Solution

HealthQx Episode Insights™

A data-driven consulting service for payers, TPAs, and providers who want to identify, design, and scale value-based initiatives.

 

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Let Data DriveYour Value-Based Initiatives

  • Leverage your claims history to improve care quality and help reduce costs. Our experts use data to identify and analyze care variations, then deliver episode opportunities to drive value-based improvements.

  • Drive physician adoption of VBR initiatives using our transparent provider-attribution reports. You can identify and target providers for discussions to garner buy-in and facilitate change.
  • Develop measurable value-based care strategies based on episode analytics.  You can quantify the potential impact of each strategy to help prioritize staff and resource investments.

  • Launch, grow, and evolve your value-based programs with insights and guidance from our team.  Our consultants have helped advance the value-based programs of TPAs and payers representing almost one-third of all commercial-covered lives.

Accelerate Your VBR Transition

  • Identify VBR entry points

    • Analyze payment history, using models developed by the Health Care Incentives Improvement Institute (HCI3) to identify the episodes and providers to target for a VBR program.
    • Work together with our consultants on VBR opportunities in your market and receive guidance on initial targeting

  • Tailor programs to help increase provider engagement

    • Enable collaboration between health plans and providers to help improve the quality of care at a reasonable cost.
    • Create a framework for transparent, evidence-based discussions about medical costs and quality based on episode-of-care definitions, ranging from acute conditions to major procedures.
    • Model provider contract terms needed to reflect value-based payment program performance and reimbursement levels.

  • Monitor VBR program results

    • Compare actual performance of budgets and targets with benchmarks for VBR and fee-for-service plans with help from our consultants, to identify improvements after initial implementation.
    • Receive guidance to help you adapt, evolve, and scale your VBR strategies based on initial program results.

Our outcomes

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As health plans everywhere launch Total Cost of Care (TCOC) initiatives, many are leveraging a comprehensive solution to help lower costs and improve outcomes.

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On-demand Webinar

The Evolution of Value-Based Care

On-demand Webinar

The Evolution of Value-Based Care

Learn how to use retrospective analysis to define equitable, empirically grounded Episodes of Care that you can successfully apply in a prospective context.

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On-demand Webinar

New Innovations in Value-Based Care Webinar

On-demand Webinar

New Innovations in Value-Based Care Webinar

Discover how new technology and collaboration are creating powerful VBC models.

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Together, we are accelerating the journey toward improved lives and healthier communities.