The Impact of Managed Medicaid on Insurance Networks: Good or Bad?
In January 2020, the District of Columbia issued an RFP for the D.C. Healthy Families Program, the District of Columbia Healthcare Alliance Program, and the Immigrant Children’s Program. These small-scale RFPs -- which are expected to cover just under 200,000...
COVID Exacerbates Network Inadequacy for Children’s Behavioral Health Providers
The large-scale disruption that is occurring in the lives of children will likely last through 2021. Consequently, there is a great deal of professional concern over the short-term and long-term impact of isolation in children who are being kept from a formative...
How Will Increased Medicaid and CHIP Enrollment Impact Your Provider Network?
The coronavirus pandemic has impacted nearly all areas of our lives. This is especially the case with the insurance industry. One especially relevant outcome is the uptick in Medicaid and Children’s Health Insurance Program (CHIP) members that poses new concerns for...
Own vs. Rent: What is the Best Way to Establish a Viable Provider Network?
Insurance carriers are under significant pressure to cut costs while continuing to support the recent pandemic-related surge in Medicaid enrollment. These expectations may make insurance companies question whether it makes sense to own or rent their provider network....
COVID’s Impact on Children’s Behavioral Health
Children everywhere are feeling the unpredictable effects of COVID and the resulting societal change, including family insecurity, job loss, eviction, and domestic violence. This has led many kids to experience developmental regressions such as lapses with potty...
Lower Health Care Costs by Addressing Social Determinants of Health
The Cost of a Healthy Life The American Hospital Association reports socioeconomic factors are responsible for approximately 40% of a patient’s health outcomes. Inequities in patient populations better known as social determinants of health can have a significant...
Is Your Provider Network Ready for Your RFP?
Last month, the Ohio Department of Medicaid (ODM) released a request for applications (RFA) to lead Ohio’s next-generation managed care program supporting more than 90% of Ohioans receiving health care services through Medicaid. In addition, the state also issued an...
Maintaining a Healthy Provider Network: Resolve & Prevent Network Inadequacy Fines
The Texas Department of Insurance fined Humana $700,000 in 2018 for network inadequacies caused by an insufficient number of anesthesiologists in two counties. The loss of revenue combined with the negative press are a thorn in the side of any health insurer who must...
FQHCs: Add Them To Your Network Now
An estimated 40 million people have lost work, along with their health insurance, since the global pandemic appeared in the U.S. earlier this year. Many of these individuals will turn to Medicaid for health insurance needs. This federal and state-funded plan already...
CEO Spotlight: Sarah Mahoney-Olofson
Leading TOG Network Solutions since 2010, CEO Sarah Mahoney credits the company’s success to swiftly understanding client needs, clearly communicating with clients and colleagues, and developing pioneering technology solutions. Sarah spearheads an organization whose...