EPISODES OF CARE
Value+ Plan Designs™
Powering the nation’s first value-based
health plans with episodes of care
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.
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
Reduce cost-sharing
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
WHITE PAPER
See the latest from the experts at Manatt Health on how episodes of care payment models can be implemented into employee health benefit designs.
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.
WHITE PAPER
Learn from industry experts at the University of Michigan’s VBID center on why converging APMs and VBID creates a more accountable, affordable, high-quality healthcare ecosystem for employers and plan members.
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.
WHITE PAPER
Discover how commercial health plans save money and improve outcomes through episodes of care alternative payment models in a report from Milliman.
Flexible designs, meant to fit your unique needs
Depending on your current plan design and cost-sharing levels, Signify Health will offer personalized guidance to the various dials and parameters that can be customized and help you maintain or improve the actuarial value of your plan.
Ready to chat about Signify Health Value+ Plan Designs?
