Value-Based Managed Services

As value-based care and payment models continue to emerge and evolve, provider organizations are confronted with the need for new expertise. Not only do organizations need to measure and effect clinical care, they also have to manage various forms of “risk contracts," payment programs, and even provider- sponsored health plans.

Quick facts

  • Supporting clients since 1996
  • Provide support for 500,000 lives
  • Processed more than 10 million claims
  • Licensed TPA
  • Staff includes more than 220 employees and, 40 nurses, all with an average industry experience of 7.5 years
  • Experts complete more than 20,000 member and provider calls a quarter

Capabilities

Valence Health offers a full suite of managed services. With a staff of seasoned professionals, each with more than 10 years of industry experience, Valence performs core functions on behalf of its clients so they can focus on their patients. From Medical Management to Claims Processing to Financial Reporting, Valence creates a customized relationship with each client. This relationship evolves over time, as customers gain experience, scale, and confidence. With the goal of a long-term partnership, Valence supports clients on each step toward the value-based model.

Our managed services include:

  • Provider relations
  • Complete member management
  • Benefit Coordination
  • Member and provider call center
  • Claims processing
  • Financial accounting and reporting (internal and regulatory)
  • Care management
  • Cost and utilization analysis management
  • Provider capitation and reimbursement payments
  • Broker commission management
     

Client Benefits

  • Allows clients to enter the value-based spectrum at a place that is most appropriate
  • Empowers clients to grow or start their own health plan or risk arrangements quickly and cost effectively
  • Facilitates adoption of tested “best practice” methodologies
  • Provides “instant-on” bandwidth and expertise to take advantage of market opportunities

Sample Clients 

“Valence Health’s willingness to go above and beyond the call of duty has contributed to our ability to maintain regulatory compliance and improve the care of our members.”

Mary Dale Peterson, MD,
President & CEO
Driscoll Children’s Health Plan


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