Case study: Accelerating value-driven care through provider specialty tiering

Leading health plans know that to stay competitive and meet the demands of the members and employer groups they serve, they must proactively increase the value of care they provide while decreasing costs. That’s why one major health plan in North Carolina, serving nearly 4 million members across the state’s 100 counties, took action in recent years to implement a provider specialty tiering program that helps guide members toward higher-performing, lower-cost providers using Cotiviti’s Network Intelligence Risk-Readiness® provider scoring system.