Wakely Network Evaluation & Strategy Tool (NEST)

MA networks perform best with the help of Wakely NEST.

Whether you’re a health plan looking to optimize the growth and profitability of your products, or a provider network seeking to improve cost and quality performance, Wakely’s Network Evaluation & Strategy Tool (NEST) gives you the insights you need to build, optimize, and maintain high-performing Medicare Advantage networks.

  • Health plan leaders can use the MA comparisons provided by NEST to inform both network development initiatives and contract negotiation strategy. The integrated insights from NEST make it easy to understand how competitors are tailoring provider networks, and which providers they are excluding.
  • Health systems can use NEST data and insights to curate high-performing, clinically integrated networks, improving their performance in value-based contracts and making them more attractive to health plans.    

Request a consultation to learn more about NEST.

Designed to work harder for you.

Wakely NEST is a web-based software service, available to our customers 24/7. Your organization can use the NEST platform to analyze, explore, and build provider networks with greater confidence than ever, thanks to these features:

  • One integrated solution – Unlike fragmented point tools, NEST unifies adequacy, quality, and financial insights in a single platform.
  • Actuarial + strategic expertise – NEST was built by expert Wakely consultants who have deep knowledge of Medicare Advantage markets.
  • Future-ready platform – NEST was designed to evolve with CMS requirements and support both emerging and established markets.

Understand the competition and improve network performance with one powerful tool.

NEST simplifies the process of evaluating and optimizing provider networks in a competitive environment. Use NEST to:

Understand the competitive landscape
Gain visibility into how your network compares to competitors on utilization, outcomes, and quality.

  • Benchmark network strength regionally, nationally, or by county
  • Identify provider-level performance variations down to the National Provider Identifier (NPI)
  • Support more effective rate negotiations with quality-based insights

Ensure network adequacy & compliance
Simplify the process of meeting CMS requirements and closing coverage gaps.

  • Generate CMS-compliant Health Service Delivery (HSD) submissions for providers and facilities
  • Pinpoint adequacy shortfalls at the county or regional level
  • Prioritize recruitment efforts to strengthen compliance and coverage

Drive strategic network design
Use robust analytics to shape networks that balance quality, access, and financial sustainability.

  • Evaluate risk scores and Hierarchical Condition Categorie (HCC) prevalence across provider panels
  • Identify opportunities for value-based arrangements at the provider level
  • Align network design with market growth, profitability, and quality goals

Ready to learn more about NEST?

Request a COnsultation

Unique products and tools.

Wakely has developed these industry-leading products and tools, which empower our clients to make highly informed strategic decisions.

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Wakely National Risk Adjustment Reporting (WNRAR)

Provides risk adjustment metrics from 35 states and 19 million lives.

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Risk Score Opportunities (RSO)

Identifies and prioritizes members who are most likely to have a condition that has not been coded.

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Wakely Plan Valuation Model (WPVM)

Supports pricing, mental health parity compliance, cost and utilization analysis and more.

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Risk Adjustment Payments: Investigation of Discrepancies Tool (RAPID)

Gets the most out of your EDGE data.

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Wakely Analytics Health Operations Optimization (WAHOO)

Helps payers and providers optimize financial performance with a complete package of services and tools.

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Wakely Affordable Care Act Competitive Analysis Tool (WACACAT)

Allows users to interactively explore market metrics.

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Wakely Risk Assessment (WRA)

Provides a transparent, open-code, high-performance risk assessment model.

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Wakely Risk Insight (WRI)

Includes two major components: The Medicare National Report (MNR) and WRI-MA. Both pinpoint drivers of profitability and compare them to national benchmark data.

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Wakely Risk Insight National Reporting Project (WRINR)

Identifies key profitability drivers for the individual and small group markets.

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Wakely Medicare Repricing Analysis Tool (WMRAT)

Aids the comparison of payment rates across multiple lines of business, categories of service, geographic locations, and providers.

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Wakely ACA Database (WACA)

Contains the most robust and detailed ACA data available in the industry.

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Risk Adjusted Payments & Identifying Discrepancies for Medicare Advantage Plans (RAPID-M)

Helps plans optimize risk scores by identifying RAPS and EDS inconsistencies

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Risk Adjustment Data Integrity Analysis & Lineage (RADIAL)

Compares multiple data sources to provide transparency in risk score differences.

Risk Adjustment Data Integrity Analysis & Lineage (RADIAL)