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EPISODES OF CARE

Value+ Plan Designs

Powering the nation’s first value-based
health plans with episodes of care

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Transformative plan designs,
transformative results

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.

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Better value without sacrifices? 
No problem.

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.

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Address more spend

Get secure fixed, packaged prices for entire health episodes addressing 60-100% of the average plan spend, depending on configuration

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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

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Reduce cost-sharing

Lower the average member out-of-pocket for some health episodes from over $3,000 to under $200

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Improve care quality

Improve patient outcomes by vetting providers for cost and quality, and holding them clinically and financially accountable for outcomes

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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).

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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.

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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.

Download the white paper

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.

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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.

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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.

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WHITE PAPER

Discover how commercial health plans save money and improve outcomes through episodes of care alternative payment models in a report from Milliman.

Download the white paper

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.

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Learn more about Value+ Plan Designs

See if Signify Health Value+ Plan Designs are right for you with our detailed product overview.

Download the brochure

Learn more about
Value+ Plan Designs

See if Signify Health Value+ Plan Designs are right for you with our detailed product overview.

Download the brochure

Ready to chat about Signify Health Value+ Plan Designs?

Contact us