The provider network represents the single greatest component of total medical expense for managed care organizations. However, for many executives, network management remains a reactive, fragmented process focused primarily on retrospective compliance. A recent webinar hosted by the Association for Community Affiliated Plans (ACAP) and presented by TOG Network Solutions explores how leading health care plans are breaking this cycle by transforming their networks into strategic financial assets.
The Shift Toward Proactive Network Intelligence
During the webinar, titled Network Intelligence: Unlocking Predictable Profitability in Safety Net Health Plans, Eric Olofson, President of TOG Network Solutions, details a methodology designed to achieve predictable success in complex markets. The foundation of this approach is the unification of multiple data streams—including payer, provider, transparency, and competitor data—into a single, financially aware view of network health. This transition allows health care executives to move beyond basic adequacy reporting to address the root causes of financial drain and MLR instability.
Pinpointing Hidden Losses with Forensic Analysis
One of the most critical takeaways from the briefing is the application of forensic financial analysis to the provider network. Rather than accepting general utilization trends as the sole driver of declining margins, this methodology allows plans to pinpoint exactly where the P&L is being impacted by hidden losses. The webinar includes case studies on identifying unit cost leakage within specific hospital systems and countering the exclusivity trap, where long-standing contracts often fail to deliver the expected market leverage.
By standardizing unit cost analysis against objective Medicare benchmarks, health care plans can secure a transparent defense against egregious billing and ensure that reimbursement rates align with market value. The webinar also explores how to activate unused contract levers to resolve overpayment issues that often go undetected without deep contract expertise.
On-Demand Access to Strategic Network Methodology
The webinar provides a blueprint for building a high-value network where strategic positioning, cost efficiency, and quality performance work in tandem. For executives focused on stabilizing costs and driving measurable improvement, this recorded webinar offers tangible insights into the next generation of provider management.
The full webinar is now available for on-demand viewing for all health care executives seeking to transform their provider network from a cost center into a core engine for financial strength.
Watch the recording here