Business Intelligence

Today's provider organizations must have actionable financial information at their fingertips to manage declining reimbursements, shifting utilization patterns, and increasing cost pressures. Mapping the transition to value-based care is a fundamental strategic process, but many organizations don't know where to begin. 

In addition to clinical guidelines, providers need to consider cost per provider, per patient, and per condition. Valence combines the expertise of on-staff actuaries with robust technology to provide valuable insights.

Valence Solution

vQuest, Valence’s Cost and Utilization module, allows users to dissect and track costs and variations for a variety of metrics and benchmarks including:

  • PMPM medical costs
  • DRG Summary
  • Pharmacy costs
  • Inpatient costs and outcomes benchmarks
  • Trends and variances
  • Productivity and outcome comparisons at provider, practice, location and entity levels

Results

Texas Children's Hospital

  • Monthly trends and performance tracking
  • Utilization and costs in-line with benchmarks

Alliant Health Plan

  • 10+ years of full analytical support
  • Enhanced product pricing
  • Now dominant payer in market

Easy Choice Health Plan

  • Reduced MLR
  • Improved premium values
  • Promoted product alignment for value-based care