High value networks are insurance networks that offer lower copays and coinsurance but a smaller network of providers. They are emerging in the value-based care environment as a small network of providers aggregated by health insurers through an intentional process that evaluates fee levels, quality care, consistent outcomes, substantial integration to ensure a wide range of services and the providers’ ability to cooperate with the health plan.
The end game for health insurers with high value networks is to lower costs and improve quality. Successfully done, the networks are smaller in size but higher in quality and lower in costs for both patients and payers. If this model can continue proving itself, it could be a model for all networks about how to achieve the holy grail of low cost and better outcomes.