THE PRIZM PLATFORM
Find the most cost-effective network for your population
Evaluate health plan networks using Medicare rates as a benchmark to identify cost-effective solutions and ensure fiduciary alignment.
NETWORKS
Custom Network Comparisons
Identify the most cost-effective network for your population* and support fiduciary compliance by importing a census file to run group-specific network comparisons.
*Input weights for specific geographic areas and claims types to get results that accurately reflect a group's distribution and utilization.
INPUTS
OUTPUTS
NETWORKS
Network Comparisons by Procedure
Ensure fiduciary alignment by evaluating how your existing health plan network compares to alternative networks for specific high-cost procedures and services, with the option to view rates as a % of Medicare or % discount from billed charges.
NETWORKS
Network Comparisons by Code
Assess whether proposed direct contract rates for a Center of Excellence are competitive with rates offered through a commercial insurer's network, with the ability to drill down by code for the most frequently billed procedures.
For Brokers & Advisors
Why Networks for Brokers & Advisors?
Show clients which network is most cost-effective for their population, and document the fiduciary diligence behind the recommendation.
- Group-specific network comparisons. Import a census and claims file to compare networks weighted to your client's actual geography and utilization.
- Employer Group Reports with independent actuarial review from Windsor Strategy Partners.
- Equip self-funded employer group clients with a member shopping tool that supports Transparency in Coverage requirements.
- Provider disruption, network adequacy, and network tiering, modeled against the group's own census before you recommend a network change.
Explore more of PRIZM
One platform, five ways to put price transparency data to work.
