Glenridge HealthCare Solutions Partners with Quest Analytics to Evaluate Network Adequacy

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Oct 25, 2010, 08:15 ET

BALTIMORE, Oct. 25 /PRNewswire/ -- Glenridge HealthCare Solutions, a leading consulting, technology and professional services firm, and Quest Analytics, L.L.C., a health care software analytics company, today announced a strategic partnership that enhances Glenridge's ability to assist health plan clients in planning, building and maintaining high performance provider networks, as well help plans with process review and data validation initiatives, especially related to Medicare Advantage Plans' data reporting and validation audit requirements for CMS.

Glenridge works with health plan clients on network development and network management initiatives as well as assisting with the new data validation audits. With this partnership, Glenridge has new and valuable tools to scope a prospective provider network build, monitor progress to goal and resolve network gaps during the building stage, and assure appropriate adequacy and distribution as networks and markets evolve.

"As new standards have evolved in measuring member access to care, utilizing the Quest Analytics Suite to fulfill this need is invaluable to our customers," said Terry Spoleti, Co-founder, Glenridge HealthCare Solutions. "Our partnership with Quest enhances our ability to build effective provider networks that meet the market-specific requirements for network adequacy. Quest's Medicare Advantage Module enables us to offer real-time reporting on network adequacy and gap analyses based on the actual and specific CMS network requirements for the counties in development -- a game changer for MA network development. The Quest Suite has enabled Glenridge to significantly enhance its network analytics and reporting capabilities for all of our health plan clients. We have also used the Quest application to provide a framework to establish and measure network adequacy standards for Medicaid network builds. We see this application providing real value to health plans as the need increases for sophisticated analytic tools to measure multiple performance metrics for current and future networks."

"Health plans need to understand the importance on how their networks are being analyzed now that the market is shifting from simple access to more sophisticated network adequacy on both their existing networks as well as when targeting expansion areas," said Robert Smith, Senior Account Manager of Quest Analytics. "It's no longer about having simple access to care, but having an adequate network. Our technology, combined with Glenridge's experience, significantly streamlines the process that includes measuring adequacy and preparing a health plan for data validation readiness."

About Quest Analytics

Quest Analytics, L.L.C., (http://www.questanalytics.com) provides industry-leading software solutions to commercial and Medicare Advantage health plans, government agencies, consultants, brokers and employers to evaluate health care provider network adequacy.

About Glenridge HealthCare Solutions

Glenridge HealthCare Solutions (http://www.glenridgehealth.com) is a professional services and data management firm specializing in provider network development, managed care strategy and health plan operations. We are currently engaged by several regional and national health plan clients to assist in network management and expansion planning initiatives as well as data and financial analysis.