Kozani Health integrates as ValenzProteKHt™ for complete and comprehensive bill review solution
PHOENIX, Ariz. (April 1, 2021) — Vālenz® announced today it has acquired Kozani Health, integrating a new and innovative means for self-funded employers and the self-insured community to control costs across the life of a claim.
Kozani Health, which provides customized solutions to meet the challenges of paying medical claims appropriately, joins the ever-expanding Valenz ecosystem of data and solutions as Valenz ProteKHt™. The new solution offers detailed line-by-line bill reviews performed by nurses, certified coders and practicing specialists to uncover inappropriate billing and care provided.
With success rates averaging 70 percent, Valenz ProteKHt is the industry’s recognized comprehensive and complete bill review solution. Valenz ProteKHt offers clear, defensible, transparent and plan-specific reviews that deliver savings of 10-30 percent above the PPO allowable with a signed contract, agreed upon and authorized by the provider.
“We are excited to welcome Kozani Health as part of our data-driven Valenz ecosystem,” said Rob Gelb, Chief Executive Officer. “By bringing our teams together, we are providing self-funded employers and the self-insured community improved cost savings at each step in the life cycle of a claim, strengthening their ability to realize every opportunity to balance cost, quality and utilization under the Claim Cost ArcSM. Our solutions aside, which clearly align value for all, our cultures and the commitment to customer service and ‘customer love’ will be a continuing defining characteristic of our now, collective success.”
Valenz is focused on changing the trajectory of healthcare expenses, creating new opportunities for self-insured employers to control costs while empowering members to lead strong, vigorous and healthy lives. Valenz delivers a 20-40 percent improvement in savings from traditional health plan approaches by bridging the divide between robust analytics, care management, high-value provider networks, payment integrity and claim management.
“We are energized to begin our company’s next chapter as Valenz ProteKHt,” said Michael Scott, Chief Executive Officer and Co-Founder of Kozani Health. “Integrating our claim management solutions into the Valenz ecosystem will accelerate the growth and evolution of our services and bring value to our customers.”
“With this integration, we assure clients they will experience the same close partnership and personal attention as they have with Kozani Health,” said Heather Wilson, Chief Operating Officer and Co-Founder of Kozani Health. “Now, we can also offer the benefit of being part of the Valenz ecosystem. Together, we are committed to nurturing the same ‘customer love’ that has made Kozani Health a symbol of success in the market.”
About Valenz
Vālenz® 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 connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
About Kozani Health
Kozani Health, headquartered in Mesa, Ariz., provides customized bill review and bill review sign-off solutions to analyze pricing, coding and care provided to ensure appropriate payment. Since its inception in 2015, Kozani Health has forged long-term customer relationships and continuously improved solutions to solve customer challenges.
About Great Point Partners
Great Point Partners, founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm with approximately $1.3 billion of equity capital currently 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, which has $307 million of committed capital. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III) and public equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 200 growing healthcare companies. The private equity funds invest across all sectors of the healthcare industry with a particular emphasis on biopharmaceutical services and supplies, pharmaceutical infrastructure, alternate site care, medical device 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
Vālenz® Appoints Brian Fabbro as Vice President, Business Development
/in Announcements, Events, Featured /by Maris PanjadaPHOENIX, Ariz. (July 16, 2021) — Vālenz®, a leading innovator for a data-driven ecosystem of solutions that reduces medical claim costs and promotes quality healthcare, today announced the appointment of Brian Fabbro as Vice President, Business Development. With more than 14 years’ experience in sales and account management in the health industry, Fabbro is highly skilled in business and market development and client services.
“With a tremendous background in developing strategic partnerships and delivering innovative medical cost containment solutions to the self-insured employer community, Brian is very well positioned for this key role in accelerating growth for the company,” said Nathan Nelson, Senior Vice President, Growth. “He offers a winning combination of creating and executing enterprise initiatives that exceed sales targets and take the company forward. We are excited to welcome him to the Vālenz team.”
Fabbro brings leadership experience in the healthcare and insurance industries and specializes in consultative benefit planning, cost management, and tailoring high-impact self-funded solutions to client needs. He excels in managing distribution channels, cultivating business partnerships, and developing new territories and revenue streams.
“It’s truly an honor to join a company that is leading the way toward lowering costs holistically and improving health outcomes through its unique ecosystem of data-driven services,” Fabbro said. “Valenz is an excellent fit for my skills, and I look forward to supporting business growth that aligns with better, more cost-effective healthcare.”
Before joining Valenz, Fabbro most recently served as Sales Director for a tech-enabled third-party administrator in St. Louis, Mo. He also has held key positions at other companies including Benefit Planning Consultants Inc., Cigna, and Washington National Insurance Company. Fabbro is a graduate of Butler University in Indianapolis, Ind.
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® Announces Partnership with Beecher Carlson
/in Announcements, Featured, Press /by Maris PanjadaRisk Bearing Provider Organization Assessment Can Help Minimize Risk, Drive Savings for Value-Based Care
PHOENIX, Ariz. (July 12, 2021) — Vālenz® has announced a strategic partnership with Beecher Carlson, an insurance brokerage firm that leverages advanced analytics for optimal risk management. Through this partnership, Valenz and Beecher Carlson collaboratively offer the industry’s most in-depth Risk Bearing Provider Organization (RBPO) Assessment for thorough, data-driven analysis of whether an organization is positioned successfully for two-sided risk contracts in a value-based payment model.
Value-based payment models offer significant opportunities to reduce costs, enhance quality and improve outcomes. However, the pay-for-performance reimbursement structure might not be right for every health system or provider group. This RBPO Assessment identifies areas that need assistance and offers solutions to address potential deficiencies. It also helps determine if the program goals and incentives are aligned with the organization’s expected results and endorsed by all stakeholders.
“While there is a high level of interest and enthusiasm for value-based care, the clinical and financial risks need to be carefully considered – and in a two-sided contract, cultural and operational requirements must be in place to ensure success,” said Rob Gelb, Chief Executive Officer of Valenz. “Through this partnership with Beecher Carlson, we are excited to provide actionable insights and proven solutions to guide our clients’ approach to value-based care.”
As noted by Brad Lawson, Senior Vice President-Provider Risk Solutions of Beecher Carlson, the RBPO Assessment financial models assess risk-reward ratios, quantifying maximum probable gains as well as the maximum probable losses. “The 360-degree data and trend analyses account for real-world conditions, allowing organizations to stay nimble, proactively manage risk, and prepare for developing situations – such as an influx of more serious cases following the COVID-19 pandemic as a result of delayed care,” he said.
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. Valenz is backed by Great Point Partners.
About Beecher Carlson
Beecher Carlson is a large account risk management broker that values depth of industry and product knowledge. Operating as a single profit center organized by specialization, we align our service teams to be structured based on what is best for clients’ business rather than geographic convenience. We go beyond one-off transactions and utilize advanced analytics on every program. By quantifying the effects each decision will have on a company’s risk profile, we take the mystery out of buying insurance. Execution on analytical findings is our true differentiator in mitigating losses and affecting process changes. Our collective success is earned by creating the ideal risk management solution for our clients. To learn more, visit beechercarlson.com.
Pairing Member-Centric Provider Access with Supporting Services Is Key to Sustainable Health Spending
/in Announcements, Featured /by Diane MorganSelf-insured employers understand the importance of providing access to high-performing, high-value providers to ensure members are offered the most effective health plan. Designing a network to achieve smarter, better, faster healthcare requires far more than a network of providers and facilities.
Employers require data transparency to identify the specific healthcare services their members need. They also need flexibility in network design to provide that access, along with quality and overall program value for their health plans.
For example, a high-performing contracted network might be appropriate for a health plan with members in close geographic proximity, while an open access solution could be a more aligned approach for a self-insured employer with a remote workforce. Others could benefit from a hybrid design that leverages aspects of both models while creating consistency across their program.
A strong place to start is considering how to balance quality, utilization and costs as you establish your network as the foundation of a broader platform for your members. When you combine a well-crafted, data-driven network with defensible market-based pricing and a range of care and claims management solutions, the result is a fully integrated health ecosystem – built to enhance transparency, enable quality decision-making, and improve total spend savings by 20-40 percent.
Low-value care is a significant source of inefficiency in the U.S. healthcare system, with estimates suggesting that 10-20 percent of annual healthcare spending (around $350 billion to $490 billion) is lost on unnecessary and often harmful care and wasteful spending. A high-value network model, “credentialed” through the use of big data and advanced analytics, will consistently drive quality care and sustain high customer satisfaction alongside lower plan expenses.
And as healthcare costs continue to increase, employers’ interest is trending in the direction of value-based care contracting models. While only 6 percent of employers had developed direct contracts with providers in 2019, 22 percent were considering a move to that model. Based on feedback from employers we engage with each day, the number of employers interested in value-based and direct contracting models is climbing.
Whichever model of provider access makes sense for your plan, you’ll need supporting solutions to drive optimal improvements in quality, utilization and costs across the life cycle of every claim. A holistic ecosystem will integrate high-value networks and open access models with enhanced solutions that bridge the divide between robust analytics and member-centric services.
With fully insured health plan costs rising by roughly 9 percent each year, the key to sustainable spending lies in the power of the fully integrated health ecosystem and a review of self-insured and self-funding options. When you combine all the elements necessary to drive improvements in quality, utilization and costs, you create synergy that lowers the Claim Cost ArcSM and supports strong, vigorous and healthy lives.
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About the Author: 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.
Nathan Nelson Promoted to Senior Vice President, Growth at Vālenz®
/in Announcements, Events, Featured /by Maris PanjadaNelson brings 20+ years’ experience in accelerating business growth to his new role
PHOENIX, Ariz. (June 2, 2021) — Leaders at Vālenz have announced that Nathan Nelson, MBA, has been promoted to Senior Vice President, Growth. Nelson joined the firm as Vice President, Business Development in April 2019. In his new role, he oversees the sales organization and will lead the company forward for strong business growth across all areas of revenue.
“Since joining the team two years ago, Nathan has been a catalyst for ensuring our vision and organizational strategies are delivered to the market, and for enabling brand awareness consistently,” said Rob Gelb, Chief Executive Officer. “He is the consummate team player and works to collaborate with every member of sales, client services and leadership.”
Nathan’s career spans two decades of proven success in sales and account management for the healthcare industry, primarily in the managed care segment. Prior to joining Valenz, highlights from his extensive career include sales and leadership in claim management, workers’ compensation, underwriting and account management. Nathan graduated magna cum laude with his master’s in business administration from Webster University in St. Louis, Mo.
“I am honored and excited to take this next step as a Senior VP at Valenz for many reasons, not the least of which is the extraordinary innovation Valenz delivers for the self-insured industry, as well as the providers and partners who support them,” Nelson said. “As we continue to grow our ever-expanding ecosystem – which is fueled by data and optimized by data transparency unlike anything other firms can provide – the growth opportunities for our team are limitless, as are the savings improvement opportunities for our clients.”
Nelson’s promotion is effective immediately. 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 Announces Strategic Partnership with Turquoise Health
/in Announcements, Featured, Press, Valenz Access /by Maris PanjadaDatabase of negotiated hospital rates elevates consumer transparency and choice
PHOENIX, Ariz. (April 26, 2021) — Vālenz® announced today a partnership with Turquoise Health, a software solutions company that facilitates consumer transparency through its newly launched platform listing payer-negotiated hospital rates.
With new price transparency regulations requiring hospitals to share previously undisclosed rates for many services, Turquoise Health has created the first comparison engine for consumers to make cost-effective decisions about their care.
With full access to Turquoise Health’s database of hospital rates, Valenz will incorporate the comparison information into its concierge-level navigation program and self-service member portal. Valenz also will utilize the data to build highly efficient networks that drive quality care and customer satisfaction alongside cost savings.
“Our partnership with Turquoise Health aligns with our data-driven ecosystem and helps us take a significant step toward providing the transparency our clients and their members need,” said Rob Gelb, CEO of Valenz. “Not only can we share the cost structure of hospital services to help guide members’ decisions, but we can also help them gauge the quality of the service. It’s a key component of the Valenz promise to assure smarter, better, faster healthcare.”
As of Jan. 1, 2021, the federal rule requires hospitals to publish a machine-readable file listing their negotiated payment rates for hundreds of medical procedures, as well as a website where consumers can search for services and prices. Initial compliance has been mixed, with reports of some hospitals blocking their pricing from showing up on web searches – making the Turquoise Health platform all the more valuable in elevating transparency.
CEO Chris Severn says its database currently has more than 2,000 verified rates, and the list continues to grow as Turquoise painstakingly combs through and verifies hospital pricing data.
“This is just the beginning of making hospital billing more clear and patient-friendly,” Severn said. “Using both public price rates data and Turquoise participating provider data, we are showing there is a market for transparency in healthcare. We help put negotiating power where it belongs — in the hands of the consumer.”
About Valenz
Vālenz® 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 connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
About Turquoise Health
Turquoise Health launched in 2020 with a vision to simplify healthcare reimbursement through price transparency. CTO Adam Geitgey, formerly a Director of Engineering at Groupon, brings deep consumer marketplace experience to the healthcare sector. Turquoise invites providers and payers to become Turquoise Verified partners. Using the software suite, organizations create “price certainty” for patients while easing claims adjudication on the back end. Turquoise already counts major revenue cycle partners and hospital systems as satisfied clients. To learn more, visit turquoise.health or email info@turquoise.health.
Engaging Early and Often to Manage the Boomerang Effect of COVID-19
/in Announcements, Featured /by Maris PanjadaThe COVID-19 pandemic continues to prompt many people to delay diagnostic testing and obtaining necessary medical care, leading to a decrease in both procedures and diagnoses. The result is the creation of unexpected utilization patterns, which the industry is only beginning to understand and attempt to reconcile.
While some patients delayed care for just a few months, others – including those with chronic conditions – have not yet returned for follow-up care and routine health screenings such as colonoscopies and mammograms. Researchers have predicted that patients will emerge with more serious health conditions, including later-stage diagnoses and more advanced stages of diseases such as cancer and certain cardiac-related conditions.
Consider these findings:
Engaging early and often to prevent long-term health consequences and increased costs caused by delayed care has never been more critical. Guided by insights from biometrics, utilization data and paid claims analysis, self-insured employers can identify gaps in care and engage members with real-time interventions, providing navigation to the right care path before serious issues occur.
Today’s technologies deliver insights from patient data, clinical drivers and social determinants of health to identify members at risk before their condition deteriorates. Once identified, care coordination to connect them with key resources 24 hours a day is possible. This level of continuous, evidence-based engagement guides better long-term health decisions while allowing self-insured employers to target the 5-15% of claims that drive up to 70% of health plan spending.
Self-insured employers will position themselves well to offer this level of support for their members through:
But it is not just about engaging the member. Establishing a central point of contact for everyone across the care continuum, from members to care providers and payers, delivers comprehensive care with transparency.
With the right tools and information, delivered in real time, self-insured employers will find actionable information at each step in the life cycle of a claim. From high-performance network design through comprehensive and complete bill reviews, data-driven insights lead to health care costs that are fair, defensible, transparent and consistent for everyone.
Long before the current health crisis began, we have embraced the Vālenz® core promise of delivering smarter, better, faster healthcare. Although COVID-19 has created numerous challenges, maintaining the health and well-being of our clients and employees is more important than ever. We remain committed to early health engagement and ensuring the right care paths to keep everyone strong, vigorous and healthy.
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Rob Gelb is Chief Executive Officer of Vālenz®, an ecosystem of data-driven solutions that creates new opportunities for self-insured employers to control costs while empowering members to lead strong, vigorous and healthy lives.
Maurice Steenland Joins Vālenz® Leadership Team
/in Announcements, Events, Featured /by Maris PanjadaAs Vice President, Strategic Enablement, Steenland appointed to accelerate value for Valenz clients
PHOENIX, Ariz. (April 9, 2021) — Vālenz® is pleased to announce the appointment of Maurice Steenland as Vice President, Strategic Enablement.
In his new role, Steenland will be responsible for synchronizing departments to accelerate strategic initiatives that bring greater value to Valenz clients, fulfilling the company’s strategic vision and mission. He will continue to drive the expansion of the firm’s data engagement solution, v-Lens, to advance predictive modeling, data-driven decision enablement and transparency across the ecosystem.
“We are excited to welcome Maurice to this key strategic role on our senior leadership team,” said Rob Gelb, Chief Executive Officer of Valenz. “With deep expertise in uncovering operational efficiencies and enabling data and analytics to inform better decisions, Maurice is an excellent fit for the Valenz team. His highly strategic and analytical approach will no doubt add higher levels of transparency across our data-driven ecosystem to deliver smarter, better, faster healthcare.”
Steenland brings 20-plus years in executive roles for health-related organizations. Most recently, he was principal consultant for SISIX, LLC after serving as Vice President, Informatics for Optum, where he managed the Informatics and advanced analytics and data science teams that developed client outcomes reporting, predictive tools and methods to identify emerging risk and cost containment programs.
Steenland also has held leadership positions at CIGNA Healthcare, Coventry Health Care and Intracorp, with specialization in operations, utilization management, strategy and business development. He earned his master’s in business administration from the prestigious Wharton School of the University of Pennsylvania.
“I’m thrilled to join such a future-focused team at Valenz and have the opportunity to pave the way toward quality, utilization and cost transformation through transparency, efficiency and data-driven solutions,” Steenland said. “As we combine analytics-driven approaches with influencing skills to drive change and efficiencies, I look forward to providing greater savings and solutions for our clients in the self-insured industry.”
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 connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
Vālenz Announces Acquisition of Kozani Health
/in Announcements, Featured, Misc., Valenz Claim /by Adam LeeKozani Health integrates as ValenzProteKHt™ for complete and comprehensive bill review solution
PHOENIX, Ariz. (April 1, 2021) — Vālenz® announced today it has acquired Kozani Health, integrating a new and innovative means for self-funded employers and the self-insured community to control costs across the life of a claim.
Kozani Health, which provides customized solutions to meet the challenges of paying medical claims appropriately, joins the ever-expanding Valenz ecosystem of data and solutions as Valenz ProteKHt™. The new solution offers detailed line-by-line bill reviews performed by nurses, certified coders and practicing specialists to uncover inappropriate billing and care provided.
With success rates averaging 70 percent, Valenz ProteKHt is the industry’s recognized comprehensive and complete bill review solution. Valenz ProteKHt offers clear, defensible, transparent and plan-specific reviews that deliver savings of 10-30 percent above the PPO allowable with a signed contract, agreed upon and authorized by the provider.
“We are excited to welcome Kozani Health as part of our data-driven Valenz ecosystem,” said Rob Gelb, Chief Executive Officer. “By bringing our teams together, we are providing self-funded employers and the self-insured community improved cost savings at each step in the life cycle of a claim, strengthening their ability to realize every opportunity to balance cost, quality and utilization under the Claim Cost ArcSM. Our solutions aside, which clearly align value for all, our cultures and the commitment to customer service and ‘customer love’ will be a continuing defining characteristic of our now, collective success.”
Valenz is focused on changing the trajectory of healthcare expenses, creating new opportunities for self-insured employers to control costs while empowering members to lead strong, vigorous and healthy lives. Valenz delivers a 20-40 percent improvement in savings from traditional health plan approaches by bridging the divide between robust analytics, care management, high-value provider networks, payment integrity and claim management.
“We are energized to begin our company’s next chapter as Valenz ProteKHt,” said Michael Scott, Chief Executive Officer and Co-Founder of Kozani Health. “Integrating our claim management solutions into the Valenz ecosystem will accelerate the growth and evolution of our services and bring value to our customers.”
“With this integration, we assure clients they will experience the same close partnership and personal attention as they have with Kozani Health,” said Heather Wilson, Chief Operating Officer and Co-Founder of Kozani Health. “Now, we can also offer the benefit of being part of the Valenz ecosystem. Together, we are committed to nurturing the same ‘customer love’ that has made Kozani Health a symbol of success in the market.”
About Valenz
Vālenz® 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 connects cost and quality data from comprehensive care management services (Valenz Care), high-value provider networks (Valenz Access), claim flow management (Valenz Claim), complete bill review (Valenz ProteKHt), and solutions for payment integrity, revenue cycle management and eligibility compliance (Valenz Assurance) for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners.
About Kozani Health
Kozani Health, headquartered in Mesa, Ariz., provides customized bill review and bill review sign-off solutions to analyze pricing, coding and care provided to ensure appropriate payment. Since its inception in 2015, Kozani Health has forged long-term customer relationships and continuously improved solutions to solve customer challenges.
About Great Point Partners
Great Point Partners, founded in 2003 and based in Greenwich, CT, is a leading healthcare investment firm with approximately $1.3 billion of equity capital currently 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, which has $307 million of committed capital. Great Point manages capital in private (GPP I, $156 million and GPP II, $215 million of committed capital, and GPP III) and public equity funds. Great Point Partners has provided growth equity, growth recapitalization, and management buyout financing to more than 200 growing healthcare companies. The private equity funds invest across all sectors of the healthcare industry with a particular emphasis on biopharmaceutical services and supplies, pharmaceutical infrastructure, alternate site care, medical device 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
Next Generation RBP Roundtable: Evolving Collaborative Approaches for a Balanced Reimbursement Strategy
/in Events, Featured, Misc. /by Adam LeeThe COVID-19 pandemic has had unprecedented impact on healthcare’s delivery, consumption and expense. While the use of virtual care has skyrocketed, 20 percent of U.S. households reported delaying care for serious problems during the pandemic, which can lead to major complications and catastrophic claims.
It is more important than ever for self-insured employers to have strategies in place that ensure their members are getting the right care, at the right time, from the right providers.
Vālenz® hosted a roundtable discussion focused on how the next generation of reference-based pricing programs focus on active collaboration between all parties to improve health outcomes while ensuring transparency.
Watch as Valenz CEO Rob Gelb and Adam V. Russo, Esq., Co-Founder and CEO of The Phia Group, discuss how innovative reimbursement strategies can bring balance to the quality-utilization-cost equation.
You will learn how the next generation RBP model integrates deep analytical insights with member-centric services to:
Click here to download a PDF of the slides.
Vālenz CaptiV: Reduce Risk, Gain More Control of Your Health Plan Spend
/in Announcements, Featured, Valenz Claim /by Adam LeeAs health care costs rise exponentially, self-insured employers are facing greater risks of high-dollar claims. Recognizing the significant risk-reduction advantages and cost-effectiveness of combining employer plans in a medical stop loss (MSL) group captive program, Vālenz® has launched CaptiV to solve the challenges market volatility can pose for small to medium-sized employers.
Valenz CaptiV goes beyond risk sharing to provide a fully integrated, data-driven model for cost and risk reduction. By bringing together employers that are committed to managing their medical costs while improving health outcomes – and equipping them to engage early and often via its end-to-end analytics platform – Valenz CaptiV represents the next generation of MSL group captives.
“We operate at the center of the MSL group captive, actively engaging the group of employers and their employees in our proprietary ecosystem of data and service solutions,” said Rob Gelb, Chief Executive Officer of Valenz. “Our analytic and predictive capabilities uncover new strategies to drive a 20-40 percent improvement in savings by targeting the high-dollar claims that drive the majority of health plan spending. We continually integrate those learnings among Valenz CaptiV members to reduce the potential for catastrophic claims and create value for everyone.”
For self-insured employers with fewer than 1,000 employees, Valenz CaptiV leverages a larger and more diverse population to reduce plan level and catastrophic risk, while delivering exceptional cost-reduction strategies, increased underwriting credibility, and long-term rate stability.
“For captive members, our ecosystem offers unparalleled data-driven collaboration. from pre-claim loss to post-claim resolution,” said Gelb, explaining, “Valenz solutions build on one another, providing actionable information at each step in the life cycle of a claim.”
To accelerate its captive offerings, Valenz partnered with MSL Captive Solutions, the industry’s only platform dedicated to the development and delivery of comprehensive services exclusively for MSL captives. MSL Captive Solutions works with top insurance carriers and claims administrators to deliver market-leading results for Valenz CaptiV members.
“Properly structured group captives have proved to reduce costs and increase plan stability by effectively managing, diversifying and broadly diffusing risk,” said Phil Giles, Managing Director of MSL Captive Solutions. “By taking a discerning approach to membership and enabling more active, data-driven risk management, Valenz CaptiV promises superior performance.”
Together, the firms offer more strategic, proactive risk control and cost-reduction decision-making. And, as costs are contained, Valenz CaptiV members share in the profitability of the program.
For more information on Valenz CaptiV, call (866) 762-4455.
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 MSL Captive Solutions, Inc.
MSL Captive Solutions is the industry’s only platform devoted exclusively to the development of comprehensive (re)insurance solutions for group and single-parent medical stop loss captives.
MSL Captive Solutions provides consultative underwriting support to some of the industry’s leading stop loss carriers and operates independently to work with all qualified brokers, consultants, and captive managers. For more information visit www.mslcaptives.com.