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Advancing Multi-Tier Network Leadership with Provider Data and Price  Transparency

Illustration of person with smart phone in hand with a dollar sign

Industry

Healthcare

Challenge

The Regional Blues Plan's existing provider directory vendor lacked the technical capability to support multi-tier network products. This limitation hindered their market competitiveness, negatively impacting sales and revenue. Additionally, new federal regulations in 2022 required the modernization of their digital tools to ensure compliance.

Results

With Perspecta's support, the Regional Blues Plan reversed declining sales tied to previous directory limitations, improved member experience with accurate and personalized provider search and tier display, gained competitive advantage by becoming a market leader in multi-tier network product offerings, achieved regulatory compliance with price transparency standards, and enhanced revenue opportunities by strengthening its digital infrastructure and product appeal.

Key Products

ProviderDirectoryAI (PDAI), Price Transparency, Multi-Tier Network Logic

Perspecta's solutions have been instrumental in transforming our digital infrastructure, allowing us to lead the market in multi-tier network products while ensuring compliance with new regulations.

VP, Technology

Regional Blues Plan

The Challenge

The Regional Blues Plan sought to expand its portfolio with health insurance products featuring multi-tier network and plan benefits. However, their existing provider directory vendor lacked the technical capability to support this complex design, directly affecting their competitiveness and sales. The implementation of the Transparency in Coverage (TiC) and No Surprises Act (NSA) regulations in 2022 added urgency for the Blues Plan to modernize its digital tools to stay compliant.

The Solution

To address these challenges, the Regional Blues Plan selected Perspecta as its new provider directory and price transparency solution partner. The implementation process involved:

  • Defining network and plan-specific requirements;
  • Integrating a member-specific directory into the existing member portal via SSO; and
  • Deploying Perspecta’s price transparency solution to align with regulatory mandates.

The Results

With Perspecta’s support, the Regional Blues Plan reversed declining sales tied to previous directory limitations, achieving a 15% increase in sales. The enhanced user experience with accurate, personalized provider search and a tiered display improved overall member satisfaction. The plan gained a competitive advantage by becoming a market leader in multi-tier network product offerings and achieved full compliance with price transparency standards.

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