Managed care networks and stop loss pricing

Managed care networks can help reduce expenses by negotiating prices with facilities, physicians and other providers for covered services. When reviewing network options for your self-funded groups, you may want to consider what carriers look for in a network to ensure you get the best possible pricing for their coverage.

Stop loss carriers consider many factors when evaluating managed care networks, including:

• Claims eligibility
• Claims experience
• Hospital capabilities

Network selection is critical to any stop loss contract, as the discounts offered can greatly impact the overall pricing of the policy. Read our recent Inside Track article to learn more about the importance of managed care networks and how they affect stop loss pricing.