Cutler Institute for Health and Social Policy

Population Health and Health Policy

Tiered Provider Networks

1/1/2004 - 1/31/2006
Principal Investigator: 
Andrew Coburn
Bill Thomas, Ph.D.

The purpose of this project is to determine where and how tiered provider networks are utilized, to describe the characteristics of these networks, and to develop insights into strategies used by health plans when implementing and operating tiered provider networks. The concept underlying tiered networks is that health plans may be able to reduce costs and/or improve quality by directing consumers to certain providers and to avoid others. Unlike traditional HMO arrangements, tiered network plans typically allow members to access all providers, not just a subset. Through a variety of tactics, such as the disclosure of provider ?scores? as well as differential cost sharing arrangements, consumers are encouraged to shop for health care services among select and non-select providers.
In collaboration with Mercer Human Resource Consulting, a set of questions will be included in this firm?s 2005 web-based Survey of Employer Sponsored Health Plans. To answer questions that cannot be addressed with a structured response survey, site visits will be conducted, including personal interviews and focus groups, in five case study communities in which tiered provider networks are operational. Finally, to assess the direction and magnitude of changes occurring in tiered network programs, information derived from the analyses of 2005 survey results and site visits will be used to develop a refined set of tiered network questions for the 2006 Mercer survey.

Start Date: 
Thu, 2004-01-01
End Date: 
Tue, 2006-01-31
Legacy Muskie ID: 

Nellie Mae Education Foundation nominates Pious Ali for the Lawrence W. O'Toole Award

Pious Ali

Pious Ali, Youth and Community Engagement Specialist in Cutler’s Children, Youth, and Families Programs, has been nominated for the Lawrence W. O’Toole Award by the Nellie Mae Education Foundation. Pious is one of six nominees from the New England states.

The Nellie Mae Education Foundation believes that student-centered learning – where learning is personalized, engaging, competency-based and not restricted to the classroom – will prepare young people to graduate high school ready to contribute to their communities and succeed. This award is given out each year to an individual, school district, or non-profit that has exhibited great leadership in moving student-centered approaches to learning forward in the New England region.

The winner will be selected by online voting and will be awarded a $100,000 grant to help advance student centered learning!


Learn More

Connect With Us