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.
Vālenz® CEO Outlines Six Areas of Focus for Self-Insured Employers in 2022
/in Featured, Press/by Maris PanjadaWith 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.
Vālenz® to Present at Oklahoma City Event Hosted by True Captive Insurance
/in Announcements, Events, Featured, Press/by Maris PanjadaJan. 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.
Vālenz® Unveils Solution to High Air Ambulance Costs
/in Announcements, Featured, Press/by Maris PanjadaValenz uses proven, proprietary repricing methodology to protect from surprise out-of-network billing
PHOENIX, Ariz. (December 23, 2021) — To help self-insured employers comply with requirements of the No Surprises Act (NSA) – and to protect plan members from sky-high surprise medical bills for out-of-network emergency air transport – Vālenz® has rolled out a new VMS™-validated solution within its ever-expanding ecosystem. The air ambulance solution creates a defensible qualified payment amount (QPA) for air ambulance services using Valenz’ proprietary repricing methodology. The result is fair pricing that assures a uniform level of protection for out-of-network air ambulance services.
“Recognizing that the January 1 requirements of NSA have a lot of employers chasing new solutions popping up in the market, we want Valenz clients to rest assured that the repricing methodology behind the Valenz air ambulance solution is completely tried and true,” said Rob Gelb, Chief Executive Officer. “In keeping with our long-standing commitment to transparency and balance billing protections, we are thrilled to apply our proven repricing methodology to combat runaway costs for emergency care, including air transport.”
The need is real – and dire. Over the last decade, the median billed charges for air ambulance services have doubled and even tripled (depending on the provider), with a staggering 71% of all air ambulance rides involving an out-of-network charge. As a result, the average cost for an air ambulance has soared to $50,000-$75,000 for helicopter and fixed wing transports, respectively.
By embedding its market-sensitive repricing methodology into air ambulance claim and cost review, Valenz is well ahead of the curve, said Gelb. “While others are working to develop new solutions, Valenz has always used this innovative repricing methodology to lower costs, enhance care and improve outcomes through quality-first care delivery – now we’ve just extended it to air ambulance. It’s all part of our promise to engage early and often for smarter, better, faster and more transparent healthcare.”
For more information about Valenz and how the Valenz ecosystem supports NSA compliance and balance billing protections, visit valenzhealth.com/nsa.
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz® Chief Operating Officer Amy Gasbarro Joins SIIA Board of Directors
/in Announcements, Featured, Press/by Maris PanjadaPHOENIX, Ariz. (December 17, 2021) — Amy Gasbarro, Chief Operating Officer for Vālenz®, has been elected to the Board of Directors for the Self-Insurance Institute of America, Inc. (SIIA).
Gasbarro has worked with SIIA in various capacities since 2014, most recently as a trustee for Self-Insurance Political Action Committee (SIPAC), the advocacy and fundraising arm of SIIA. Her three-year term on the board will begin in January 2022.
“It is truly a privilege to become part of SIIA’s outstanding leadership group,” Gasbarro said. “The importance of self-insured health plans in the market is escalating, so this is a great opportunity to continue to advance self-insurance initiatives across the country. I am looking forward to making a strong impact on the SIIA board.”
SIIA works to protect and promote the business interests of companies involved in the self-insurance and captive insurance marketplace. As a single, member-based association, it is dedicated to meeting all the information, educational, networking and legislative/regulatory representation that a company needs.
“Amy has dedicated years of service to SIIA, and we are so proud to see her join the Board of Directors,” said Rob Gelb, Chief Executive Officer at Valenz. “It’s an honor for us as well to have one of our own guiding thought leadership within SIIA to support the evolving needs of the self-insured community and keep it strong, vigorous and healthy.”
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz® CEO: “Independent Dispute Resolutions Are Not Inevitable” Under No Surprises Act
/in Announcements, Featured, Press/by Maris PanjadaValenz repricing methodology mitigates risk of payment disputes
PHOENIX, Ariz. (December 10, 2021) — In response to “growing and unnecessary concern” about Independent Dispute Resolution (IDR) requirements that begin Jan. 1, 2022, under the No Surprises Act (NSA), leaders at Vālenz® are reaching out with assurance to clients that they already have proven tools to mitigate and even eliminate the need for IDRs.
Under the NSA, if there is a payment dispute from a provider, the health plan is required to participate in a third-party, unbiased arbitration process to establish a qualifying payment amount (QPA) for similar services in a geographic area. The health plan may need outside resources to fulfill claim settlement support for the IDR process, a stipulation that has created a rush of new IDR support solutions in market.
However, according to Rob Gelb, Valenz Chief Executive Officer, there is no need for Valenz clients to engage with new pop-up IDR solutions. For years, Valenz has used its proprietary VMS™ repricing methodology to circumvent payment disputes by ensuring fair, defensible, market-sensitive QPAs that both parties agree to. QPAs are based on years of real-world data from Valenz Access contracted networks, as well as additional layers of data from the broader Valenz ecosystem. Valenz has always negotiated with providers in the rare instances where they appeal a QPA. The IDR process only comes into play when an agreement isn’t reached through the normal appeal process and a provider decides to risk paying the cost of going to an independent arbiter.
“As a health data tech company with deep roots in member advocacy, our business model is built on a framework of clinical care management with a decades-long commitment to validation, integrity and accuracy (VIA). We’ve been delivering agile, data-driven solutions to pricing and reimbursement for years, always engaging early and often for smarter, better, faster healthcare,” said Gelb. “For us, this is not new at all – our repricing methodology is tried and true.”
Gelb advises all self-insured employers to embrace the power of transparency and data for improving the high costs of healthcare coverage today – and be cautious of solutions that don’t address root causes. “While others are fueling fear that IDRs will now be commonplace, we’re here to say the opposite – IDRs are not inevitable features of NSA compliance, not when you partner with Valenz.”
For more information about VMS™ visit valenzhealth.com/vms. To discuss how Valenz ensures fair and defensible pricing, call (866) 762-4455.
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz® Renews Triple URAC Accreditation
/in Announcements, Featured, Press, Valenz Care/by Maris PanjadaContinues legacy of excellence in clinical care combined with claim validity, integrity and accuracy
PHOENIX, Ariz. (December 3, 2021) — Vālenz® is proud to announce the renewal of its three URAC accreditations in Health Utilization Management, Case Management and Disease Management. URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. By achieving this status, Valenz has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.
“Because it underscores our staunch commitment to meeting rigorous standards in quality and accountability for clinical care management, we are very proud to renew our URAC accreditation,” said Janet Koch, RN, BSN, CCM, Vice President of Care Management at Valenz.
Rob Gelb, Chief Executive Officer, explains how clinical quality is integral to optimization within the entire claim-cost continuum – and pinpointing quality-first, cost-saving solutions for self-funded health plans requires the ability to see all intricacies and connections between clinical care and reimbursement.
“Valenz is unique in the way we combine clinical care management, advocacy and navigation for every member with assurance in the validity, integrity and accuracy of every claim,” said Rob Gelb, Chief Executive Officer. “Within the Valenz ecosystem, these two functions are inextricably linked – and fueled by data to ensure all claims are valid and true for accurate payments.”
That innovative and proprietary approach is foundational to the true value of the Valenz ecosystem and its ability to deliver the desired returns for Valenz clients. “Ensuring we consistently meet the high standards required for URAC accreditation is just one of many ways we keep our promise to engage early and often for smarter, better, faster healthcare,” said Gelb.
For more information about Valenz, visit valenzhealth.com.
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
About URAC
Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.
Vālenz® Promotes Nathan Nelson to Chief Revenue Officer
/in Announcements, Events, Featured/by Maris PanjadaPHOENIX, Ariz. (December 3, 2021) — Vālenz®, the innovators behind the industry’s most transparent, data-driven ecosystem for self-funded employers and their health plan partners, recently announced Nathan Nelson, MBA, has been promoted to Chief Revenue Officer.
Nelson, who joined the firm as Vice President of Business Development in April 2019, was promoted to the executive team when he was appointed Senior Vice President of Growth earlier this year. “Nathan’s rapid rise within our organization speaks volumes about the ways he embraces a client-centric focus in everything we do, from clinical and member advocacy to assuring the validity, integrity and accuracy of claims,” said Rob Gelb, Chief Executive Officer. “His commitment to the character, culture and vision that drive Valenz is laser-focused on keeping the client at the center of all decisions and propelling forward the power of the ecosystem for smarter, better, faster healthcare.”
Nelson brings 20+ years’ experience driving strong business growth across all areas of revenue – with proven success in sales and account management for the healthcare industry, primarily in the managed care segment. Prior to joining Valenz, he held sales and leadership positions in claim management, workers’ compensation, underwriting and account management.
“I am excited to lead our sales and client relationships forward,” Nelson said. “The opportunities for our clients are as limitless and groundbreaking as the Valenz vision. I look forward to expanding our clients’ success – and our own – in this new role.”
For more information about Valenz and its leadership team, visit valenzhealth.com.
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz® Unveils Solutions to Replace Traditional Reference-Based Pricing
/in Announcements, Featured, Press, Valenz Access/by Maris PanjadaInnovative reimbursement strategies maximize plan dollars, improve provider relationships and drive significant savings
PHOENIX, Ariz. (November 19, 2021) — At a recent customer event, Vālenz® leaders unveiled a package of solutions that offer innovative alternatives to traditional reference-based pricing (RBP) agreements, designed to give self-insured employers more leverage in their local markets.
According to Rob Gelb, CEO of Valenz, the market needs to move away from traditional RBP approaches, which continue to be focused on basic payment reductions. “Now is the time to change the way you look at a reference-based approach to reimbursement that is defensible and allows customers to position in the market without contracts,” Gelb said. “The new Valenz package is designed to do this, plus it offers options to share risk with our customers.”
Each solution is fueled by data-driven insights and supported via the proprietary Valenz VMS™ Repricing Methodology yield fair, market-sensitive reimbursements that deliver improvement in savings as high as 75 percent, according to Gelb.
Valenz solutions offer options for self-insured employers to choose the path to smarter, better, faster healthcare that is best for their markets:
“These solutions help maximize savings opportunities, reduce risk to the health plan, and put leverage back in the self-insured employer’s favor,” Gelb said. “That’s the power of the Valenz ecosystem. It lets us do what we do best, which is creating partnerships through contracts with providers.
“When we engage early and often to ensure active collaboration among the patient, providers and employer plans, we can ensure transparency and ultimately improve health outcomes.”
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz® Releases New Provider Locator for Members
/in Announcements, Featured, Press, Valenz Access/by Maris PanjadaNew search capabilities bring more transparency into access, cost and quality
PHOENIX, Ariz. (October 29, 2021) — In keeping with their commitment to innovation that fuels strong, vigorous and healthy lives, Vālenz® has announced the release its new Provider Locator tool. Available online for plan members and administrators to access anytime, the new and improved Provider Locator is uniquely designed to bring more information and transparency to the process of choosing a provider for healthcare services.
In addition to an array of filters for members to refine searches according to their individual needs and preferences, the new Provider Locator also includes star-ratings and cost data, as well as an interactive map that pins provider locations within the defined geography. Search results include providers currently under contract within each member’s Valenz Access provider network, as well as “Valenz-Friendly” providers who have previously accepted reimbursement from Valenz.
“Engaging early and often for smarter, better, faster healthcare can take many forms, but in most cases, it begins with connecting people to quality providers who will deliver the right care at the right time and at the right cost according to plan coverage,” said Maurice Steenland, Senior Vice President of Product and Delivery. “We are very excited about this initial release and look forward to continuously expanding the data available to plan members in support of their healthcare decisions.”
With future updates, says Steenland, the Provider Locator tool will become more robust with expanded cost and quality data for providers in Valenz networks.
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz® to Attend SIIA’s 2021 National Educational Conference & Expo
/in Announcements, Events, Featured, Press/by Maris PanjadaEvent to be held October 3-5 in Austin, Texas
PHOENIX, Ariz. (October 1, 2021) — As Diamond members of the Self-Insurance Institute of America (SIIA) and industry-leading innovators for the self-insured and captive insurance marketplace, Vālenz® leaders have announced they are attending SIIA’s annual National Educational Conference and Expo again this year.
The 41st annual conference event, which takes place virtually and in person, provides event participants with many opportunities to discover game-changing solutions, including the data-driven Valenz ecosystem.
“We are excited about this year’s conference theme – The Way Forward – because it reflects the need to reimagine the paradigms of self-funded health plans,” said Rob Gelb, Chief Executive Officer at Valenz. “That’s what we do every day within the Valenz ecosystem. We make it possible to achieve measurable, meaningful improvements in cost and quality year over year.”
Several members of the Valenz executive team will be attending this year’s SIIA conference, including Amy Gasbarro, Chief Operating Officer; Nathan Nelson, Senior Vice President, Growth; Jordan Hersh, Vice President, Business Development; Chris Shoffner, Vice President, Business Development; and Brittney Parrish, Senior Client Services Executive.
By integrating data from high-value provider networks, care management, revenue cycle, claim management and more, Valenz provides uniquely transparent and data-driven decision enablement. “Part of the way forward for our industry will be shaped by how we target the 5-15 percent of claims that drive up to 70 percent of health plan spending – that’s the key to driving costs down while driving quality and member experience up,” Gelb said.
The in-person component of the 2021 conference will be held at the JW Marriott Hotel in Austin, Texas. Educational content is being delivered virtually with a combination of live and pre-recorded sessions scheduled throughout the conference. Attendees are encouraged to talk with Valenz at the event for a one-on-one exploration of next-generation data engagement and decision enablement that drives smarter, better, faster healthcare.
About Valenz
Valenz enables self-insured employers to make better decisions that control costs across the life of a claim while empowering their members to lead strong, vigorous and healthy lives. Valenz offers transparency through data to pinpoint members at highest risk, address gaps in network designs, ensure appropriate and accurate charges, and expertly navigate employees to optimal care solutions for substantial cost savings and improved health outcomes. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.