Healthcare is advancing quickly toward new models of value-based care and payments, and along the way prompting employers and providers to help create healthier populations through better care and smarter spending. At Benefit Management, we know these new models bring with them unique needs and challenges, so we’ve built an innovative team of healthcare and finance experts to keep you ahead.
Our Value-Based Administration (VBA) program offers value-based payments and benefit packages, including a turn-key bundles program, capitation, shared savings and pay-for-performance. We then automate the claims administration and payment distribution to ensure accurate and efficient payments with a scalable solution.
The best part? Our VBA services don’t require you to change any daily processes or operations—you simply enjoy the benefits of value-based payments, including healthier populations and smarter spending.
People, Processes & Technology
By bringing together people, processes and technology, we can constantly adjust and elevate our approach according to the individualized value-based payments in place.
Effective value-based administration demands more than the ability to process a claim. It’s about knowing how a network is built—inside and out—it’s about understanding how providers are contracted and how reimbursement models should function.
That’s why Benefit Management built a team of highly skilled individuals representing decades of specialized industry experienced, including:
- 30+ years contracting with health plans, providers, and Clinically Integrated Networks (CIN) for value-based payment models, bundled payments, and Patient Centered Medical Homes (PCMH)
- 20+ years building provider networks and maintaining provider contracts and demographic/payment information
- 10+ years representing independent and employed providers to payors
In all things, we aim to constantly improve our process. For the VBA service line, we knew the process would have to include both automation and flexibility because every value-based payment includes unique features, such as individualized bundle definitions, benefit design and contracted providers.
Today, our processes address the unique needs of every client and contract, with capabilities that include:
- Utilize existing systems to administer value-based payments
- Automate claims processing, payment administration and
- Seamlessly maneuver and scale complex value-based payments
- Ensure timely and accurate payments to providers
- Administer provider incentive criteria tied to value-based
We know value-based payment models will depend largely on technology for success, so we aligned with Oracle, a multinational technology leader, to develop custom software that enhances our ability to administer value-based payments.
Technology-driven features and capabilities include:
- Load, track and manage value-based payment contracts
- Load provider agreements and payment models
- Reconcile clinical and claims data
- Implement quality metrics payment administration and distribution
- Manage auditing, reconciliation and reporting
With comprehensive consultation and advisory services, providers and payors can take advantage of our expertise and insight while automating the administration of their value based payments. To set you up for success, our consultation team offers:
Ready for next-level success? Let our people, processes and technologies guide you along the way—we can help you conquer the challenges of healthcare reform and capitalize on the opportunities of value-based administration.