Online ISSN: 2577-5669

Comprehensive analysis of Utilization Trend and Opportunities to scale up a registered Health Insurance company’s Preferred Provider Network

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Dr M Gayathri Nair, Dr Neha Ahire
» doi: 10.5455/jcmr.2023.14.06.6


The aim of the study is to analyse the utilisation trends and identify the opportunities to scale up the company’s Preferred Provider Network and to provide recommendations and insights to the company so that they can increase their earnings and profits. The company’s provider networks data of year 2019, 2020 and 2021 up to month of July was received. The secondary data thus received had details of all network and non-network hospitals and other necessary related information. The data was cleaned, classified and the study variables were analyzed. Appropriate statistical software and tools like Microsoft Power BI and Microsoft Excel was used for data analysis and the statistical result thus obtained were used for interpretation with respect to the outcome variables. This study that was carried out helped in understanding the utilization of the different pricing patterns within the provider network and helped in identifying why a particular pricing category is preferred over others. Furthermore, it also aided in accessing the company’s savings and in framing recommendations for its better financial performance.

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