HiLabs has been recognized in the Gartner® Market Guide for U.S. Healthcare Payers’ Provider Network Management (PNM) Applications, a key industry resource for payer CIOs and technology leaders. The report provides insights into vendors supporting healthcare payers in developing marketable provider networks, ensuring compliance, and optimizing payer-provider relationships.
Provider Network Management
Gartner highlights vendors offering flexible, modular solutions that align with the operational maturity and specific needs of healthcare payers. HiLabs earned recognition for its MCheck suite of products that includes NetworkIQ HiLabs’ groundbreaking, modular network management application designed to allow payers to develop, manage, and sculpt provider networks effectively all within the same application.
“Superior provider networks are essential for payer business operations,” said Amit Garg, Co-founder and CEO of HiLabs. “By optimizing provider networks, health plans can deliver higher-quality, lower-cost care for all members. HiLabs believes no PNM solution is sufficient unless it delivers on all the ‘three Cs’ of network management: Compliance, Competitiveness, and Cost of Care. With NetworkIQ, powered by HiLabs proprietary algorithms, health plans can finally elevate network management from a regulatory requirement to a strategic advantage. regardless of network type.”
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A Focus on Data Quality
The Gartner® report also highlights a critical component of PNM solutions: data management tooling to identify duplicate records, inconsistencies, or errors and ensure data quality, accuracy, and usability. HiLabs‘ NetworkIQ empowers health plans to go beyond compliance and tackle competitors by benchmarking against other payors’ rates, physician performance, and network penetration. NetworkIQ sets a new standard in network management by seamlessly integrating clinical and member data, unlocking cost savings, and enhancing care quality for health plans.
“Provider data is foundational for so many payer functions, especially network management,” Garg continued. “Poor data leads to poor networks, plain and simple. You must fix the data first. Legacy provider data solutions simply have not delivered on either cost or quality but AI can. Our industry leading, accuracy-first approach allows payors to curate high-performing and cost-effective networks for their members, stay ahead of their competitors, and forecast network disruption as providers enter and exit their networks. ”
Source: PRNewswire