HealthQx Episode Insights™

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

Let Data Drive Your 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.

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.

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.

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 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.

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Additional Resources

Value-based Reimbursement State-by-State

Review current state strategies in this national study of state value-based payment models.

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Accelerate Value-based Reimbursement with Data-driven Consulting

View our HealthQx® Analytics as a Service brochure to learn how to accelerate value-based reimbursement with data-driven consulting.

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