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Transformative plan designs,
Until now, employers and their TPAs have needed to make a difficult choice. Either spend more on providing employees with healthcare coverage at the expense of their business, or put additional cost and burden directly on the shoulders of employees and their families.
Watch the video to learn how Signify Health Value+ Plan Designs help employers say goodbye to the ultimatum – offering a path toward a more affordable, quality-driven, and transparent health plan option.
Better value without sacrifices?
Doing what’s right for plan members and what’s right for business shouldn’t be at odds. With Signify Health’s Value+ Plan Designs, affordability and quality don’t come at the expense of experience or provider choice. By applying Value+ as a customizable add-on or “wrap” benefit, TPAs and employers can offer an alternative to today’s costly, fragmented fee-for-service structure without disrupting network access.
Address more spend
Get secure fixed, packaged prices for entire health episodes addressing 60-100% of the average plan spend, depending on configuration
Promote high-value care
Promote the use of high value providers by plan members experiencing a qualified health episode, with transparent costs and no surprise billing
Lower the average member out-of-pocket for some health episodes from over $3,000 to under $200
Improve care quality
Improve patient outcomes by vetting providers for cost and quality, and holding them clinically and financially accountable for outcomes
Reduce plan expenses
Significantly reduce medical spend by offering protection from annual inflation, wide variation in provider prices, and low-value treatments
Activate alternative payment models and value-based
insurance design, all with one solution
Supercharge your health plans with a convergence of episodes of care alternative payment models (APMs) and value-based insurance design (VBID).
An episodes of care alternative payment model (APM) financially rewards providers based on the holistic health outcome of a patient over the entire course of treatment for a condition or illness. Episodes of care simplify healthcare financing by bundling all services and costs related to the treatment together under one guaranteed price tag.
Value-based insurance design (VBID) aligns plan members’ out-of-pocket costs with the value of health services received while removing barriers to necessary care and introducing barriers to unnecessary care. Value+ uses unique cost-sharing and incentive mechanisms to encourage plan members to seek high-value care providers.
How Value+ Plan Designs work
Activate a high-value provider network
Value+ Plan Designs identify, contract, and engage local, regional, and national high-value providers that are clinically and financially accountable for better outcomes over entire health episodes. By pre-negotiating episode prices with participating Value+ providers – then steering members towards the highest-performing based on cost and quality – healthy competition is created by delivering high-quality care at a reasonable cost.
Secure fixed, guaranteed prices
Value+ Plan Designs secure fixed prices for episodes that address 60% to 100% of total medical costs, depending on the plan sponsor’s configuration choices. We offer the widest breadth of episodes available today, spanning chronic conditions, procedures, maternity, behavioral health, substance abuse, and more.
Incentivize high-value care
Customized and flexible incentives programs encourage plan members to seek the highest-value, episode-contracted providers when experiencing a qualified health episode. These incentives are often in the form of significantly reduced out-of-pocket expenses and/or cash bonuses. Plus, transparent quality and price information helps plan members make the right choices along the way. When choosing a Value+ provider, plan members will never receive an unexpected bill for health care expenses - and despite the lower plan member cost-sharing, the plan can maintain its current actuarial value or even improve it.