At AHIP 2025 in Las Vegas this week, Quest Analytics and Arcadia announced a data integration partnership that is expected to give payers the ability to build more competitive networks.
Quest Analytics gives physician-level intelligence on a single platform. Provider performance intelligence is rapidly becoming a business lever, not just a compliance requirement.
Embedding advanced provider performance insights directly into network design gives payers visibility into which providers deliver the best outcomes at the most efficient cost, according to the announcement.
Health plans can then make more informed network decisions when building and refining provider networks that offer the best member engagement strategies.
WHY THIS MATTERS
While health plans can access provider cost and quality data, many still struggle to build competitive networks, steer members to high-value providers, improve risk arrangements with providers, or support member acquisition and retention with data-backed quality transparency.
The Quest Analytics/Arcadia integration is looking to close that gap.
THE LARGER TREND
Quest Analytics' data-driven SaaS platform enables clients to combine proprietary and third-party data for clinically informed network decisions. Its Provider Claims Insights (PCI) delivers metrics on claims activity, procedures, conditions treated, efficiency, effectiveness and payer mix.
By integrating elements of Arcadia's CareJourney Provider Performance Index with Quest's PCI solution, clients gain metrics on physician cost and performance on over 250 episodes derived from Arcadia's Medicare fee-for-service claims data asset.
"This partnership with Arcadia reinforces our commitment to embedding care delivery intelligence directly into Quest Enterprise Services (QES), where network decisions are made," said Steve Levin, CEO of Quest Analytics.
Arcadia clients include Aetna, Cigna, Highmark Blue Cross Blue Shield, Intermountain Health, Ochsner Health and the state of California.
ON THE RECORD
"It is no longer sufficient for payers to build networks tuned to adequacy rather than performance," said Dr. Luke Hansen, CMO Arcadia. "By leveraging intelligence on provider performance, payers can identify those who consistently deliver high-quality care at lower costs. This enables networks that are not just compliant but optimized for cost and clinical performance."
Email the writer: SMorse@himss.org