v-Rx Powered by ScoutRx: Significant Savings and Enhanced Services

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PHOENIX, Ariz. (June 30, 2020) – Costs of prescription drugs continue to rise exponentially, with total spending in the United States predicted to reach $610 billion in 2021. As pharmacy benefits represent a significant expense for self-insured employers, Vālenz™ is changing the approach to prescription drug coverage with its latest solution.

v-Rx, powered by ScoutRx, offers innovative cost-reduction and containment strategies that significantly enhance the benefits and services traditionally offered by a pharmacy benefits manager.

“While PBMs focus on getting the best discounts and the biggest rebates, we believe those should be considered short-term solutions. The real opportunity is to deliver long-term strategies that contain costs perpetually and help self-insured employers regain control of their pharmacy spend,” said Rob Gelb, Chief Executive Officer for Valenz.

With a suite of services comprising three core offerings, v-Rx creates long-term reductions in pharmacy benefit spend with average annual savings of 43 percent, while also delivering a concierge-style experience for members.

“Traditional PBM solutions base their savings on discounts without taking pharmaceutical inflation into account. The V-Rx solution gives the group the ability to dramatically reduce their spend and maintain that reduction year-over-year,” said Jordan Hersh, Vice President, Enterprise Solutions for Valenz. “At the same time, members receive highly personalized service and advocacy to assure that they never have to go without their medication.”

The three tiers of v-Rx services include:

  • Specialty Pharmacy: Alternative funding is used to reduce specialty drug costs by up to 100%.
  • Co-Pay Optimization: The full-service co-pay card optimization program enhances group savings without changes or disruption for individual members.
  • International Pharmacy: Dramatic savings for many brand-name, domestically equivalent medications, including temperature-sensitive items.

The v-Rx solution further expands the Valenz ecosystem, offering seamless pharmacy benefits delivery and a superior platform for healthier and more satisfied members.

Learn more about v-Rx powered by ScoutRx here.

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. Learn more at www.gppfunds.com.

About ScoutRx

ScoutRx is a dedicated collection of pharmacy benefit professionals delivering revolutionary solutions to drastically reduce the pharmacy benefit costs for our plan sponsors and their members. Focused on servicing self-funded organizations, ScoutRx offers a fresh approach to maximizing savings and minimizing pharmacy benefit spend. Learn more at scoutrxconsulting.com.

 

Vālenz VzReturn Offers Employers Safe Return-to-Work Solution During COVID-19 Pandemic

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PHOENIX, Ariz. (May 22, 2020) – As America turns its attention to re-opening the economy and employers plan for their employees’ return to work, Vālenz™ is introducing VzReturn, a solution for protecting  workforce health and safety during the COVID-19 pandemic. A Valenz Care solution, this comprehensive client-centric set of services further expands the Valenz ecosystem and offers immediate value to self-insured employers.

Valenz VzReturn helps employers meet their legal obligations while also limiting potential health risks for their workforce by providing onsite temperature checks, personal protective equipment and antibody testing where available, prior to and upon their employees’ return to work. The solution also includes a variety of management tools and educational resources for Human Resources leaders and employees to improve emotional fitness and physical well-being.

According to Amy Gasbarro, Chief Operating Officer for Valenz, employers may also access Valenz Care’s personalized health coaching via multiple channels, including telephone, in-person and web chat, as well as Textcoach,™ a secure messaging platform for employees to connect with a licensed mental health counselor to address concerns such as coping, stress, depression or anxiety.

“COVID-19 has presented unprecedented economic and operational challenges for employers, especially now given the lack of consistent guidance related to safe return-to-work policies and procedures,” said Rob Gelb, Chief Executive Officer for Valenz. Gelb added that Valenz is dedicated to offering client-centric solutions like VzReturn to help clients engage early and often to mitigate employer risk while meeting employee health and safety needs during the pandemic response.

“Providing this safe return-to-work onsite solution offers a clearly defined path for employers as they reopen their businesses and resume normal operations. Additionally, with VzReturn, our clients have the tools to continually protect the workforce should employees encounter virus exposure outside the workplace, requiring additional stays of quarantine,” Gelb said. “The Valenz VzReturn solution is just one more component of our promise to support our clients in achieving smarter, better, faster healthcare.”

Click here to learn more about Valenz VzReturn.

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. Learn more at www.gppfunds.com.

Right Care, Right Time: Three Ways Nurse Case Managers Deliver Integrated, Patient-Centered Care

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Through attentive care, dedicated service and comprehensive guidance, nurse case managers make a tremendous impact on patient outcomes. As an integral part of Vālenz Care, a triple-URAC accredited solution within the complete Vālenz™ ecosystem, Valenz nurse case managers work closely with patients, providers, employers and payers to ensure the right care at the right place and time, paving a more cost-effective path to healthy outcomes.

As we recognize World Health Day on April 7 – and because 2020 has been named the International Year of the Nurse by the World Health Organization – we are celebrating the vital role nurses play in keeping the world healthy. How do nurse case managers accomplish this?

Valenz Care Management Senior Manger Sylvia Robinson, RN, COHN, says their most significant role in today’s healthcare is coordinating and managing patient care. “Care coordination is a collaborative process that involves navigating treatment with physicians, social workers, patient families and other providers, such as home health and physical therapists,” she says. “Ultimately, our goal is aimed at determining the care that plan members need and guiding them on improving health while also minimizing healthcare expenses.”

For patients, nurse case managers are the central point of contact and advocates for high-quality, lower-cost care. For self-insured employers and other professional stakeholders, they help manage health administrative costs and quality by reducing unnecessary and/or preventable emergency room visits, hospitalizations, tests and other high-dollar claim events.

“The Valenz promise is to engage early and often for smarter, better, faster healthcare, and our nurse case managers are essential to that promise,” said Amy Gasbarro, Chief Operating Officer. “Their work improves quality and outcomes while empowering our clients to move from reactive plan models to proactive population health management.”

This level of care and service results in healthier outcomes for all involved. Here are three primary ways our nurse case managers positively impact care quality and healthy outcomes:

 Patient Education and Support

By providing continuous, evidence-based guidance and education, nurse case managers fulfill a key responsibility in helping patients and families fully comprehend health conditions and treatment options, so they can stay on the path to better long-term health.

“When patients have greater awareness and understanding of the treatment plan – and when they receive support from nurse case managers – we tend to see a much better likelihood of compliance,” says Valenz Nurse Case Manager Jessica Mangum, RN, OCN, CCM.

Nurse case managers also provide guidance to patients on effectively self-managing chronic conditions, so patients can take charge of their health and be their own catalysts in making positive lifestyle changes.

“A key component of the education process is to also evaluate the patient’s understanding of that education and his or her ability to take action on it,” Robinson says. “That includes setting short-term goals that they can achieve and celebrating those successes with positive feedback.”

Avoiding Unnecessary Costs

While providing comprehensive care that is appropriate for the patient’s needs, nurse case managers strive to minimize out-of-pocket costs.

When our Nurse Utilization Managers are notified of a new diagnosis or treatment recommendation, they conduct a clinical review to determine that the criteria are met for medical necessity and ensure alignment with the most appropriate level of care, according to evidence-based guidelines for that diagnosis. This helps eliminate expenses tied to unnecessary or excessive treatments.

“When we can manage the length of stay and promote case management, we can achieve effective cost containment while providing excellent service to the members and the plan,” says Valenz Nurse Utilization Manager Staci Cunningham, LPN.

In addition, the shift in focus to proactive health management – getting regular medical care before serious illness strikes – enables nurse case managers to help reduce or eliminate the need for costly medications and physician or emergency visits. That’s a benefit for both members and payers.

Navigating the Health System

For many people, the complexities of the healthcare system can feel so overwhelming, they don’t know where to start.

“Some of the biggest challenges patients face in navigating their care is lack of understanding of the healthcare industry,” Robinson says. “The average patient does not grasp how insurance and healthcare work. They often become frustrated and give up, and then they lose trust in anyone in the healthcare field.”

That’s where a nurse case manager comes in: providing guidance and information on what is covered by a patient’s insurance, managing co-pays, controlling out-of-pocket expenses, and accessibility to care, among many other issues.

“Patients need an advocate to get them through this journey,” says Nurse Utilization Manager Nichole Barone, LPN. “We can research insurance plan documents to give patients the clarity they need; help them understand what benefits they are entitled to; determine whether they need pre-certification before treatment; and assist them in securing all those things.”

Also, people with serious diagnoses like cancer may need a wide range of procedures and tests, which can quickly become confusing for a stressed patient. “By tackling these procedures one by one, we ensure the patient gets the proper, necessary care at the correct time,” Barone says. “We support patients by guiding them through the process so they can focus on getting back to the best possible health.”

Celebrating Nurses on World Health Day

As we celebrate World Health Day in 2020, which is also the International Year of the Nurse, the recognition of our nurse case managers and the amazing work they do takes the spotlight – and it is well deserved. We are proud to acknowledge nurses’ contributions on the front lines of patient care all across the globe, and we share our deep appreciation for the critical role they play in keeping people and communities healthy everywhere.

 About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. Learn more at www.gppfunds.com.

2020 Year of the Nurse: Vālenz Celebrates the Impact of Nursing Excellence

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As the innovators behind a new, data-driven ecosystem that reduces medical claim costs and promotes quality healthcare, Vālenz™ joins the World Health Organization in recognizing 2020 as the Year of the Nurse. Integral to Valenz’s services is its team of nurse case managers, who work closely with patients, providers, employers and payers to target the most appropriate levels of care before services are rendered, resulting in substantial savings for plans and members.

“Nurse case managers are essential to the Valenz promise of engaging early and often for smarter, better, faster healthcare,” said Amy Gasbarro, President of Vālenz Care, a triple-URAC accredited solution within the firm’s complete healthcare administrative ecosystem. “Their work improves quality and outcomes while also empowering our clients to move from reactive plan models to proactive population health management.”

For patients, nurse case managers are advocates for high-quality, lower-cost care – and many registered nurses on the Valenz team specialize in common and costly health conditions such as diabetes, cancer and pregnancy, among others. For self-insured employers and other professional stakeholders, nurse case managers help manage health administrative costs and quality by reducing expensive, unnecessary and/or preventable emergency room visits, hospitalizations, tests and other high-dollar claim events.

“Driven by actionable data — both individualized and aggregated — our Case Management solution ensures comprehensive care while minimizing out-of-pocket costs,” said Rob Gelb, Chief Revenue Officer of Valenz. “Our nurses serve as a central point of contact, guiding clients through treatment, so they can focus on what matters most — returning to good health.”

For all these reasons and more, says Gelb, Valenz is proud to celebrate the incredible impact of nursing excellence – this year and every year. For more information about Valenz Care, call (877) 601-2200.

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Serving self-insured employers, third-party claim administrators, brokers and benefit consultants, trust and labor organizations, stop-loss carriers, integrated healthcare delivery networks, and health/dental plan payers, Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. More information is available online at valenzhealth.com. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. GPP is currently making new private equity investments from GPP III. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III which has $306 million in committed capital) and public (BioMedical Value Fund family, approximately $1.1 billion) equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 100 growing healthcare companies. The private equity funds invest across all sectors of the healthcare industry, with particular emphasis on biopharmaceutical services and supplies, outsourcing and alternate site care, pharmaceutical infrastructure and information technology-enabled businesses. The firm pursues a proactive and proprietary approach to sourcing investments and tuck-in acquisitions for its portfolio companies. Visit Great Point at www.gppfunds.com.

Celebrating the Case Manager’s Critical Role in Smarter, Better, Faster Healthcare

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This week, in honor of National Case Management Week (Oct. 13-19), leaders at Vālenz are sending a message to case managers across the country: Thank you.

“Case managers are pivotal in the complex process of ensuring safe, effective and timely patient care,” said Rob Gelb, Chief Revenue Officer of Valenz. “In the nationwide effort to reduce healthcare costs while improving quality and outcomes, case management delivers big wins for everyone, especially patients and self-insured employer groups.”

Case management is one of three primary, URAC-accredited services offered via Vālenz Care, a core solution within the complete healthcare administrative ecosystem recently unveiled by Valenz. Dedicated nurse case managers work closely with patients, providers, employers and payers to target the most appropriate levels of care before services are rendered, resulting in dramatic savings for the plan and member.

“Driven by actionable data – both individualized and aggregated – the work of our care management team helps our clients move from a plan model of reactive care to one of proactive population health management,” explained Amy Gasbarro, President of Valenz Care.

For patients, case managers are care coordinators, navigators, and advocates for high-quality care that comes at a lower cost because it is the right care at the right place at the right time – every time. For self-insured employers and other professional stakeholders, they offer a value-focused path to managing health administrative costs and quality by reducing expensive emergency room visits, hospitalizations and other high-dollar claim events.

For all that and more, the entire team at Valenz is grateful to case managers – this week and every week.

About Valenz

Through a complete health administrative ecosystem, Valenz connects cost and quality data on a single-source, end-to-end analytics platform for smarter, better, faster healthcare. Serving self-insured employers, third-party claim administrators, brokers and benefit consultants, trust and labor organizations, stop-loss carriers, integrated healthcare delivery networks, and health/dental plan payers, Valenz solutions integrate data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim) and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) into the ecosystem. Valenz is backed by Great Point Partners.

About Great Point Partners

Great Point Partners (“GPP”), founded in 2003 and based in Greenwich, CT, is a leading health care investment firm, currently with approximately $1.8 billion of equity capital under management and 28 professionals, investing in the United States, Canada and Western Europe. GPP is currently making new private equity investments from GPP III. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III which has $306 million in committed capital) and public (BioMedical Value Fund family, approximately $1.1 billion) equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 100 growing health care companies. The private equity funds invest across all sectors of the health care industry, with particular emphasis on biopharmaceutical services and supplies, outsourcing and alternate site care, pharmaceutical infrastructure and information technology enabled businesses. The firm pursues a proactive and proprietary approach to sourcing investments and tuck-in acquisitions for its portfolio companies. Reach Great Point at 203-971-3300 or www.gppfunds.com.