To meet member and employer demand for greater visibility into provider quality and more affordable healthcare, we’re offering a new optional supplemental product for commercial group employers in partnership with Garner Health that will identity top-performing providers in our network and cover out-of-pocket costs for participating members who choose to see these providers.
When is this product going into effect?
There’s a small pilot group with the Garner product going into effect July 1. For all other groups, it will be available for purchase effective August 1.
How does it work?
Members in participating groups who choose to use Garner can log into a website or app and identify Garner’s “Top Providers” in primary care, behavioral health and over 80 specialties. If the member chooses to see one of these providers, Garner will reimburse the member’s eligible out-of-pocket expenses.
Members will still be covered as before for seeing other in-network providers if they choose.
What data and methodology does Garner use when designating top-performing providers?
Garner applies over 500 proprietary clinical metrics to over 60 billion de-identified claims from more than 320 million patients nationwide, evaluating clinical outcomes, adherence to evidence-based care guidelines and cost efficiency. Providers who rank in the top tier of their specialty and geographic market earn the Top Provider designation.
For more details on Garner’s methodology, see Garner’s website.