April 2021 - Valenz

Vālenz Announces Strategic Partnership with Turquoise Health

April 26, 2021/in Announcements, Featured, Press, Valenz Access /by Maris Panjada

Database of negotiated hospital rates elevates consumer transparency and choice

PHOENIX, Ariz. (April 26, 2021) — Vālenz^® announced today a partnership with Turquoise Health, a software solutions company that facilitates consumer transparency through its newly launched platform listing payer-negotiated hospital rates.

With new price transparency regulations requiring hospitals to share previously undisclosed rates for many services, Turquoise Health has created the first comparison engine for consumers to make cost-effective decisions about their care.

With full access to Turquoise Health’s database of hospital rates, Valenz will incorporate the comparison information into its concierge-level navigation program and self-service member portal. Valenz also will utilize the data to build highly efficient networks that drive quality care and customer satisfaction alongside cost savings.

“Our partnership with Turquoise Health aligns with our data-driven ecosystem and helps us take a significant step toward providing the transparency our clients and their members need,” said Rob Gelb, CEO of Valenz. “Not only can we share the cost structure of hospital services to help guide members’ decisions, but we can also help them gauge the quality of the service. It’s a key component of the Valenz promise to assure smarter, better, faster healthcare.”

As of Jan. 1, 2021, the federal rule requires hospitals to publish a machine-readable file listing their negotiated payment rates for hundreds of medical procedures, as well as a website where consumers can search for services and prices. Initial compliance has been mixed, with reports of some hospitals blocking their pricing from showing up on web searches – making the Turquoise Health platform all the more valuable in elevating transparency.

CEO Chris Severn says its database currently has more than 2,000 verified rates, and the list continues to grow as Turquoise painstakingly combs through and verifies hospital pricing data.

“This is just the beginning of making hospital billing more clear and patient-friendly,” Severn said. “Using both public price rates data and Turquoise participating provider data, we are showing there is a market for transparency in healthcare. We help put negotiating power where it belongs — in the hands of the consumer.”

About Valenz

Vālenz^® enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Turquoise Health

Turquoise Health launched in 2020 with a vision to simplify healthcare reimbursement through price transparency. CTO Adam Geitgey, formerly a Director of Engineering at Groupon, brings deep consumer marketplace experience to the healthcare sector. Turquoise invites providers and payers to become Turquoise Verified partners. Using the software suite, organizations create “price certainty” for patients while easing claims adjudication on the back end. Turquoise already counts major revenue cycle partners and hospital systems as satisfied clients. To learn more, visit turquoise.health or email info@turquoise.health.

Engaging Early and Often to Manage the Boomerang Effect of COVID-19

April 22, 2021/in Announcements, Featured /by Maris Panjada

The COVID-19 pandemic continues to prompt many people to delay diagnostic testing and obtaining necessary medical care, leading to a decrease in both procedures and diagnoses. The result is the creation of unexpected utilization patterns, which the industry is only beginning to understand and attempt to reconcile.

While some patients delayed care for just a few months, others – including those with chronic conditions – have not yet returned for follow-up care and routine health screenings such as colonoscopies and mammograms. Researchers have predicted that patients will emerge with more serious health conditions, including later-stage diagnoses and more advanced stages of diseases such as cancer and certain cardiac-related conditions.

Consider these findings:

Nearly half of Americans (47%) said they delayed or canceled health care services since the pandemic started.
Among households with delayed care, most contain people with chronic illnesses who should be getting routine medical attention.
Advanced cancer diagnoses are currently on the rise because many people decided not to get screening tests in 2020 that may have indicated the presence of cancer earlier.

Engaging early and often to prevent long-term health consequences and increased costs caused by delayed care has never been more critical. Guided by insights from biometrics, utilization data and paid claims analysis, self-insured employers can identify gaps in care and engage members with real-time interventions, providing navigation to the right care path before serious issues occur.

Today’s technologies deliver insights from patient data, clinical drivers and social determinants of health to identify members at risk before their condition deteriorates. Once identified, care coordination to connect them with key resources 24 hours a day is possible. This level of continuous, evidence-based engagement guides better long-term health decisions while allowing self-insured employers to target the 5-15% of claims that drive up to 70% of health plan spending.

Self-insured employers will position themselves well to offer this level of support for their members through:

Concierge-level navigation for advocacy, education, and direction of quality care that results in positive medical experiences
Predictive analytics combined with member-centric services during the patient journey
Full-service care management programs that identify at-risk members and offer personalized services to improve health outcomes
Guidance and information on what is covered by a member’s benefit plan, managing co-pays, controlling out-of-pocket expenses, and accessibility to care
Using the power of data-driven solutions to provide the right care at the right place at the right time

But it is not just about engaging the member. Establishing a central point of contact for everyone across the care continuum, from members to care providers and payers, delivers comprehensive care with transparency.

With the right tools and information, delivered in real time, self-insured employers will find actionable information at each step in the life cycle of a claim. From high-performance network design through comprehensive and complete bill reviews, data-driven insights lead to health care costs that are fair, defensible, transparent and consistent for everyone.

Long before the current health crisis began, we have embraced the Vālenz^® core promise of delivering smarter, better, faster healthcare. Although COVID-19 has created numerous challenges, maintaining the health and well-being of our clients and employees is more important than ever. We remain committed to early health engagement and ensuring the right care paths to keep everyone strong, vigorous and healthy.

***

Rob Gelb is Chief Executive Officer of Vālenz®, an ecosystem of data-driven solutions that creates new opportunities for self-insured employers to control costs while empowering members to lead strong, vigorous and healthy lives.

Portrait of Maurice Steenland, Vice President, Strategic Enablement at Vālenz

Maurice Steenland Joins Vālenz^® Leadership Team

April 9, 2021/in Announcements, Events, Featured /by Maris Panjada

As Vice President, Strategic Enablement, Steenland appointed to accelerate value for Valenz clients

PHOENIX, Ariz. (April 9, 2021) — Vālenz^® is pleased to announce the appointment of Maurice Steenland as Vice President, Strategic Enablement.

In his new role, Steenland will be responsible for synchronizing departments to accelerate strategic initiatives that bring greater value to Valenz clients, fulfilling the company’s strategic vision and mission. He will continue to drive the expansion of the firm’s data engagement solution, v-Lens, to advance predictive modeling, data-driven decision enablement and transparency across the ecosystem.

“We are excited to welcome Maurice to this key strategic role on our senior leadership team,” said Rob Gelb, Chief Executive Officer of Valenz. “With deep expertise in uncovering operational efficiencies and enabling data and analytics to inform better decisions, Maurice is an excellent fit for the Valenz team. His highly strategic and analytical approach will no doubt add higher levels of transparency across our data-driven ecosystem to deliver smarter, better, faster healthcare.”

Steenland brings 20-plus years in executive roles for health-related organizations. Most recently, he was principal consultant for SISIX, LLC after serving as Vice President, Informatics for Optum, where he managed the Informatics and advanced analytics and data science teams that developed client outcomes reporting, predictive tools and methods to identify emerging risk and cost containment programs.

Steenland also has held leadership positions at CIGNA Healthcare, Coventry Health Care and Intracorp, with specialization in operations, utilization management, strategy and business development. He earned his master’s in business administration from the prestigious Wharton School of the University of Pennsylvania.

“I’m thrilled to join such a future-focused team at Valenz and have the opportunity to pave the way toward quality, utilization and cost transformation through transparency, efficiency and data-driven solutions,” Steenland said. “As we combine analytics-driven approaches with influencing skills to drive change and efficiencies, I look forward to providing greater savings and solutions for our clients in the self-insured industry.”

About Valenz

Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

Vālenz Announces Acquisition of Kozani Health

April 1, 2021/in Announcements, Featured, Misc., Valenz Claim /by Adam Lee

Kozani Health integrates as ValenzProteKHt™ for complete and comprehensive bill review solution

PHOENIX, Ariz. (April 1, 2021) — Vālenz^® announced today it has acquired Kozani Health, integrating a new and innovative means for self-funded employers and the self-insured community to control costs across the life of a claim.

Kozani Health, which provides customized solutions to meet the challenges of paying medical claims appropriately, joins the ever-expanding Valenz ecosystem of data and solutions as Valenz ProteKHt™. The new solution offers detailed line-by-line bill reviews performed by nurses, certified coders and practicing specialists to uncover inappropriate billing and care provided.

With success rates averaging 70 percent, Valenz ProteKHt is the industry’s recognized comprehensive and complete bill review solution. Valenz ProteKHt offers clear, defensible, transparent and plan-specific reviews that deliver savings of 10-30 percent above the PPO allowable with a signed contract, agreed upon and authorized by the provider.

“We are excited to welcome Kozani Health as part of our data-driven Valenz ecosystem,” said Rob Gelb, Chief Executive Officer. “By bringing our teams together, we are providing self-funded employers and the self-insured community improved cost savings at each step in the life cycle of a claim, strengthening their ability to realize every opportunity to balance cost, quality and utilization under the Claim Cost Arc^SM. Our solutions aside, which clearly align value for all, our cultures and the commitment to customer service and ‘customer love’ will be a continuing defining characteristic of our now, collective success.”

Valenz is focused on changing the trajectory of healthcare expenses, creating new opportunities for self-insured employers to control costs while empowering members to lead strong, vigorous and healthy lives. Valenz delivers a 20-40 percent improvement in savings from traditional health plan approaches by bridging the divide between robust analytics, care management, high-value provider networks, payment integrity and claim management.

“We are energized to begin our company’s next chapter as Valenz ProteKHt,” said Michael Scott, Chief Executive Officer and Co-Founder of Kozani Health. “Integrating our claim management solutions into the Valenz ecosystem will accelerate the growth and evolution of our services and bring value to our customers.”

“With this integration, we assure clients they will experience the same close partnership and personal attention as they have with Kozani Health,” said Heather Wilson, Chief Operating Officer and Co-Founder of Kozani Health. “Now, we can also offer the benefit of being part of the Valenz ecosystem. Together, we are committed to nurturing the same ‘customer love’ that has made Kozani Health a symbol of success in the market.”

About Valenz

Vālenz^® enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Kozani Health

Kozani Health, headquartered in Mesa, Ariz., provides customized bill review and bill review sign-off solutions to analyze pricing, coding and care provided to ensure appropriate payment. Since its inception in 2015, Kozani Health has forged long-term customer relationships and continuously improved solutions to solve customer challenges.

About Great Point Partners

Great Point Partners, founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm with approximately $1.3 billion of equity capital currently under management and 28 professionals, investing in the United States, Canada, and Western Europe. GPP is currently making new private equity investments from GPP III, which has $307 million of committed capital. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III) and public equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 200 growing healthcare companies. The private equity funds invest across all sectors of the healthcare industry with a particular emphasis on biopharmaceutical services and supplies, pharmaceutical infrastructure, alternate site care, medical device and information technology enabled businesses. The firm pursues a proactive and proprietary approach to sourcing investments and tuck-in acquisitions for its portfolio companies. Reach Great Point at 203-971-3300 or www.gppfunds.com

Vālenz Announces Strategic Partnership with Turquoise Health

Engaging Early and Often to Manage the Boomerang Effect of COVID-19

Maurice Steenland Joins Vālenz^® Leadership Team

Vālenz Announces Acquisition of Kozani Health

Solutions

About Valenz

Resources

For Clients