Provider Network Statistical Analysis
Client: California Department of Managed Health Care (DMHC)
Mission Analytics Group supported the DMHC in providing analysis related to DMHC's licensing of health care service plans to operate in the state of California, pursuant to the Knox-Keene Act (KKA) Health and Safety Code section 1340, et seq. Mission developed a statistical model based on provider network data, the DMHC’s analysis resulting from the use of geographic mapping software, and other resources identifying overall patterns of practice which will assist the DMHC in determining network compliance. Mission identified statistically significant variations between individual health plan networks and the industry overall in order to determine what constitutes “reasonable” access for where a clear network standard is not established.