Capability

Provider Network Development

Networks built to perform — access, adequacy and quality.

Start a conversation

A high-performing provider network balances access, regulatory adequacy, measurable quality and total cost of care. Carafelli Healthcare designs and expands networks around where care actually happens and where quality is strongest.

Meeting network-adequacy minimums is table stakes. The networks that actually perform are designed with claims data, monitored continuously, and built on relationships that hold. Carafelli Healthcare brings the health-plan perspective to network strategy for both plans and providers.

How Carafelli Healthcare helps

Data-driven designNetwork built from claims, utilization and outcomes data — not a static directory.
Adequacy monitoringMeeting time-and-distance standards, continuously, not just at filing.
Gap closureDeliberately closing geographic and specialty access gaps.
Recruitment strategyTargeting high-value providers by outcomes and total cost of care.
Value-based readinessNetworks built around providers who can succeed under shared risk.
Performance monitoringOngoing measurement so the network keeps performing.

Common questions

What is network adequacy?

Having enough of the right providers, within required time and distance standards, to serve your members. It is a regulatory minimum — strong networks go further.

Do you work with plans or providers?

Both. The network looks different from each side, and Carafelli Healthcare has built and evaluated them from the plan's perspective.

Related capabilities

Let’s talk about Provider Network Development.

A short conversation with Christine is the fastest way to see where the opportunity is.

christine@carafelliconsulting.com