Care Bundles and Navigation for Better Costs and Quality

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As the costs and complexities of healthcare continue to skyrocket, the methods of pricing for provider services and the way the industry looks at care are facing a much-needed change.

Historically, providers have received separate payments for each individual service or patient treatment. This fee-for-service reimbursement model, used by many commercial payers, relies on provider networks and focuses on the quantity of services provided, rather than the total package of care and the cost and quality of those services. In addition, when coupled with the complications of insurance billing and reimbursement, fee-for-service models often lead to inflated costs for patients and providers.

Vālenz® Health believes employers can generate greater savings, appropriate utilization and higher quality of care when deploying healthcare models built on episodes of care, as demonstrated through the Valenz comprehensive range of care bundles. Although bundled pricing is not new, the Valenz model is distinctly different, as it deploys numerous reliable data sources to arrive at defensible local market-sensitive rates while driving members to high-value care.

By aggregating years of robust data from thousands of provider network cases with industry-leading sources of payment-, cost-, charge-based and clinical data sets, together with intuitive member navigation, Valenz optimizes cost, quality and utilization of care. Read more in our white paper.

Staff Spotlight: Mike Reese, Vice President, Member Advocacy

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Get to know Mike Reese, Vice President, Member Advocacy, in this month’s Cultural Case Study!

1.) What is one word you’d use to describe Valenz culture?

Engaging. My experience has been that the Valenz culture is people focused. We concentrate on engaging with team members to produce a fun and collaborative environment. Our goal is to have a culture where team members can tap into their purpose and also experience joy in what they do. We’re also focused on our patients, as well, ensuring that we’re actively engaging with them and providing the most positive healthcare experience they have ever had. At Valenz, we really do engage early and often – not just with our patients, but also with our own teams.

2.) When someone asks you about work/Valenz, what do you say?

As the Vice President of Member Advocacy, I oversee multiple departments and support the growth and development of the leaders on those teams. More importantly, I like to share that my favorite part of my job is the people. I feel very fortunate to be part of such a supportive culture! I enjoy the folks I work with, and it’s great to be able to provide them with the tools and resources they need to get their jobs done to the best of their abilities. Knowing that I’m supporting the team that’s making a difference in the lives of the members and patients we work with is very fulfilling. Something else I like sharing about Valenz is the growth of the organization. It’s pretty awesome to look at the growth of the company in every department and see the impacts we are having on an increasing number of members as we help them get the care they need at no cost!

3.) How is Valenz a good fit for your talents, skills, and passions?

I thrive in environments where I can share new ideas, help people grow, and get the chance to be innovative, and Valenz is certainly an environment that fits that bill. There’s lots of brainstorming here, and we’re lucky to have so many subject matter experts on different topics, so coming up with new ideas and solutions with folks who have deep knowledge is enjoyable and fulfilling. The culture here is also very welcoming to new ideas, solutions, and trying new things – no matter who the idea comes from! You don’t have to be a Vice President here to have folks listen to your ideas.

Vālenz® Health Honored Again, Ranking No. 2155 Among America’s Fastest-Growing Private Companies

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RADNOR, Pa. (Aug. 13, 2024) — Inc. revealed today that Vālenz® Health ranks as one of the fastest-growing private companies in America: No. 2155 on the 2024 Inc. 5000 list, and No. 155 among health services companies. This marks the fourth time in the past five years that Valenz Health has appeared as an Inc. 5000 honoree.

The prestigious ranking provides a data-driven look at the most successful companies within the economy’s most dynamic segment — its independent, entrepreneurial businesses. Microsoft, Meta, Chobani, Under Armour, Timberland, Oracle, Patagonia and many other high-profile brands have been Inc. 5000 honorees.

“We’re thrilled to be recognized again this year among America’s fastest-growing private companies, confirming the success of our unique approach to delivering innovative and transformative models in simplifying healthcare,” said Rob Gelb, Chief Executive Officer of Valenz Health. “As our company continues to expand, we’re driving tremendous momentum toward unlocking new strategic growth opportunities for our customers while facilitating high-value care for everyone we serve.”

The Inc. 5000 class of 2024 represents companies that have driven rapid revenue growth while navigating significant economic disruption over the past three years. Among this year’s top 500 companies, the average median three-year revenue growth rate is 1,637 percent. In all, this year’s Inc. 5000 companies have added 874,458 jobs to the economy over the past three years.

“To see all the intriguing and surprising ways that companies are transforming sectors, from healthcare and AI to apparel and pet food, is fascinating for me as a journalist and storyteller,” said Mike Hofman, Inc. editor-in-chief.

After joining the Inc. 5000 list for the first time in 2020, Valenz Health has continued to experience consistently rapid growth, both organic and acquisitive. Valenz Health has acquired six companies since 2022 – most recently Healthcare Bluebook™, the industry’s leading healthcare quality and cost navigation solution for consumers and responsible employers nationwide.

As a long-respected partner of providers and payers to ensure an elevated experience for all in the healthcare value chain, Valenz Health leverages its fully integrated solutions on a single platform to simplify healthcare. Offering unparalleled access to provider cost, quality and utilization data, Valenz Health empowers members and customers with the information they need to choose high-value care that ensures the best possible outcomes.

For complete results of the Inc. 5000, including company profiles and an interactive database that can be sorted by industry, location and other criteria, visit www.inc.com/inc5000. All 5000 companies are featured on Inc.com starting today, and the top 500 appear in the new issue of Inc. magazine, available on newsstands beginning Tuesday, Aug. 20.

About Vālenz® Health

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. For more information, visit valenzhealth.com.

About the Inc. 5000 Methodology

Companies on the 2024 Inc. 5000 are ranked according to percentage revenue growth from 2020 to 2023. To qualify, companies must have been founded and generating revenue by March 31, 2020. They must be U.S.-based, privately held, for-profit, and independent—not subsidiaries or divisions of other companies—as of December 31, 2023. (Since then, some on the list may have gone public or been acquired.) The minimum revenue required for 2020 is $100,000; the minimum for 2023 is $2 million. As always, Inc. reserves the right to decline applicants for subjective reasons. Growth rates used to determine company rankings were calculated to four decimal places.

About Inc.

Inc. Business Media is the leading multimedia brand for entrepreneurs. Through its journalism, Inc. aims to inform, educate, and elevate the profile of our community: the risk-takers, the innovators, and the ultra-driven go-getters who are creating our future. Inc.’s award-winning work achieves a monthly brand footprint of more than 40 million across a variety of channels, including events, print, digital, video, podcasts, newsletters, and social media. Its proprietary Inc. 5000 list, produced every year since its launch as the Inc. 100 in 1982, analyzes company data to rank the fastest-growing privately held businesses in the United States. The recognition that comes with inclusion on this and other prestigious Inc. lists, such as Female Founders and Power Partners, gives the founders of top businesses the opportunity to engage with an exclusive community of their peers, and credibility that helps them drive sales and recruit talent. For more information, visit www.inc.com.

Valenz Communities Connect Supports the Wounded Warrior Project

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The Valenz Communities Connect project is pleased to share that we’re supporting the Wounded Warrior Project in Q3 this year! The Wounded Warrior Project provides life-changing programs and services to veterans, helping them adjust to civilian life and recover from the physical and mental wounds of war. Some of these resources include access to adaptive sports, financial education, mental health services, and so much more. Vālenz® Health will support the organization in multiple ways to make a lasting difference.

As part of our commitment to giving back, we’ve set up a donation website to support this incredible organization that provides essential services to wounded veterans and their families. Visit our donation page here to make your contribution. Every dollar counts and makes a significant impact on the lives of those who’ve served our country. Each Valenz employee who donates can apply for a matching donation of up to $200 to be made on their behalf. Employees can also apply to use their paid Volunteer Time Off to volunteer with this organization or local veterans’ organizations throughout the quarter. We thank the Valenz community for your generosity and support in making this initiative a success!

Vālenz® Health Completes Acquisition of Healthcare BluebookTM

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Vālenz® Health, a leading platform of integrated cost containment and payment integrity solutions, announces it has completed its acquisition of Healthcare BluebookTM, an industry-leading healthcare cost and quality navigation platform. The acquisition brings together the two companies’ complementary services as a one-of-a-kind member engagement and digital “front door” experience and payment integrity data platform.

“This is a transformative moment for the industry. We are addressing the unmet needs of the market and eliminating point solution fatigue through a single, integrated platform designed to simplify healthcare,” said Rob Gelb, Chief Executive Officer of Valenz Health. “Our acquisition of Healthcare Bluebook empowers us to create a uniquely data-informed platform that drives momentum in enabling smarter, better, faster, transparent healthcare. Together, we will ensure our customers and their members have access to high-value care with innovative network options and a full suite of prospective tools to improve the member experience, create choice for employers, and establish rewards for all.”

Healthcare Bluebook has long established itself in the industry by combining objective price and quality data with intuitive online navigation capabilities, driving savings and delivering measurable ROI to consumers and responsible employers nationwide. Valenz Health’s highly innovative solutions include expansive data sets, care management capabilities, payment integrity and plan performance support. Leveraging a suite of fully integrated solutions on a single platform, Valenz Health and Healthcare Bluebook expand their power to support growth, improve outcomes and deliver a positive experience.

“We are excited to unlock long-term strategic growth opportunities and value for our customers and their members as a combined business,” said Mike O’Neil, Chief Executive Officer of Healthcare Bluebook. “Healthcare Bluebook will operate in ‘business as usual’ mode for the foreseeable future. Over time, Valenz Health and Healthcare Bluebook will integrate our data and functionality to enhance our client offerings while maintaining the product, service and outcomes that our customers rely on.”

Valenz Health first announced its definitive agreement to acquire Healthcare Bluebook in mid-July. With the acquisition now complete, Healthcare Bluebook customers will benefit from being part of the Valenz Health fully integrated platform that optimizes the cost, quality and utilization of healthcare.

Stifel and Raymond James acted as financial advisors to Valenz Health, while William Blair acted as financial advisor to Healthcare Bluebook. Debevoise & Plimpton LLP acted as legal counsel to Valenz Health; Goodwin Procter LLP acted as legal counsel to Healthcare Bluebook.

Vālenz® Health Signs Definitive Acquisition Agreement with Healthcare BluebookTM to Create an Industry-Leading Integrated Health Cost, Quality and Utilization Data Platform

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RADNOR, Pa. (July 11, 2024) — In a significant development for the healthcare industry, Vālenz® Health, a leading platform of integrated cost containment and payment integrity solutions, signed a definitive agreement to acquire Healthcare BluebookTM, an industry-leading healthcare cost and quality navigation platform. The combination will bring together the companies’ complementary offerings and create an integrated member engagement and digital ’front door’ experience and payment integrity data platform. The transaction is expected to close within 45 days subject to certain regulatory approvals.

Healthcare Bluebook combines objective price and quality data with intuitive online navigation capabilities to drive savings and deliver measurable ROI to consumers and responsible employers nationwide. Healthcare Bluebook is an industry leader in comprehensive cost and quality insights across medical and pharmacy care options for employers and their employees. Valenz Health’s many solutions include expansive data sets, care management capabilities, payment integrity solutions and plan performance support. When combined with Healthcare Bluebook, Valenz Health will fulfill what the industry wants and needs to empower members, drive improved health outcomes and simplify healthcare.

According to Rob Gelb, Chief Executive Officer of Valenz Health: “Together, we will be able to offer a single source of data and solutions on an integrated platform that will make it easier for the industry to execute on a healthcare experience that delivers higher-quality, cost-effective and more efficacious care for members. We are exceptionally well positioned to deliver a new pathway for consumers to achieve the Valenz Health promise to engage early and often for smarter, better, faster and more cost-effective healthcare.”

“Because Healthcare Bluebook and Valenz Health share an uncompromised commitment to transparency, member advocacy and cost savings, we will be able to execute at a much deeper level to directly benefit self-insured plans and their members,” said Mike O’Neil, Chief Executive Officer of Healthcare Bluebook. “Together, we will make it easier for members to find and receive high-quality care at a fair price every time, putting members in charge of their own care.”

Clients will continue to experience the same close partnership and personal attention they have come to expect from Healthcare Bluebook and will benefit from it being part of the Valenz Health fully integrated platform.

Stifel and Raymond James acted as financial advisors to Valenz Health. William Blair acted as financial advisor to Healthcare Bluebook. Debevoise & Plimpton LLP acted as legal counsel to Valenz Health; Goodwin Procter LLP acted as legal counsel to Healthcare Bluebook.

About Vālenz® Health

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz Health mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz Health engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.

Kelso & Company, a leading middle-market private equity firm with a shared vision for accelerating positive change in the delivery of healthcare for the self-insured industry, is the capital partner for Valenz Health. For more information, visit valenzhealth.com.

About Healthcare BluebookTM

Healthcare BluebookTM uses industry-leading objective quality and price data and claims-driven ROI reporting to deliver healthcare value insights to consumers, employers, healthcare providers and payors. Bluebook’s intuitive online healthcare shopping solution provides employers and members with an easy-to-use benefits solution that increases movement from low-value to high-value care and prescription medications, driving savings, rapid ROI and greater price predictability. Combined with a proven engagement methodology, Bluebook’s innovative suite of services empowers smarter healthcare choices while decreasing costs and improving health outcomes.

Primus Capital, the capital partner for Healthcare Bluebook™, is a growth-oriented private equity firm focused on investing in leading healthcare, software and technology-enabled services companies.
For more information, visit healthcarebluebook.com.

Staff Spotlight: Hava Moss, Talent Acquisition Manager

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Get to know Hava Moss, Talent Acquisition Manager, in this month’s Cultural Case Study!

1.) What’s one word you would use to describe the Valenz culture?

Welcoming! The culture at Valenz is genuinely welcoming. There’s a profound respect for everyone who engages with our organization, be it employees, candidates, or clients. This respect extends to time and work, fostering a feeling of being truly valued within the Valenz space. Every meeting I’ve attended has been warm and inviting, with participants placing great importance on each conversation. In all my interactions, I’ve consistently felt comfortable and welcomed, making the experience at Valenz both pleasant and inclusive.

2.) When someone asks you about Valenz/work, what do you say?

As someone in the HR department, I get to talk about Valenz multiple times a day! I usually explain the experience at Valenz in two parts:

First, what we do as an organization: Valenz is dedicated to providing services and solutions that contain the cost of healthcare while improving healthcare outcomes. Innovation and creativity are at the heart of our approach, allowing us to make a significant impact in various ways.

Second, the experience of working for Valenz: We strive to provide exceptional experiences for our employees, offering numerous opportunities for learning, growth, and innovation.

In my specific role, I have the privilege of contributing to our success through hiring. Creating an exceptional experience for everyone who considers us as an employer is incredibly meaningful to me. Coupled with the impactful work we do, it’s a job I look forward to every day!

3.) How is Valenz a good fit for your talents/skills and passions?

I thrive in environments where I can build genuine, meaningful connections with the people around me, and Valenz is perfect for that.

One of my favorite aspects of Talent Acquisition is working closely with candidates and building lasting relationships. I enjoy meeting new candidates, guiding them through the interview process, and seeing those relationships evolve from candidate to colleague.

This is the place for those who value meaningful connections and seek an employer dedicated to making a positive impact on others’ lives.

Vālenz® Health Consolidates Solutions on Single Platform, Reduces Point Solution Fatigue and Simplifies Healthcare

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RADNOR, PA (June 7, 2024) — As the healthcare industry becomes more complicated, self-insured employers are seeing greater challenges in managing multiple point solution vendors. The use of multiple vendors stands in the way of consolidating data, quickly pinpointing the right solutions to minimize healthcare spend, and fully engaging members in care and services that drive improved health outcomes.

According to Rob Gelb, Chief Executive Officer of Vālenz® Health, “With a vision to simplify healthcare, Valenz consolidated its suite of solutions on a single platform to support the self-insured community more effectively and efficiently.”

At its recent annual client appreciation celebration, the Valenz team gathered with valued customers and partners to solve the industry’s most challenging issues, including point solution fatigue. The consensus: It is a far more convenient, cost-effective and timely option to collaborate with one partner, leveraging one integrated platform of solutions and one powerful source of data.

The opportunity to engage members early with intuitive navigation to providers, a digital front door, and a suite of care management services with bundled care options improves engagement by 25 percent, producing an average savings of up to 50 percent. Adding access to payment integrity solutions with full bill review options for in-network and out-of-network claims further drives cost savings on billed charges. In addition, integrating these services with stop loss underwriting that is aligned with cost-containment solutions and plan design can yield premium savings of 50 percent.

By curating, tailoring and streamlining its solutions for each health plan on one integrated platform, Valenz eliminates the common problem of point solution fatigue. Consequently, employers benefit from greater savings, higher efficiency and elevated member experiences – all from a single team of experts dedicated to their specific needs.

“We found it so inspiring to engage in pivotal conversations about shifting the environment of healthcare and driving behavioral changes that bend the cost curve while improving quality and outcomes of care,” Gelb said. “As we all agree that the healthcare environment is on an unsustainable upward trajectory, we look forward to collaborating further to do what’s right for the industry – optimizing the cost, quality and utilization of care for everyone.”

Engaging early and often, Valenz leverages its transparent, value-based model and provides intuitive navigation across the entire member health journey. By ensuring the highest possible quality of care and optimal outcomes at appropriate costs, the result is strong, vigorous and healthy lives.

About Vālenz® Health

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. For more information, visit valenzhealth.com.

Lauren Tomlinson, CPA, Joins Vālenz® Health as Controller

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PHOENIX, Ariz. (May 31, 2024) — Vālenz® Health announces that Lauren Tomlinson, CPA, has joined the leadership team as Controller.

Previously, Tomlinson was partner at EisnerAmper LLP, where she spent more than 20 years leading complex audit engagements and ensuring financial reporting integrity. She has managed all aspects of client engagements, including the performance of risk assessments, team management, technical research, planning and budgeting, billing and collections, monitoring of utilization and realization, and driving successful key initiatives.

“As she ensures financial quality through effective execution and dynamic leadership, Lauren makes the complexities of the accounting process look easy,” said Christina Morrison, Chief Financial Officer of Valenz. “She brings expertise in acquisition accounting, internal control and process improvements, with the ability to quickly understand a company’s business landscape and revenue streams. Lauren is extremely well positioned to lead our team’s financial reporting.”

At Washington University in St. Louis, Tomlinson earned a bachelor’s degree and a master’s in business administration, both in accountancy. A licensed Certified Public Accountant, she is based in Bryn Mawr, Pa.

“Valenz is especially unique regarding our deep investment in process improvements and the way we prioritize the key role of accounting in making these improvements,” Tomlinson said. “The strong culture at this company promotes an environment where everyone cares deeply about what we’re doing together to serve our customers the best way we can.”

About Vālenz® Health  

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. For more information, visit valenzhealth.com.

Staff Spotlight: Marca Reese, Bill Review Relations Manager

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Get to know Marca Reese, Bill Review Relations Manager, in this month’s Cultural Case Study!

Question 1: What is one word you’d use to describe the Valenz culture?

“Opportunity! Valenz has allowed me an opportunity to not only participate in ‘day-to-day’ goals and expectations associated with the Bill Review Team, but also expand to different branches within our organization with potential ideas and concepts for service enhancements. Regardless of an employee’s position or title, the culture at Valenz is open and welcomes input from employees of all levels. It’s also one that appreciates ‘experience’ and turns to those experienced individuals for opinions and recommendations, while giving the individual credit for their ideas and input. I’ve also found Valenz to be a welcoming platform for people who want a chance to learn and grow. This company provides excellent resources, tools, and mentors for those individuals to empower them to meet their goals.”

Question 2: When someone asks you about work/Valenz, what do you say?

“I start by sharing that I’m part of a team that helps self-funded employers protect the integrity of their Group Health Fund. I help make sure only eligible charges are being considered for benefit determination, which provides cost savings for the fund, and the environment gives us the opportunity to value and truly help each and every member. But I also like to share that the Valenz culture is unique. I feel safe to admit sometimes I don’t know the answer to everything, and there are still things left for me to learn. Here, you are recognized as a human who can ‘spill milk’ and learn through those mistakes. The CEO looks out for all levels of employees, and I’ve seen new employees gain self-confidence since coming to work here. It’s amazing what you can do and how much more you can learn in an atmosphere that fosters those sorts of things!”

Question 3: How is Valenz a good fit for your talents, skills, and passions?

“I have over 30 years of experience in the medical claims field, so Valenz has provided me with an opportunity to use all the claims knowledge I have on a daily basis. I also have lots of ideas and proposals for how we can make our work better, and those are always heard here. Something I’ve learned over the course of my career is that I really enjoy advocating for people when they can’t advocate for themselves. I love to offer my help that way, and at Valenz, I can really do that. I can use my level of understanding to take the time and dig in and figure out how to help members here, and I really enjoy that. Something else I enjoy is being a mentor and getting to answer questions. There’s always space and time for questions at Valenz, and I love being the one to show someone the ropes or explain a new idea!”

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