Just like you can’t judge a book by its cover, you can’t judge hospitals or specialists by a single achievement. Quality matters, and no hospital is good at everything. The same is true of specialists. The reality is that care facilities and specialists are generally high performing in certain areas, but low performing in others. Further complicating things, prices vary significantly, even in-network. In fact, the decision of where members receive care has a huge impact on price.
The cost of a procedure at a hospital may be five to 10 times more expensive than if it was performed at a surgery center in any given market – a variance driven by care setting, not quality.
This makes navigating care within the community tricky. To solve for this, we take a data-driven approach that identifies and matches members with the highest-quality providers and care facilities. To make things even easier for members, we have a team of care navigators who provide peace of mind and convenience as they coordinate appointments and ensure care runs smoothly before and after each visit. Our team helps find and refer members to high-value, in-network and cost-effective providers and facilities. They make the process simple for members, whether inside our four walls or in the community.