ABC Training Company High Cost Claimants by Network Affiliation Evaluate a breakdown of your top claimants by network to illuminate cost drivers. 12% 88% High Cost In Network High Cost Out of Network Claimant In Out of Diagnosis ID Network Network 93 $161,010 $0 COMPLICATIONS OF TRANSPLANTED HEART 1067 $129,372 $0 ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY 345 $128,556 $153 ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES UNSPECIFIED 909 $109,960 $3,061 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 407 $84,479 $0 OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY INVOLVI 166 $79,619 $5,894 OTHER COMPLICATIONS DUE TO OTHER VASCULAR DEVICE IMPLANT AND GRAFT 949 $63,100 $0 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 995 $55,343 $2,260 STAPHYLOCOCCUS AUREUS SEPTICEMIA 533 $51,378 $5,226 ATRIOVENTRICULAR BLOCK COMPLETE 679 $22,357 $104,684 PARTIAL EPILEPSY WITH IMTRACTABLE EPILEPSY $885,174 $121,278 Total Paid Points to consider: • What factors contribute to out of network utilization? • Is there an opportunity to negotiate discount arrangements with specific providers? • Does your network include high quality, low-cost providers, and centers of excellence? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[17]