EnsureExcel©

Organizations can design and deploy:

• Premium specialty networks
• Tiered provider networks
• Narrow networks for value-based products
• Centers of Excellence pathways

Network configurations are fully customized by specialty, geography, payer contract, and population segment.

EnsureEXCEL© influences referral behavior by adding performance intelligence into clinical and operational workflows.

The platform:

• Surfaces preferred specialists at point-of-referral
• Flags high-cost or low-performance referral leakage
• Recommends optimal providers based on cost, quality, and access
• Aligns referrals with value-based care pathways

This drives clear reductions in network leakage and unnecessary variation in care.

To support payer and ACO strategies, EnsureEXCEL© helps organizations implement benefit-based steering mechanisms, including:

• Lower member cost share for premium network providers
• Preferred pathway incentives
• Tiered copay structures
• Value-based referral nudging

This creates a strong alignment between benefit design, clinical processes, and provider performance.

EnsureEXCEL© identifies high-performing primary care physicians for:

• MSO network expansion
• ACO geographic growth strategies
• CIN alignment initiatives
• Market entry planning

The platform highlights PCPs with strong outcomes, risk management capabilities, and high-value referral patterns which are critical for scaling population health models.