#USA #San Francisco #Healthcare Costs #Serif Health #Network Benchmarking

Serif Health Introduces Network Benchmarking Tool

Serif Health has unveiled an innovative module aimed at transforming how brokers, benefits consultants, and self-funded employers make decisions regarding healthcare networks. This new feature, called Network Benchmarking, provides a comprehensive analysis that goes beyond basic discount rates, revealing more about how different networks perform for specific clients.

As healthcare costs continue to rise rapidly—with the average American on an employer health plan projected to spend $8,460 in 2026—having accurate and detailed information is more critical than ever. Milliman's 2026 Medical Index indicates a significant increase in healthcare costs, with families facing nearly $38,000 in annual expenses. This backdrop makes the need for informed network selection a high-stakes concern for employers.

Making Informed Decisions

Traditionally, network selections were guided primarily by advertised discounts, but these can often be misleading. With Network Benchmarking, advisors can access a detailed look at a network's performance by comparing negotiated reimbursement rates, provider participation, referral patterns, and out-of-network utilization. By utilizing a dataset that includes payer transparency files and national claims data, this tool equips benefits consultants with actual data rather than theoretical discounts, making their recommendations much more robust.

Brokers and consultants can leverage this module to generate side-by-side comparisons of various networks, ensuring decisions are data-backed and reflective of real-world performance. Some of its capabilities include:

• - Percentage of Medicare rates: Normalized analysis allowing for straightforward comparisons across different networks.
• - In-network capture rates: Evaluating both breadth and cost-effectiveness of the networks.
• - Disruption metrics: Assessing continuity of care across network boundaries, weighing potential savings against member impact.
• - Cost modeling: Based on accurate current rates reflecting the actual plan designs, rather than just headline discounts.

A Paradigm Shift in Network Evaluation