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Vālenz® Health Announces the Acquisition of MCM, Expands Care Management and Population Health Solutions

July 27, 2022/in Announcements, Featured, Integrations, Press, Valenz Care/by kamryn cain

PHOENIX, Ariz. (July 27, 2022) — Vālenz® Health announced today it has acquired Medical Cost Management Corporation, d.b.a. MCM Solutions for Better Health and its subsidiary, Med-Care Management, Inc, (MCM), a leading provider of managed care and population health management programs spanning the entire continuum of care for self-funded plans. In May, Valenz announced the acquisition of VerifPoint, a credential verification organization today recognized as VPoint™.

As a Valenz company, the combined MCM and Med-Care subsidiary which have served the multi-employer labor space for more than 35 years, will adopt the trade name Valenz Care. Valenz Care offers member and clinical advocacy through concierge navigation and triple URAC-accredited services for care management, disease management and utilization review. The acquisition accelerates the collective ability to deliver data-driven medical cost management and population health management to labor and public entities, as well as commercial customers.

“Valenz continually explores new ways to deliver on our core promise to engage early and often for smarter, better, faster healthcare, and we are thrilled to now deliver that promise to MCM customers and their members,” said Rob Gelb, Chief Executive Officer of Valenz. “The addition of MCM solutions clearly aligns with the Valenz commitment to deliver care optimized solutions that influence member choices prior to costly healthcare decisions being made. Together, we will prospectively – and continually – address member care needs for improved outcomes and cost containment throughout the member’s healthcare journey.”

The partnership with MCM further fortifies the Valenz Healthcare Ecosystem Optimization Platform, an end-to-end, fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider to enable better decision-making, starting long before care is provided and continuing long after a claim is paid.

“We look forward to introducing our customers to the highly innovative Valenz ecosystem and expanding opportunities to provide cost-efficient and comprehensive care management across the health continuum,” said Thomas J. O’Connor, President of MCM. “Our companies share a dedication to serving the self-insured industry, advocating for plan members, and ensuring high quality, cost-effective care, making our partnership a natural fit.”

MCM, a physician-directed company, is URAC accredited in health utilization management and is licensed in all states with requirements. Its solution portfolio also includes chronic disease management, catastrophic care management, a comprehensive health and wellness program, health risk assessments, predictive modeling, and data reporting.

 

 

 

 

 

 

 

 

 

 

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

About MCM

A pioneer in medical management, Medical Cost Management Corporation, dba MCM Solutions for Better Health, was founded by Michael O’Connor in 1986 to meet the population health management needs of self-funded plans, Taft-Hartley Trusts, associations and claim payers. MCM and its subsidiary Med-Care Management, Inc., provided services to more than 550 plans representing over 600,000 members nationwide. MCM is now part of the Valenz Health family.

https://www.valenzhealth.com/wp-content/uploads/2022/06/Valenz_MCM_News-Annc-600x432-final.jpg 432 600 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2022-07-27 01:05:312022-12-16 23:06:26Vālenz® Health Announces the Acquisition of MCM, Expands Care Management and Population Health Solutions

Vālenz® Announces Corporate Sponsorship for HCAA TPA Summit in July

July 1, 2022/in Announcements, Events, Featured, Press/by kamryn cain

PHOENIX, Ariz. (July 1, 2022) — As Corporate Sponsors of the HCAA TPA Summit, Vālenz® leaders have announced they will join this year’s key networking event in St. Louis for third-party administrators and the self-funded industry.

The HCAA TPA Summit addresses relevant topics and issues for the self-funded marketplace while providing opportunities to connect with colleagues. The annual conference aims to inform and inspire participants as they break through barriers, differentiate themselves in the market, and transform their thinking while self-funding continues to evolve.

This year’s event, with a forward-facing theme of “Gateway to the Future,” will feature discussion topics including value-based care, mission vs. margin, technology as a key step toward advocacy, improving client service while navigating the legal landscape, and much more.

“As always, we’re looking forward to engaging with new and old friends at the HCAA TPA Summit while sharing the benefits of our comprehensive, data-driven solutions,” said Rob Gelb, Chief Executive Officer of Valenz. “We know Third Party Administrators need a platform that delivers data engagement, decision enablement and true transparency to optimize self-funded plans. That’s where the Valenz Healthcare Ecosystem Optimization Platform supports strong, vigorous and healthy lives – and companies — through its fully integrated solution that improves care quality and health outcomes while minimizing costs. We’re excited about sharing more in St. Louis.”

The HCAA TPA Summit will be held July 18-20 at the Hyatt Regency St. Louis at the Arch downtown. Attendees are encouraged to connect with Valenz to explore the benefits to their business and plan members provided by full data transparency, robust analytics, and a unique integration of services across the care and claim continuum that drives smarter, better, faster healthcare.

About Valenz

Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2022/06/Announcement-Iimage_600x432.jpg 432 600 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2022-07-01 05:00:192022-07-01 16:40:09Vālenz® Announces Corporate Sponsorship for HCAA TPA Summit in July

Vālenz® Partners with GenRocket to Produce Test Data Fifty Times Faster

June 30, 2022/in Announcements, Featured, Press/by Maris Panjada

PHOENIX, Ariz. (June 30, 2022) — Vālenz®, a tech-enabled healthcare ecosystem optimization platform for the self-insured industry, recently partnered with GenRocket, a synthetic test data automation company, to leverage synthetic test data in its quality assurance process for the company’s next-generation claims processing platform.

According to Garth Rose, CEO and Co-founder of GenRocket, software testing requirements for healthcare industry applications are particularly complex, with strict data privacy regulations along with complex data sets to manage. “Valenz, like most companies, realized using real data posed unacceptable privacy and security risks, and the option to manually create the necessary test data posed undesirable time constraints,” explained Rose.

GenRocket’s synthetic test data automation platform replicated the data model from the Valenz claims application to generate realistic and accurate synthetic data without the use of any PHI during testing and development. “Using GenRocket’s synthetic test data automation platform, we were able to produce 300,000 claim records approximately 50 times faster than a manual method of scrubbing data to produce the required test data for building and testing the next generation of our platform,” said Edward Zwicker, Chief Information Officer for Valenz.

“With GenRocket, we accelerated our time to market significantly, allowing Valenz to re-direct staff to other time-sensitive tasks required for us to deliver a more automated and scalable claims processing platform to better support our customer needs,” added Zwicker.

For more details, read the case study: https://www.genrocket.com/newsletter/private-secure-healthcare-test-data-produced-50x-faster-with-genrocket/

About Valenz

Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

About GenRocket
GenRocket is the leader in real-time synthetic Test Data Automation (TDA), high-performance technology for provisioning test data for Agile and DevOps environments. GenRocket’s patented, groundbreaking platform accelerates test data provisioning by more than 1,000% as it improves data quality and test coverage while reducing cost and ensuring data privacy. Headquartered in Ojai, California, GenRocket operates in global markets through a network of systems integration partners and has customers in more than 14 vertical markets including financial services, insurance, and healthcare. For more information, visit www.genrocket.com.

https://www.valenzhealth.com/wp-content/uploads/2022/06/Valenz_GenRocket-Case-Study-Presser-600x432-1.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-06-30 16:39:282022-07-01 17:12:39Vālenz® Partners with GenRocket to Produce Test Data Fifty Times Faster

Vālenz® is Proud Title Sponsor of SIIA 2022 National Conference in Phoenix

June 3, 2022/in Announcements, Featured, Misc., Press/by kamryn cain

PHOENIX, Ariz. (June 3, 2022) — Vālenz® announced today it is the Title Sponsor of the 42nd annual Self-Insurance Institute of America (SIIA) National Conference & Expo this fall – an event that will be even more special because the conference will be held in the Valenz hometown of Phoenix and is fully in-person for the first time in three years.

Scheduled for Oct. 9-11 at the JW Marriott Phoenix Desert Ridge Resort & Spa, the SIIA National Conference & Expo is the world’s largest self-insurance event, offering educational programs, meaningful insights and game-changing solutions on the latest industry topics.

“Our sponsorship of the SIIA National Conference this year will bring Valenz full circle,” said Rob Gelb, Chief Executive Officer of Valenz. “We launched the Valenz ecosystem at the national conference in October 2019, which was the last time it was held in person before the pandemic. Three years later, we are celebrating being together again and unveiling the fully integrated Healthcare Ecosystem Optimization Platform. It is a tremendous honor to now say thank you to the SIIA community through the Title Sponsorship in our hometown. We can’t wait for October.”

Valenz has been a Diamond Member of SIIA since 2020, which signifies the highest level of support for SIIA’s mission and demonstrates a leadership position in serving the needs of the self-insurance community.

“We were very excited to announce Valenz as the Title Sponsor for this year’s conference,” said SIIA President & CEO Mike Ferguson. “Not only have they been a great supporter of the organization, but they also are an industry innovator in healthcare cost containment solutions for so many of our members involved with self-insured health plans and captives. With Valenz’s support, we expect Phoenix to be a wonderful host city for our biggest event of the year.”

Gelb will facilitate an “Engagement Accelerator” session at the conference called “Selling in the Self-Insurance Market,” which will address the acceleration of change, the challenges of staffing and other industry developments that may shift the mind of the buyer in the self-insurance value chain. Participants will share their experiences and strategies on how to work most effectively to support the self-insurance industry buyers while achieving corporate growth objectives.

Registration for the conference – along with links to the daily schedule, session topics, speakers, FAQs and more – is available at https://www.siiaconferences.org/2022/register_now.cfm.

About Valenz

Vālenz® 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. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your 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/2022/06/Valenz_SIIA-Sponsorship-22-1_600x432.jpg 417 580 kamryn cain https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png kamryn cain2022-06-03 14:22:142022-06-06 14:23:59Vālenz® is Proud Title Sponsor of SIIA 2022 National Conference in Phoenix

Vālenz®, VerifPoint Announce Integration and Launch of Comprehensive Provider Credentialing Solution

May 24, 2022/in Announcements, Featured, Integrations, Press, Valenz Assurance/by Maris Panjada

PHOENIX, Ariz. (May 24, 2022) — Vālenz® announced today it has integrated with VerifPoint, an industry-leading Credentialing Verification Organization for health systems, hospitals, providers and health plans. 

The integration of the two companies creates a new solution called Valenz VPoint™, a provider credentialing and continuous monitoring solution that offers effective, diligent credential verification to ensure quality of care for patients and members. As a critical component of the Valenz strategy to assure Validation, Integrity and Accuracy (VIA) for providers, VPoint offers NCQA-certified and URAC-compliant credentialing and re-credentialing solutions. 

In addition, VPoint and Valenz Assurance will combine to enhance VIA Provider Solutions, a comprehensive compliance management solution to improve medical coding efficiency, reimbursement assurance, auditing toolsets, claims accuracy, credentialing, medical staff licensing and exclusion monitoring. 

“We are thrilled to partner with VerifPoint in accelerating our collective ability to deliver data-driven, analytical solutions for credentialing and continuous monitoring,” said Rob Gelb, Chief Executive Officer of Valenz. “With the launch of VPoint, we are poised to support our clients with reduced exposure and facilitate higher-quality care. This is a clear example of how Valenz continually delivers on our promise to engage early and often for smarter, better, faster healthcare.” 

The integration of VerifPoint further fortifies the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider across all phases of the claim life continuum. While minimizing the opportunity for fraud, waste and abuse, VPoint’s credentialing and monitoring services protect clients from denials, appeals, unpaid claims and penalties associated with employing or paying providers with improper licenses or disciplinary issues. 

“As we join the highly innovative Valenz ecosystem, we are well positioned to accelerate growth and value for clients together,” said Asim Ashary, CEO and President of VerifPoint. “The two companies share a deep commitment to meeting client-specific needs while proactively anticipating the constant changes in technology and the healthcare industry. We look forward to the next steps toward an exciting future as one united company.” 

About Valenz 

Vālenz® 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. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz, ranked two years in a row on Inc. 5000, is backed by Great Point Partners.

About VerifPoint 

A Credentials Verification Organization based in Lake Forest, Calif., VerifPoint offers easy and customizable medical credentialing solutions and provides highly affordable, timely and accurate healthcare practitioner information. Our vision is to be the leading service provider for medical credentialing by providing optimum and best system solutions that are fully adaptable to meet the special needs of clients while keeping pace with the ever-changing needs of technology and the healthcare industry. Fully certified by NCQA, VerifPoint provides primary source verification that meets industry and regulatory standards such as NCQA, TJC, URAC, CMS and AAAHC. 

https://www.valenzhealth.com/wp-content/uploads/2022/05/Valenz_VPoint_Web-Annc-600x432-3.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-05-24 16:55:422022-06-13 15:18:20Vālenz®, VerifPoint Announce Integration and Launch of Comprehensive Provider Credentialing Solution

Vālenz® Hires John Paolacci as Chief Claims Officer

May 13, 2022/in Announcements, Featured, Press/by Maris Panjada

PHOENIX, Ariz. (May 13, 2022) — Vālenz® is pleased to announce John Paolacci, MBA, has joined the company as Chief Claims Officer. With more than 20 years’ experience in managed care and claims, Paolacci has served in leadership roles in client services, operations, strategic planning, managed care product design, pricing, strategic partner contracting, business development strategy and M&A integrations. At Valenz, he will lead the Validation, Integrity and Accuracy (VIA) of claims and payments, implementing tech-enabled solutions that support a robust claim infrastructure for accelerated and streamlined claim operations.

As Chief Claims Officer, Paolacci will partner with Amy Gasbarro, Chief Operations Officer, who ensures early engagement and continuous clinical, member and provider advocacy across the entire healthcare ecosystem. Together, Gasbarro and Paolacci will facilitate a seamless entry for self-insured employers and members into the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider across the Claim Cost ArcSM.

“John is widely recognized as a results-driven, solutions-oriented leader with deep expertise in claim management and cost containment,” said Rob Gelb, Chief Executive Officer of Valenz. “His superior capabilities position us well to continue building a strong foundation in claim operations as our member base grows, and his philosophy of servant leadership aligns perfectly with the collaborative Valenz culture. We are thrilled he is joining the team.”

Most recently, Paolacci was Senior Vice President, Managed Care for Sedgwick, with responsibility for standalone managed care cost containment divisions including medical bill review, provider networks and client services. He also has held senior leadership positions with York Risk, Avizent Risk, and the Frank Gates Service Company.

Paolacci earned his master’s degree in Business Administration at Franklin University in Columbus, Ohio, He lives in Granville, Ohio.

“I’m honored to have the opportunity to be part of such an energetic, collaborative company that is driving true innovation in the market,” Paolacci said. “As we anticipate the needs of our self-funded customers and continue building the next generation claim organization to serve an ever-evolving healthcare industry, I look forward to advancing the business operations and Valenz vision for smarter, better, faster healthcare.”

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your 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/2022/05/Valenz_John-Paolacci-Annc_600x432.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-05-13 21:26:392022-05-16 13:40:29Vālenz® Hires John Paolacci as Chief Claims Officer

Vālenz® Hires Kevin O’Donnell as Vice President, Enterprise Solutions

March 25, 2022/in Announcements, Featured, Press/by Maris Panjada

PHOENIX, Ariz. (March 25, 2022) — Vālenz® is pleased to announce Kevin O’Donnell, MPA, has joined the company as Vice President, Enterprise Solutions.

O’Donnell brings extensive experience in providing advisory and strategic services, project management and implementation support to healthcare organizations. He will be 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. Other key responsibilities include driving product growth, supporting client-facing sales function, and fulfilling roles within operations and technology.

“We are thrilled to have Kevin’s entrepreneurial spirit and proven success in operations, consulting and change management on the Valenz leadership team,” said Maurice Steenland, Senior Vice President, Product & Delivery. “His superior skills in implementation of care management and value-based care, as well as operational assessments and restructuring, has delivered significant results in improved care, streamlined operations and increased revenues.”

Most recently, O’Donnell was Managing Director of Operations for Evolent Health and held several other leadership positions there in operations, claims quality and payment integrity. He also served as managing consultant for Navigant.

O’Donnell 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, He lives in Newark, Del.

“I’m a firm believer in living out the culture of strong, vigorous and healthy, which Valenz has fully incorporated into the way it serves its employees, its partners, and their members,” O’Donnell said. “I’m looking forward to building upon that foundation through the proactive, sustainable solutions and customer love that have set Valenz apart as healthcare continues to evolve.”

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your 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/2022/03/Valenz_Kevin-O-Annc_600x432.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-03-25 14:21:482022-03-28 21:42:53Vālenz® Hires Kevin O’Donnell as Vice President, Enterprise Solutions

Vālenz® to Attend HCAA Executive Forum as Corporate Sponsor

February 11, 2022/in Announcements, Events, Featured, Press/by Maris Panjada

Event scheduled for Feb. 21-23 in Las Vegas

PHOENIX, Ariz. (February 11, 2022) — As Corporate Sponsors of the HCAA Executive Forum, Vālenz® leaders have announced they are attending the key networking event for the self-funded industry in Las Vegas this year.

The HCAA Executive Forum, which addresses timely industry topics while providing opportunities to connect with colleagues, returns to an in-person format for the first time in two years. A real-time, live-streaming option is available for registrants unable to attend on site. Valenz also will be featured in the B-to-B Marketplace where attendees can find rich information about how the health data technology firm improves cost, quality and outcomes for self-funded plans and their members.

“This year’s conference theme, Unstoppable Spirit, is very fitting when you consider the new challenges the self-insured industry has had to solve and overcome during the pandemic,” said Rob Gelb, Chief Executive Officer at Valenz. “As we become more agile and adaptable in a dramatically changed world, we look forward to sharing data-driven solutions that simplify the complexities of self-insurance through true transparency and decision enablement.”

The HCAA Executive Forum will be held Feb. 21-23 at the Bellagio, with live-streaming of presentations occurring at Pacific Time. Attendees are encouraged to connect with Valenz to explore the benefits to their business and plan members through the unique integration of services across the care and claim continuum. The Valenz team attending the event includes Brian Campbell, Brittney Parrish, Greg Shelley and Steve Illions.

 

About Vālenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Vālenz® approach aligns the patient, payer and provider. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

https://www.valenzhealth.com/wp-content/uploads/2022/02/Valenz_HCAA-Annc-2022-600x432-1.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-02-11 11:58:032022-02-17 12:03:27Vālenz® to Attend HCAA Executive Forum as Corporate Sponsor

Vālenz® CEO Outlines Six Areas of Focus for Self-Insured Employers in 2022

January 21, 2022/in Featured, Press/by Maris Panjada

With a new year underway, we’re celebrating long-overdue legislative advancements that help protect healthcare consumers and support their ability to make better, more informed decisions about their health and healthcare coverage. By working to prevent unexpected medical bills and requiring greater visibility into the costs of healthcare services, the No Surprises Act (NSA) and the Transparency in Coverage (TiC) Rule enable self-insured employers to better serve their members for the benefit of all.

As a longtime champion of transparency, advocacy and engagement to drive improved member experiences and outcomes, our team at Vālenz® sees exciting possibilities ahead for real transformation in self-insurance. Here are six opportunities for self-insured employers to focus on in 2022:

1. Increase Transparency with Members

Compared with other industries, the lack of insight into costs prior to paying for health services has been unparalleled. The new NSA and TiC legislation ensures cost transparency and finally puts more control in the hands of the healthcare consumer.

Health plan members will now have full visibility into their medical costs and coverage options, so helping them find true clarity is vital. When members receive quality and cost information that’s delivered in a meaningful way, they can recognize the differences, understand what they’re paying for and make the right buying choices. These smarter decisions made by well-informed members are key to the health of the plan as well, keeping costs low and quality high.

Member advocacy is central to this legislation, and it’s a good reminder that the member is central to everything we do. Whether you are a TPA adjudicating claims in making payments, a health system serving its community, or a partner like Valenz offering improved access points to care, navigation and cost savings, the benefits to the member are shared across the board at every step.

2. Improve Collaboration

When it comes to quality, utilization and cost, a lack of alignment among the patient, provider and payer typically results in friction and a diminished experience for everyone. This is where transparency takes the form of better communication and collaboration among all parties.

Provider collaboration helps secure a fair and reasonable reimbursement for high-quality healthcare services. The plan can better identify the goals regarding medical outcomes and alignment of costs, and care navigation helps members traverse a complex system, so they receive the right care at the right place and right time – ensuring the best chance of a positive result. Strong, vigorous and healthy plan members translate to a healthier plan with fewer expenses for everyone involved.

3. Respond to Legislation

Even before the NSA and TiC legislation, a movement was building toward self-funded plans offering improved transparency and cost savings. Slowly but surely, it has become very clear that the average healthcare cost of around $17,000 annually per employee – for access to a healthcare system that is difficult to navigate and comprehend, with no consistent measure of quality – is not sustainable for the plan or the member.

These major legislative shifts that occur every 10 years or so – such as HIPAA and the Affordable Care Act – offer a transformative opportunity to change the landscape of healthcare. It’s likely that many members don’t have full understanding of what it means for them. Clear and consistent communication with members must take place to drive the improved outcomes intended by the new legislation.

With the latest changes, we will see much greater visibility into the process of health coverage and service delivery, including data transparency and oversight of how business gets placed to carriers. This shift will create opportunities to examine all options and drive decisions on the best fit for each member’s unique needs.

4. Make Data-Driven Decisions

Data for the sake of data is not useful. It must tell a story that a plan and its members can act upon and understand. Tech-enabled solutions include a tremendous number of data points, but data engagement is what leads the story to fully unfold.

Turning numbers into usable information presented in a clear format can guide employers in the right direction to achieve the best results for their plan members. Data analysis and assessments present the information and actions needed for self-insured employers to unlock greater network potential, predict and save costs, and influence the model of a quality health plan.

5. Embrace Change

The self-insured industry sees shifts every year in the 5-15 percent of claims that drive 70-80 percent of the plan spend – from stop-loss renewals and rate increases to high-dollar COVID-19 claims and new therapies. Employers must keep up with the changes and fluctuations in the types of claims that drive their greatest spending and act accordingly.

As information from the clinical arm of the business (medical intelligence) coalesces with the data/technology side (tying to the claim, provider and payment), it’s possible to pinpoint that 5-15 percent in real time. Doing so provides insight into actionable steps to identify it and solve it quickly and proactively.

6. Create an Agile, Respectful Culture

The healthcare industry is evolving at a breakneck pace, accelerating through legislation and a call for change. This results in myriad healthcare management decisions new to many employer groups, including those that self-insure. A plan’s success in serving members hinges on the ability to predict and proactively manage the needs of the unique population and every individual within.

At Valenz, we have built an agile culture where we know how to be comfortable being uncomfortable. As we work to simplify the complexities of healthcare, we are not afraid to take chances that go beyond traditional norms. That’s how we grow as an organization and how we offer unique value to our partners.

We believe a culture of inclusivity and agility is the right way to address improvements to the system our members navigate. The Valenz culture is also about how we work together and how we treat the people who work with us. If you are partnering with an enterprise to help you make benefit and coverage decisions, you need to understand how they operate and know if they live out the values required for meaningful, positive and all-encompassing change.

Partnerships must be respectful and collaborative enough to refrain from a quick negative response and, in its place, say “Yes, and…” instead. That positions us to capitalize on shared resources and data, so we can uncover new solutions together. When we listen without judgment, build upon each other’s expertise, redirect when necessary and get it right together, that’s how we create healthier plans and ensure that members will be strong, vigorous and healthy in 2022 and beyond.

***

Rob Gelb is Chief Executive Officer of Vālenz®, the industry-leading ecosystem offering self-insured employers unrivaled data transparency to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate members to optimal care solutions for substantial cost savings and improved health outcomes.

https://www.valenzhealth.com/wp-content/uploads/2022/01/Valenz_Rob-NY-2022-LI-Pulse-600x432-v2.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-01-21 23:38:572022-01-24 15:07:48Vālenz® CEO Outlines Six Areas of Focus for Self-Insured Employers in 2022

Vālenz® to Present at Oklahoma City Event Hosted by True Captive Insurance

January 14, 2022/in Announcements, Events, Featured, Press/by Maris Panjada

Jan. 26 gathering of business leaders will focus on the future of business and benefits

PHOENIX, Ariz. (January 14, 2022) — Focused on self-funded health plans and how businesses can gain control of healthcare spend, Vālenz® announced today that its chief executive officer Rob Gelb will be a featured presenter at an Oklahoma City event hosted by True Captive Insurance and sponsored by Valenz. The event is Jan. 26 from 1:00-4:00 p.m. at the Petroleum Club in downtown Oklahoma City.

At the executive-level event, Gelb will discuss changes in the self-insured industry, including recent legislation, employer shifts to self-insurance, and the role of data in balancing quality, utilization and cost for better decisions about health coverage.

“Every day, I see employers face challenges as they make decisions about the financial impact of health coverage while also balancing employee health and wellbeing,” said Gelb. “Given current market conditions and the extreme competition for talent, medical benefits packages are becoming more crucial in whether or not a business becomes a preferred workplace. That’s why firms like Valenz and True Captive, as well as transformational industry leaders from EHIM, Simpara, NavMD, Benefit Management, Proactive MD, Plansight and Medxoom are doing everything possible to simplify self-insurance for employers, while helping them deliver benefits that improve health outcomes and reduce costs for the member and the plan.”

As employers seek greater control of their medical plan spend, many are turning to self-insurance. The number of U.S. employers in a self-funded structure is expected to increase from 63 percent to 70 percent this year. Gelb’s presentation will address why it is important for business leaders to develop the right partnerships for self-insurance and feel comfortable during this transformational moment in healthcare.

Space is limited, and early registration is encouraged: truecaptive.com/okc-registration

 

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the patient, payer and provider. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing ‘true transparency’ and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners. 

About True Captive Insurance

True Captive is transforming the health insurance industry by giving employers the control and stability they deserve. True Captive Insurance allows small to medium sized companies to band together to create buying power that lowers healthcare costs. Coupled with true care navigation and consumer empowerment, the True Captive Model drives costs down and creates an improved, more personalized experience for members. True Captive Insurance believes in healthcare that is personal and insurance that isn’t complicated. More information is available at truecaptive.com.

https://www.valenzhealth.com/wp-content/uploads/2022/01/Valenz_True-Captive-2022-600x432-1.jpg 432 600 Maris Panjada https://www.valenzhealth.com/wp-content/uploads/2023/01/valenz-logo-1-23-3.png Maris Panjada2022-01-14 13:47:172022-01-15 13:47:50Vālenz® to Present at Oklahoma City Event Hosted by True Captive Insurance
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