network healthplan

Network for health plans

The networks that Healthcare Highways has designed for our health plans deliver savings by providing a broad network option and a high-value network option. The broad network plans have more participating providers and generally cost more for participants. On the other hand, high-value network plans place limits on the doctors and hospitals available to their members, often excluding high-cost providers. As a result, the premiums for such plans are lower, and attractive to price-sensitive consumers.

Our provider networks offer high-value choices that are locally relevant and that employees can access wherever they may be in the U.S. according to their benefit plan.

Our proprietary networks also allow us to select and negotiate directly with providers who agree to meaningful discounts AND commit to engagement with providers to increase their practices’ efficiencies. Provider discounts are a one-time saving that only works if you start with a common price. And not all providers price the same: in fact, hospital rates can vary 300 percent or more on medical billing codes.

Efficient practices and reimbursement models provide meaningful cost savings that can improve over time.

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first choice
HCH Plus

Our Broad Network

We believe in choice, and our HCH Plus network’s broad selection of quality hospital systems, physician groups, and ancillary providers who offer highly competitive discounts provide wide choice to both employers and employee members. HCH Plus, our broadest network option, may be tiered with Healthcare Highways Sync to provide choice in affordability and coverage.


HCH Sync

High Value High Performance Network

The flagship of our network offerings, HCH Sync delivers a high-value network with the performance excellence that lowers spending on health care.

HCH Sync’s financial alignment with providers establishes incentives for efficient practice and rewards them for optimum health outcomes, which may mean fewer procedures.

HCH Sync embeds our Careways care-coordination solution to ensure that processes are in place to maximize in-network use, members (covered employees and dependents) have an advocate for advanced or chronic care who can help them navigate the healthcare system and avoid gaps in care, and in-network providers deliver the most affordable and highest-quality health care.


HCH SyncEPO

Preferred Provider Organization

Our lowest-cost solution comes from HCH Sync EPO. An exclusive provider organization, HCH Sync EPO requires that members see only providers that are part of its predetermined network. Except for emergency medical needs, only in-network providers are covered.

HCH Sync

HCH Sync EPO

HCH Plus (OK only)

Specifications

Hospital systems and physician group coverage

Directed

Directed

Broad access

Out-of-network coverage with a benefit differential in the primary area - INCLUDED

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Out-of-service-area coverage - CLIENT SPECIFIC

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Network designed to meet cost and quality metrics goals -INCLUDED

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Provider incentives for meeting efficiency and quality metrics - INCLUDED *Available only in Oklahoma

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Network Options