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Raising Health
Build Your Own Provider Network with Dan Rosenthal
Nov 5, 2024
Dan Rosenthal, a healthcare expert and former CEO at UnitedHealth Group, shares his wealth of knowledge on building and managing provider networks. He delves into the complexities of payor-provider contracts and the future impacts of transparency laws. Dan also highlights the rise of digital health startups and the innovative potential of AI-driven personalized networks. This dynamic conversation uncovers how traditional healthcare models can be challenged, offering a roadmap for startups seeking to modernize the healthcare landscape.
24:41
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Quick takeaways
- Understanding the complexities of provider-payer relationships is crucial for optimizing healthcare networks to balance costs and care quality.
- AI and price transparency are set to revolutionize provider networks by fostering personalized, data-driven healthcare solutions tailored to individual needs.
Deep dives
Understanding Provider Networks
A provider network is defined as a collection of healthcare providers and access points organized in a way that facilitates patient care. The complexities arise from the relationships and contracts negotiated between providers and payers, which often create tensions around payment agreements and quality of care. For instance, providers must ensure they are adequately compensated while also being promoted effectively within the network. Conversely, payers need to maintain a comprehensive overview of the network, balancing the total care provided against individual patient needs.
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Discover
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Listen to the best highlights from the podcasts you love and dive into the full episode