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Vālenz® Health Attends SIIA Spring Forum as a Sponsor

March 28, 2023/in Announcements, Events, Featured, Press/by kamryn cain

PHOENIX, Ariz. (March 28, 2023) — As a sponsor of the SIIA Spring Forum and long-time SIIA diamond member, Vālenz® Health is participating in the Orlando networking event this week, which is expected to be the largest gathering of senior-level self-insurance industry professionals for the first half of 2023.

The SIIA Spring Forum serves as a springboard for sharing ideas and solutions on the year’s most important topics in self-insurance – including how to address healthcare costs, quality, and transparency in a constantly changing environment, which is critical to the Valenz mission in driving smarter, better, faster healthcare.

“Because our Healthcare Ecosystem Optimization Platform uses data to lower costs and improve care at each step in the life of a claim, we’re excited about this year’s Spring Forum focus on how to assess and leverage healthcare quality,” said Rob Gelb, Chief Executive Officer at Valenz. “We look forward to engaging in some outstanding conversations on balancing quality, utilization and cost of care for the benefit of plan participants and sponsors, and their members.”

The SIIA Spring Forum will be held March 29-31 at the JW Marriott Grande Lakes in Orlando. Attendees are encouraged to connect with Valenz about its suite of data-driven solutions that flatten the trajectory of health plan costs while helping the self-insurance industry thrive.

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in the validation, integrity and accuracy of claims, and a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By leveraging data transparency and delivering an omnichannel approach across the healthcare journey, Valenz improves cost, quality and outcomes for employers and their members – engaging early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com.

https://www.valenzhealth.com/wp-content/uploads/2023/03/SIIA-web_.png 432 600 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2023-03-28 21:17:242023-03-28 21:17:24Vālenz® Health Attends SIIA Spring Forum as a Sponsor

Giving Back to our Communities: Valenz Communities Connection Project

February 17, 2023/in Announcements, Featured/by Jackie Ebel

Vālenz® Health is excited to announce our new give back program, Valenz Communities Connection Project (VCC). Giving back, a selfless act for others, has long been known to inspire happiness and improve lives – for those who give, and those who receive. Our new Communities Connection Project is designed to do just that – build strong, vigorous and healthy lives. Our employees are excited to get involved in four ways: company sponsored events, company donations, local volunteerism, and Volunteer Time Off, or VTO.

Company Sponsored Events

All employees will have an opportunity to participate in various events that the company holds on a national basis. A calendar of events that includes various volunteer opportunities will be developed and shared throughout the company. Employees will then have a chance to volunteer with their co-workers in support of various national organizations, which must be 501c3 nonprofit organizations pre-approved by Valenz to ensure alignment with our values. A few examples of these organizations include Habitat for Humanity and Feeding America. These volunteer events will be planned by designated ambassadors around the country.

Local Volunteerism

Local volunteerism will consist of regional opportunities to enhance the collective ability of Valenz to get involved in various volunteer efforts. Each region will support its own predetermined 501c3, and will have an assigned ambassador that will help coordinate these events as well as the national company events. The eastern region’s ambassador will be Amy Gasbarro, the central region’s ambassador will be Jackie Ebel, and the western region’s ambassador will be Ernesto Robles.

Company Donations

Valenz is committed to promoting better health through our own financial contributions. Valenz will match donations of up to $100 per employee per year for those who wish to contribute to their own preferred 501c3 organizations. Valenz will also announce corporate donations to select 501c3 organizations, and there may often be certain company-sponsored events in conjunction with these donations. Organizations we currently support include Wheeler Mission, Alzheimer’s Association, Direct Relief, Meals on Wheels, and No Kid Hungry.

Volunteer Time Off

We encourage our employees to take time to volunteer with causes and events that create healthy communities. Each Valenz employee is able to use 16 paid hours a year for volunteer work, 4 hours each quarter. Employees can apply to use their VTO for a recognized company event, and each region’s ambassador will help approve these hours for their co-workers in collaboration with business unit managers.

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in the validation, integrity and accuracy of claims, and a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By leveraging data transparency and delivering an omnichannel approach across the healthcare journey, Valenz improves cost, quality and outcomes for employers and their members – engaging early and often for smarter, better, faster healthcare.

https://www.valenzhealth.com/wp-content/uploads/2023/02/Valenz_VCC-600x432-2.png 432 602 Jackie Ebel https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Jackie Ebel2023-02-17 18:44:582023-02-24 14:56:55Giving Back to our Communities: Valenz Communities Connection Project

JP Thomas Joins Vālenz® Client Services Executive

February 10, 2023/in Announcements, Featured, Press/by kamryn cain

PHOENIX, Ariz. (Feb. 10, 2023) — Vālenz® Health is pleased to announce that JP Thomas has joined the team as Client Services Executive.

With 15 years in the healthcare and tech industries, Thomas brings extensive experience in project management and implementation. Under the leadership of Brian Campbell, Vice President of Client Services, Thomas’ responsibilities include day-to-day oversight of Valenz Care clients, facilitating data-driven medical cost management and population health management for labor and public entities.

“JP’s range of talents includes proven excellence in client service and relationship development, making her a great fit for delivering our promise of driving stronger, better, faster healthcare,” Campbell said. “Her solution-oriented, people-first philosophy enhances our team’s ability to proactively address our customers’ unique needs for cost-containment solutions and improved member outcomes.”

Most recently, Thomas led and directed strategic planning for clinical trial patient recruitment and retention at Verily Life Sciences in Chicago. In addition to numerous project management roles throughout her career, Thomas offers key experience with marketing/advertising initiatives and claim processing. She has a bachelor’s degree in organizational behavior from DePaul University.

“I’m thrilled to make a measurable impact on the lives of the people we serve, as we work to improve access to care and provide the guidance and support they need,” Thomas said. “I look forward to growing our client partnerships and fulfilling their trust in the Valenz team to keep them strong, vigorous and healthy.”

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in the validation, integrity and accuracy of claims, and a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By leveraging data transparency and delivering an omnichannel approach across the healthcare journey, Valenz improves cost, quality and outcomes for employers and their members – engaging early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com.

https://www.valenzhealth.com/wp-content/uploads/2023/02/Valenz_JP-Thomas-Annc_600x432.png 432 600 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2023-02-10 16:18:262023-02-10 16:18:26JP Thomas Joins Vālenz® Client Services Executive

Vālenz® Health Will Serve as Corporate Sponsor of HCAA Executive Forum

February 3, 2023/in Announcements, Featured, Press/by Tori Klein

PHOENIX, Ariz. (Feb. 3, 2023) — As a corporate sponsor of the HCAA Executive Forum, Vālenz® Health leadership has announced plans to attend the key networking event for the self-funded industry in Las Vegas this year.

Valenz also will be featured in the B2B Marketplace, where attendees can learn the benefits of leveraging the unparalleled data transparency of the Healthcare Ecosystem Optimization Platform for better program decisions and significant savings through a suite of fully integrated solutions.

“This year’s event theme, Power of the Past-Force of the Future, is very fitting as we visualize innovative, data-driven solutions that simplify the complexities of self-insurance,” said Rob Gelb, Chief Executive Officer at Valenz. “In reimagining what a health plan should be, we engage with data early and often under our Claim Cost ArcSM to drive understanding of the plan, improve claim coordination and payment processes, and uncover opportunities for cost savings and a better member experience. The result is smarter, better, faster healthcare.”

The HCAA Executive Forum will be held Feb. 20-22 at the Bellagio. Attendees are encouraged to connect with Valenz about flattening the trajectory of health plan costs and aligning everyone involved in a claim. The onsite Valenz team will be at table 13. Learn more and schedule time to meet with Valenz: bit.ly/ValenzHCAAEF23

 

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in the validation, integrity and accuracy of claims, and a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By leveraging data transparency and delivering an omnichannel approach across the healthcare journey, Valenz improves cost, quality and outcomes for employers and their members – engaging early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com.

https://www.valenzhealth.com/wp-content/uploads/2023/02/Valenz_HCAA-Web-600x432-1.png 432 600 Tori Klein https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Tori Klein2023-02-03 19:52:432023-02-03 19:52:43Vālenz® Health Will Serve as Corporate Sponsor of HCAA Executive Forum

Vālenz® Health Promotes Kevin O’Donnell to Senior Vice President, Product & Marketing

January 9, 2023/in Announcements, Featured, Press/by kamryn cain

PHOENIX, Ariz. (Jan. 9, 2023) — Vālenz® Health is pleased to announce that Kevin O’Donnell, MPA, has been promoted to Senior Vice President, Product & Marketing.

In his new role, O’Donnell will lead Valenz marketing initiatives to fuel growth and visibility for the organization. He also will continue to work with Chief Product Officer Maurice Steenland in driving innovations and further advancing the Valenz Healthcare Ecosystem Optimization Platform suite of integrated, interactive solutions.

“Kevin has brought a tremendous vision and creative mindset to Valenz, and we are thrilled that his role is expanding,” Steenland said. “Through his ongoing leadership efforts, we look forward to developing new strategies and further underscoring our ability to change the trajectory of rising plan costs, enhance member experiences, and drive better health outcomes.”

O’Donnell, who lives in Newark, Del., joined Valenz in 2022 as Vice President, Enterprise Solutions. He has been highly involved in expanding and integrating how Valenz delivers solutions for providers and payers that assure the validation, integrity and accuracy of reimbursement and claims, as well as care and member advocacy program enhancements.

Previously, O’Donnell was Managing Director of Operations for Evolent Health and held other leadership positions there in operations, claims quality and payment integrity. He earned a master’s degree in Public Administration with an emphasis in health and human services from the University of Arizona’s Eller College of Management.

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in the validation, integrity and accuracy of claims, and a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners. More information is available at valenzhealth.com.

https://www.valenzhealth.com/wp-content/uploads/2023/01/Valenz_Kevin-ODonnell-SVP.v2_600x432-v2.png 432 600 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2023-01-09 22:45:242023-01-09 22:45:24Vālenz® Health Promotes Kevin O’Donnell to Senior Vice President, Product & Marketing

Vālenz® Health Launches Next Generation of EPStaffCheckTM for Compliance Monitoring

December 1, 2022/in Announcements, Featured, Press/by Tori Klein

PHOENIX, Ariz. (Dec. 1, 2022) — Vālenz® Health announces the launch of next-generation software for EPStaffCheck™, a comprehensive compliance monitoring solution, complete with an e-commerce application. This new release helps providers easily purchase and quickly use advanced exclusion monitoring — yet another example of how Valenz supports providers with the very best compliance management solutions.

As part of the Valenz Validation, Integrity and Accuracy (VIA) suite of solutions for providers, EPStaffCheck simplifies the complexity of exclusion monitoring with updated service tiers and easy-to-administer tools that address the full range of challenges facing compliance teams. Its services protect healthcare organizations from unnecessary fines and lawsuits associated with non-compliance, while also optimizing reimbursement revenue and ensuring high-quality care for members.

“Now offering four tiers of service – Basic, Professional, Enterprise and Enhanced – this fully functional e-commerce experience allows customers to conveniently find, research and purchase their appropriate EPStaffCheck service tier,” said Maurice Steenland, Chief Product Officer of Valenz. “For customers who prefer full-service support and white-glove rapid onboarding, Valenz compliance teams are readily accessible via the Enhanced tier.”

The key features of EPStaffCheck services include:

  • integration of multiple data sources in one place to simplify searching and monitoring for exclusion, licensing and disciplinary status, with searching driven by provider name, date of birth, NPI, and state license data
  • optimization of searching with minimal inputs for accuracy to reduce exposure while increasing efficiency and lowering administrative costs
  • following best practices of the Office of Inspector General to ensure audit-readiness, with documentation trails to meet JCAHO requirements across all 50 states and U.S. territories

With EPStaffCheck, compliance teams are just a few clicks away from quickly and easily searching the millions of sanction records, often found in disparate databases, to avoid the costs and dangers of employing troubled providers. Whether there is a need for permission-based users, a need for single or batch searches, special state-specific licensure search needs, or the need for complete account oversight from Valenz, customers can find the exclusion monitoring solution that is the perfect fit for them.

Learn more about EPStaffCheck and the VIA Provider Solutions: valenzhealth.com/epstaffcheck-compliance-management

https://www.valenzhealth.com/wp-content/uploads/2022/12/shutterstock_1710535045-4tiers-600x432-1.jpg 432 600 Tori Klein https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Tori Klein2022-12-01 14:45:192022-12-01 17:41:11Vālenz® Health Launches Next Generation of EPStaffCheckTM for Compliance Monitoring

Stefani Voorhees Joins Vālenz® Health as Senior Vice President, People

November 18, 2022/in Announcements, Featured, Press/by Maris Panjada

PHOENIX, Ariz. (Nov. 18, 2022) — Vālenz® Health is pleased to announce that Stefani Voorhees, SHRM-SCP, has joined the leadership team as Senior Vice President, People.

Having served in leadership positions in human resources since 2015, Voorhees brings extensive experience in developing organizational strategy, building and implementing people-focused programs, overseeing performance management, compensation and benefits strategy, compliance, and employee engagement. She also has a strong background in recruitment and talent acquisition.

“Stefani considers human resources to be the nucleus of the business and the catalyst to driving an exceptional employee experience and highly effective talent strategy. That makes her an excellent fit for the Valenz Health culture,” said Rob Gelb, Chief Executive Officer. “Stefani will play a lead role in supporting our growth strategy and optimizing our talent to help us continue to thrive through future acquisitions and expansion. She is a terrific addition to the Valenz team.”

Most recently, Voorhees served as Head of Human Resources for Companion Protect. She also held leadership roles in human resources and talent management for BranchPattern, PeopleAdmin and Modis after working in client management and financial advisory services. She received her bachelor’s degree in human resource management.

“I’m thrilled to become part of an innovative company that places a high priority on relationships, alignment, communication and employee engagement,” Voorhees said. “People are every company’s greatest asset, and you can’t separate the people decisions from the business decisions. As I strive to foster a ‘love where you work’ mentality, I’m looking forward to the opportunity to support, develop and engage with all the great talent at Valenz.”

For more information about the Valenz executive team, visit valenzhealth.com/about/leadership.

 

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2022/11/Valenz_Stefani-Voorhees-Annc_600x432-3.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-11-18 23:33:102022-11-21 14:44:02Stefani Voorhees Joins Vālenz® Health as Senior Vice President, People

Vālenz® Health Promotes Shannah Montgomery to Client Services Executive

November 11, 2022/in Announcements, Featured, Press/by Maris Panjada

PHOENIX, Ariz. (Nov. 11, 2022) — Vālenz® Health is pleased to announce Shannah Montgomery has been promoted to Client Services Executive. Montgomery brings expertise with account management to her new role, along with client-centered service.

Montgomery held the position of Client Services Representative at Valenz for nearly two years before her promotion. Under the leadership of Brian Campbell, Vice President of Client Services, she will assist clients with new opportunities and solutions across the Healthcare Ecosystem Optimization Platform, engaging early and often to ensure strong, vigorous and healthy client relationships.

“Over the past two years, Shannah has developed great rapport with Valenz clients through her commitment to excellence and her determination to deliver on the promise of smarter, better, faster healthcare,” said Campbell. “She has a tremendous work ethic and will continue to be even more of an asset to our clients in her new position.”

Montgomery joined Valenz in 2020 with a background in account management and operations. She has a bachelor’s degree from the University of North Florida in Jacksonville. Before Valenz, she was a National Account Manager with One Call, where she was regularly promoted over the course of nearly a decade with the company.

“I’ve always been customer-service driven, and there’s nothing I value more than collaborating with my team at Valenz to enhance customer experience,” said Montgomery. “Here at Valenz, we all share that client-first approach, and it shows in everything we do. Because we get to know our clients, we understand what they need to succeed and achieve their goals – and that’s why Valenz has become one of the fastest growing private companies in the U.S.”

For more information about Valenz and its leadership team, visit valenzhealth.com.

 

About Valenz Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2022/11/Valenz_Shannah-M-Annc_600x432.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-11-11 20:46:212022-11-11 20:46:21Vālenz® Health Promotes Shannah Montgomery to Client Services Executive

As healthcare costs reach unsustainable levels, care navigators and members need better tools to guide the right care options

November 1, 2022/in Announcements, Featured, Press/by kamryn cain

From Rob Gelb, Vālenz® Health CEO

During the COVID-19 pandemic, many patients paused their doctor visits or let their medications lapse, leading to health issues going unchecked for months or years. The resulting increase in late-stage diagnoses for serious conditions like cancer and heart disease means patient acuity is higher and treatment is more extensive – all key contributors to the ongoing escalation of healthcare costs. And we are all beginning to see the impact of inflation on the healthcare system.

To battle this growing crisis, self-insured employers can advocate for members by deploying medical cost-containment solutions to connect them to necessary quality care while also minimizing expenses for both the member and the employer.

I believe members will benefit from engagement early and often throughout the patient journey, receiving proactive support from navigators who make them aware of all their care options and provide guidance to the right resources that meet not only their health needs, but their financial needs as well.

Case in point: Of the more than 100 million Americans living at or below 400 percent of the Federal Poverty Level (e.g., a family of four with a household income of $106,000 or less), many might not realize they may qualify for low- or no-cost medical care. Most likely, their employer and health plan sponsor are unaware of this opportunity as well. Although about 60 percent of U.S. hospitals receive billions in tax breaks to offer charity care, the lack of promotion of this option – and the resulting low consumer awareness – has become a significant national issue.

As part of the federal requirements of Section 501(r), members who do qualify for low- or no-cost care may receive medical treatment at one of more than 4,000 facilities across the country with fiduciary responsibilities to offer charity care. For members who are above 400 percent FPL, they may be eligible for more than 1,000 pre-negotiated care bundles or other high-quality in-network care.

The impact of healthcare’s rising costs – and the lack of transparency for patients – has become unsustainable. The key to a solution is the creation and adoption of tools that support navigators in collecting members’ financial and demographic information at the onset of navigation and providing education, support and guidance about their care options – a true model of member/patient advocacy. We need to simplify the healthcare journey for members, making it easy for them to receive the best possible care at the lowest cost while staying in network.

To address this need, Vālenz® Health created Care Value Optimizer (CVO) as a unique enhancement to its NaVcare solution for member navigation and advocacy. Leveraging the power of the Valenz Healthcare Ecosystem Optimization Platform to engage data and empower better decision-making, CVO advocates for members by triaging them to charity care, Centers of Excellence care bundles, or high-performance network offerings based on their finances, location, benefits and health profile.

Because every member is different and their needs may change over time, Valenz navigators and nurses conduct ongoing engagement to gain a comprehensive, data-supported view of members’ current needs. Navigators provide insight to the right care options depending on members’ income, health needs and ability to travel for care; and in alignment with the Valenz “Yes, And” culture, navigators also support patients with scheduling, paperwork and other requirements before they see a provider.

CVO enables effective management of the most expensive and complex treatments and procedures, benefiting the member with lower costs, better access to high-quality care, and improved health outcomes. While the member receives advocacy, employers become more empowered to balance quality, utilization and cost of care, reducing claim expense and the overall plan spend. Ultimately, CVO drives smarter, better, faster healthcare for everyone involved.

The “new normal” of a post-pandemic world has had a serious impact on the lives of many members who may find themselves deciding between putting food on the table and getting the healthcare they need. With CVO, the NaVcare Enhanced solution, and all options within the Valenz Healthcare Ecosystem Optimization Platform, self-insured employers and those who support them and their plans can take a significant step toward ensuring members won’t have to face that choice.

About Rob Gelb

Rob Gelb is Chief Executive Officer of Vālenz® Health, which simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare.

 About Vālenz® Health

Valenz Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2022/11/Rob-CVO-Article-600x432-2.jpg 432 600 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2022-11-01 15:56:552022-11-03 15:58:14As healthcare costs reach unsustainable levels, care navigators and members need better tools to guide the right care options

Vālenz® Health CEO Shares Member-Centric Strategies to Drive Improved Cost Containment and Risk Mitigation

October 28, 2022/in Announcements, Featured, Misc./by Maris Panjada

PHOENIX, Ariz. (Oct. 28, 2022) — Self-insured employers looking for cost containment strategies should be open to solutions that prioritize the member first– a shift in thinking that can have a big payoff for both the member and the employer, according to Vālenz® Health CEO Rob Gelb.

As part of a recent HCAA-sponsored “Voices of Self-Funding” podcast with host Ramesh Kumar and Imagine360 CEO Jeff Bak, Gelb addressed key trends in driving lower costs and managing risk for self-funded plans, including the roles played by enhanced transparency, data and technology.

“It starts with the employer being willing to get comfortable being uncomfortable, accepting that they may not have all the answers, and making changes in the spirit of the member to do what’s right,” Gelb said. “More than just cutting the cost of an individual claim, the conversation has to evolve around the total cost of care and placing the member first in the equation while you measure quality of care, reasonable cost and reasonable reimbursement.”

An important first step, Gelb said, is to establish transparency from the start among the provider, payer, plan and member – aligning all parties in achieving a balance of cost, quality and utilization of care.

“There’s a misalignment of incentives with the way that traditional plans design their networks, and an expectation from employers that any provider network that has broad coverage is good for their employees,” Gelb said. “When you have full alignment upfront, all parties understand throughout the process what their role is in balancing the equation of quality, advocacy and cost. That’s how we arrive at cost containment options that benefit everyone involved in the claim.”

“We’ve designed a solution as a platform that becomes a full BUCAH replacement option,” Gelb said, referring to the Valenz Healthcare Ecosystem Optimization Platform. “Economics are a big part of that. We use local and national data sets to feed UCR, paid claim data, other forms of data, and Medicare into an algorithm to determine what we call market sensitive repricing. In addition to determining what services and the price point for those services, we determine what shouldn’t even be on the claim. Then, we typically get provider signoff 50 percent of the time on all of those factors to eliminate any friction. That’s part of our methodology to contain costs and serve the member.”

Hear more from Rob in the full podcast.

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2022/10/Valenz_Rob-NY-2022-LI-Pulse-600x432-v3.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-10-28 20:25:562022-10-28 21:00:05Vālenz® Health CEO Shares Member-Centric Strategies to Drive Improved Cost Containment and Risk Mitigation
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