Why:

Cynosure convened an expert workgroup with deep experience creating and evaluating composite measures to evaluate health plan network variation. The workgroup considered multiple methodologies while exploring the impact of important technical issues and assumptions. Because of incomplete data, the focus became California hospitals and the associated plan-product networks available to consumers. Then, the workgroup created a “composite of composites” to score network performance.

Results:

In the end, the two most comprehensive and justifiable approaches yielded nearly identical results. While there is some variation in hospital network performance it is modest. Yet, outliers on both the high performing and low performing sides were discovered and regional variation was even more dramatic. Additionally, Cynosure also discovered a moderate relationship between premium cost and performance – the higher the premium is related to slightly better network performance.

Approach/Partners:

To learn more details, read a blog in Health Affairs or the Issue Brief here.

The project was undertaken with the financial and intellectual support of the California HealthCare Foundation.