Provider & Facility Network Affiliation Insights

QES® Affiliation Insights helps you understand how providers are organized by practice, group, and care sites, allowing you to identify the right contracting entities and design smarter healthcare provider networks based on affiliations and care delivery patterns.

QES® Affiliation Insights

Optimize healthcare provider network management and design with QES® Affiliation Insights, which brings clarity to your provider network by revealing the complex relationships between healthcare providers, organizations, and facilities that shape network contracting and care delivery.

Integrated directly into QES®, Affiliation Insights allows you to view the organizations where individual providers are contracted and provides visibility into the facilities where providers treat patients. By combining this information, you can better understand how to contract with providers and determine which facilities should be included in your network based on provider practice patterns. Affiliation Insights supports you at every stage of the Healthcare Provider Network Lifecycle, leading to smarter, more effective network design, network optimization, and network management.

Design Smarter Provider Networks

Build smarter networks by understanding how providers and facilities align through professional and institutional affiliations. Make confident inclusion decisions that identify high-impact entities that drive strategic network growth.

Enhance Compliance and Network Performance

Visualize the impact of provider groups and contract entities on closing network adequacy gaps. Gain insights into provider mix, quality, and cost at the entity level by integrating Provider Claims Insights.

Improve Contracting and Operational Efficiencies

Identify the most likely contracting authority and align providers under the right entities. Streamline negotiations and improve operational efficiency with targeted, data-driven decisions.

Reduce Surprise Billing Risk

Help ensure in-network alignment between providers and facilities to minimize out-of-network charges and improve the member experience.

Popular Features

Explore the most impactful features of QES® Affiliation Insights—your toolkit for discovering the contracting and clinical relationships that shape provider networks.

Contract Entity Intelligence

Understand how providers and facilities are aligned and affiliated under contract entities to guide contracting decisions – whether targeting individual providers or negotiating with larger entities.

Provider-Facility Alignment

Understand where providers deliver care and avoid contracting with those primarily affiliated with out-of-network facilities.

High-Impact Entity Finder

Identify contract entities that close multiple gaps at once, helping you prioritize partnerships that deliver the greatest network value.

Entity-Level Performance View

With the addition of Provider Claims Insights, access provider cost and quality data at the contract entity level to evaluate performance and make more informed inclusions and contracting decisions.

Network Impact Modeling

Model the effects of adding or removing entire contract entities from your network to understand how changes will influence adequacy, access, and alignment.

Contract Entity Profiles

View a comprehensive snapshot of the contract entity including provider count, specialty mix, owned facilities, and performance metrics.

QES® Affiliation Insights in Action

QES Affiliation Insights transforms how you design and manage networks by revealing the true structure behind provider and facility relationships. From accelerating network adequacy modeling to streamlining contracting and scaling into new markets, it equips teams with the intelligence needed to build smarter, more compliant networks faster.

Accelerate Network Modeling with Entity-Level Precision

Shift from provider-level network modeling to contract entity-level modeling. By understanding how providers contract, you can drastically reduce network analysis time, close network gaps more efficiently, and avoid unnecessary overbuilding.

Improve Network Integrity with Hidden Structure Visibility

Uncover hidden affiliations between providers and facilities that were not visible in traditional data sources. This helps compliance teams proactively address network adequacy risks, improve audit readiness, and support more accurate decisions regarding provider inclusion.

Streamline Contracting with Verified Provider-Facility Alignment

Identify the most likely contracting authority across a fragmented provider landscape. This clarity can enable you to consolidate outreach, reduce negotiation cycles, and improve operational efficiency across all lines of business.

Scale Network Design for New Market Entry

Quickly identify high-impact contract entities and prioritize them for inclusion when entering a new state. This approach allows you to build a compliant, high-performing network faster, while aligning with strategic growth goals.

Get Started with QES Affiliation Insights

Discover smarter solutions for contracting and network design. Schedule a complimentary consultation to explore how we can help you achieve your goals.