Value-Based Care

We provide analytics and services that give payers insights to help transform their value-based care programs. Our solutions help you find opportunities to bend the cost curve.
 

Help improve quality while lowering costs and elevating the member experience

While healthcare stakeholders are aligned on value-based care methodologies, scaling and adoption hurdles remain. To facilitate meaningful collaboration, payers and providers need accurate, timely data to show the cost and quality of care. Payers need tools to identify opportunities to apply interventions that will have the greatest impact. 

Translate data into insights

Predictive Analytics employs artificial intelligence (AI) and machine learning to help identify prospective and retrospective opportunities to improve quality and reduce costs. This helps payers pinpoint the right providers, target the right episodes of care (EOC), and set the right payment. 

Solutions that improve connectivity


Apply a standardized methodology

Optimizing and scaling value-based care programs requires a consistent view of performance. Change Healthcare’s Prometheus Analytics provides enhanced access to standardized content and methodology. Payers are empowered to measure and define episodes of care to help drive improvements across the healthcare ecosystem.

Learn how Prometheus Analytics helps improve value-based reimbursement results

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Improve provider adoption and engagement 

Our value-based care solutions provide data to inform all parties about how the VBC relationship is structured and measured. This transparency helps you establish and maintain trust with your provider network to enable a productive partnership.


Reach your value-based care goals faster

Once implemented, our solutions help you enhance your value-based initiatives by helping you quickly analyze and understand episode costs to refine your existing initiatives and identify new opportunities. 

Advance Your Value-Based Care Programs

Quickly target the right episodes and providers

Pinpoint opportunities for improvement

Analyzing vast amounts of claims data to accurately identify episode costs is often challenging. It requires claim coding knowledge and robust analytical tools capable of managing large claim data sets—and this process must be repeated monthly for the life of your value-based care program.

Change Healthcare simplifies the analysis of episode claims costs, providing fast, accurate, and secure claims analytics to help you easily identify and quantify VBC opportunities to target. In addition to learning about your savings opportunities, you will also get an actionable plan that identifies your next steps in managing your provider network.

Help reduce administrative costs and improve accuracy

Better care quality, lower costs

Eliminate waste and reduce costs while improving the quality of care delivered.

Monitoring alternative payment models is time-consuming and complex. Our value-based care solutions help simplify the design and administration of bundled payments, ACOs, and other at-risk arrangements.

Better measure and operate against your VBC outcomes to drive improvements with our comprehensive, integrated solutions.

Leverage our solutions to establish episode targets, manage episode budgets, and calculate provider payments, reducing the administrative costs and inaccuracies typical in manual VBP tracking approaches.

Conquer provider adoption and engagement challenges

Drive large-scale adoption of your VBC programs

Some programs have failed to produce meaningful savings or improved outcomes. Others were not a good economic match for providers, or never gained adequate support. Still others showed promise but fell victim to their inability to scale.

To drive meaningful change, VBC programs, payers, and providers need to leverage coordinated analytics that operate from a common definition of care. This ensures alignment, increases trust, improves provider engagement, and ultimately improves the quality of care.

Giving providers a more complete view of the care continuum will help them identify opportunities to improve care and lower costs.

$4B

in medical expenses saved in 2019 by Humana through its transition to VBC for its Medicare Advantage beneficiaries.1

33%

of covered lives impacted by Change Healthcare’s support of payers’ and providers’ VBC initiatives.

$153M

saved by Blue Cross Blue Shield of North Carolina in its first year after transitioning to value-based care.1

Source:
1. https://www.fiercehealthcare.com/hospitals/industry-voices-pandemic-shows-why-value-based-models-are-future-u-s-healthcare (Dec 14, 2020)

Explore Our Value-Based Payment Solutions