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  • Title: What we know and do not know about tiered provider networks.
    Author: Thomas JW, Nalli GA, Coburn AF.
    Journal: J Health Care Finance; 2007; 33(4):53-67. PubMed ID: 19172962.
    Abstract:
    In response to continuing concerns about escalating health care costs and poor quality care, many health plans have adopted a strategy called "tiered provider networks." With TPNs, plans provide financial incentives for members to utilize hospitals, primary care physicians, and/or specialist physicians identified as performing especially well in terms of cost-efficient and/or high-quality care. The strategy is relatively new, and little is known about TPN structure, implementation, or operation. In this article, we present findings about tiered provider networks developed from a national survey of health plans and from interviews with health plan executives, their employer clients, and providers in their networks.
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