of accuracy and then maintaining it.”

“Our directory accuracy has greatly improved…Trying to meet these regulatory requirements just wasn’t possible until we engaged Quest Analytics.”

““We want to be able to align with the best providers in terms of cost and quality and remediate those in our network or those that we employ, that aren’t the best. Looking forward, what I would say is we’re continuing to curate our networks in a way that we can be efficient, that we can meet regulatory requirements, and that we can meet consumer expectations in terms of their experience with our health system.””

““With the tools I have from Quest Analytics, we take an offensive strategy with payers to say, we are adequate, and we can be your network in a particular area without any other providers because we have everything covered from a CMS adequacy regulatory perspective.””

“The timeliness of the data was the big push for us to move to QES. Quest Analytics dropped our turnaround time to about one business week. That’s really what we needed for the network adequacy side.”

“You can’t ignore the experience and the expertise that the Quest Analytics team brings to the table. They look at things in a different way, which is very helpful, and they ask questions that make you think.”

“It’s worth the investment because it’s an additional team of people who are just thinking about how to solve for this.”

“I couldn’t hire enough people to do all the things that Quest Analytics is managing for us”

“They’re watching their accuracy score and their attestation score and hoping to see some wins, it’s almost gamified their territory management.”

“We were able to track our efforts to rebuild the network and see that trend line gets back up to network adequacy across the year.”

“It’s enabled us to do a better job and to protect consumers better.”

“The reason I cherish it is that it’s made us more effective. We’re finding more real problems that affect people, especially in the specialty areas. We bring adequacy and directory issues to the insurer’s attention and — because of our persuasive power as the regulator — they fix them.”

“We’re hoping that over time we’ll get insight into trends that will help us provide advice to the legislature regarding public policy.”

“Before Quest Analytics, we did not have the capability to compare plan performance in one snap-shot. It was beyond our wildest dreams. Now, in addition to seeing how many providers are in a particular geography, we have insight into the adequacy of other plans in a market. We can say, ‘Well, everyone else can meet that requirement. Maybe it’s something about what you have to offer that’s the problem.’”

“That was sort of an added bonus we hadn’t thought about. Quest Enterprise Services compares the health insurers’ data to the data in its system to see if there are discrepancies, which gives us the ability to quickly identify problems with the accuracy of the information.”

“Also, when no one is successfully contracting, it’s meaningful for us to get confirmation of what we’re told anecdotally by the insurers — because sometimes these facilities won’t contract at all.”

“Quest Analytics® has data regarding the providers and facilities available to fill gaps in the provider networks. We can now say, ‘You don’t have enough cardiovascular surgeons here. There are 25 of them available in the market for that county. This ability puts us on a more even playing field with the health insurers  in terms of the knowledge each of us has regarding availability.”

“We wanted something we could use to perform analytic inquiries, to be able to ask questions and dig down deep into the data to find relevant information.”

“We also wanted something that was more flexible and more granular than doing a network analysis on a very high-level, nonspecific basis.  We wanted to be able to identify areas of insufficient network adequacy for specific specialties, much like the federal government does in its programs.”