Leasing a Healthcare Provider Network: What TPAs and Smaller Carriers Need to Know

As a fund administrator or employer, you play a key role in making sure your clients and their members have access to quality, affordable care. One of the most important decisions you face is selecting the right healthcare provider network — a choice that affects member satisfaction, care quality, and your overall costs.

For many, leasing network access is a practical alternative to building a network from the ground up. It offers immediate entry to a broad, vetted group of providers with pre-negotiated rates, saving time and resources.

But not every network delivers the same value. Knowing what to look for before you sign an agreement can help you avoid gaps in coverage, manage expenses and ensure members receive consistent, high-quality care.

In this article, we’ll cover the key considerations for leasing a healthcare provider network and show how MagnaCare’s owned network can support TPAs and smaller carriers in enhancing their plan offerings and streamlining operations.

What Is a Leased Healthcare Provider Network?

Let’s start with the basics here, just in case you’re new to the concept of leasing healthcare provider networks. A leased healthcare provider network, often called network access, is an arrangement that allows you to connect your members to an existing group of contracted providers without building those relationships yourself. Instead of negotiating rates, credentialing providers, and managing contracts in-house, you gain entry to a vetted network through a partner who has already done the leg work upfront.

This approach is especially valuable for TPA’s and insurers who need quick access to a broad range of providers across multiple locations. It removes the time and expense of creating a network from scratch while still offering members access to primary care, specialists, hospitals and other services.

Leasing a network also provides flexibility. You can choose a full network that covers a wide geographic area or a more targeted set of providers tailored to your plan’s needs. The key is to work with a partner who prioritizes quality, transparency and stability so members receive consistent care at predictable costs.

Key Considerations Before Leasing a Healthcare Provider Network

Selecting a healthcare provider network is more than just finding a broad list of providers. It’s critical to do your research and make sure you’re selecting the right network. The right choice should balance access, quality, cost and stability to meet the needs of your clients and their plans. Here are four critical factors to evaluate before making a final decision.

1. Quality Standards

Not all networks use the same criteria to evaluate providers. Look for a network that follows rigorous credentialing and accreditation processes. Ask about performance metrics such as patient outcomes, preventive care rates and member satisfaction scores. A high-quality network should demonstrate that its providers meet or exceed industry standards and that it regularly reviews those standards to maintain excellence.

2. Cost Transparency

The savings you should expect from leasing a network depend on how clearly the costs are communicated. Understand the fee structure, including any per-member-per-month charges, administrative fees or claims repricing costs. Make sure you can see how negotiated discounts translate into real savings for your plan without sacrificing care quality. Transparent pricing also helps you budget more accurately and avoid unexpected expenses.

3. Flexibility for Tiering

Some plans benefit from a tiered network design, which groups providers into levels based on quality, cost or location. This approach can encourage members to use preferred providers while still giving them other options. If tiering is important to your strategy, confirm that your network partner can accommodate it and help you design tiers that align with your goals.

4. Provider Retention and Stability

When providers leave a network, it can disrupt care and frustrate members. Ask about the network’s retention rate and what steps it takes to maintain strong relationships with providers. A stable network not only improves continuity of care but also reduces administrative work associated with constant provider changes.

Pros and Cons of Leasing a Healthcare Provider Network

Now that we’ve covered the key factors to evaluate when leasing a healthcare provider network, the next step is deciding whether it’s actually the right move for your plan. While leasing can offer speed, savings and convenience, it’s important to weigh both the advantages and potential challenges before moving forward.

Pros

• Immediate access to a broad, vetted network without the time, cost and expertise required to build it yourself
• Reduced administrative workload because the contracting, credentialing and rate negotiations are handled for you
• Potential cost savings through pre-negotiated discounts and fee schedules
• Flexibility to customize coverage areas or create tiers that support the unique needs of your plan
• Ability to scale quickly if membership or geographic needs change

Cons

• Less control over network composition compared to self-built networks
• Provider turnover risk if the network does not maintain strong relationships or retention strategies
• Variable quality standards if the network’s credentialing process is not as rigorous as you require

Understanding these pros and cons can help you decide whether leasing is the right fit for your plan and identify the type of partner that can help you maximize the benefits for your organization.

Questions to Ask Before Choosing a Network Partner

If you’ve decided that leasing a network is the right move for your plan, the next step is choosing the partner who will deliver the best results. Before you sign an agreement, make sure you ask these questions.

How do you credential and monitor providers?

Look for a detailed process that verifies qualifications, licenses and performance. Ask how often providers are re-credentialed and how ongoing quality is measured.

What steps do you take to retain providers?

Strong retention helps maintain continuity of care and avoids disruptions for members. Find out what the network does to keep providers engaged and in-network.

How transparent are your costs and fees?

Request a clear breakdown of administrative fees, per-member-per-month charges and how negotiated discounts translate to actual savings.

Can you support tiered network designs?

If you plan to group providers based on quality, cost or location, make sure your partner can build and manage a tiered structure that meets your needs.

What is your geographic coverage?

Confirm that the network meets the needs of your member population, whether you require a local, regional or national footprint.

How do you handle gaps in coverage?

Ask about the process for addressing member needs when no in-network provider is available in a specific specialty or location.

By getting clear answers to these questions, you can feel confident in choosing a partner who not only meets your current needs but can also adapt as your plan evolves.

Ready to Explore Network Access with MagnaCare?

Leasing a healthcare provider network can give clients and their members immediate access to high-quality care while saving your plan time and resources. By understanding the process, weighing the pros and cons and asking the right questions, you can choose a network partner that delivers real value and long-term stability.

MagnaCare is one of the few TPAs that owns its own provider network, which sets us apart in the market. With direct ownership, we control the contracting, credentialing, and provider relationships, ensuring dependable access, transparent pricing, and greater flexibility for plan design. Because our team manages the network end to end, clients can deliver high-quality, cost-effective care to their members while focusing on running their business.

If you are ready to explore how network access can benefit your organization, connect with us today to learn more about our solutions and how we can support your goals.