All the data that is needed to create the right strategy to transform from volume to value is already abundantly available. The trick is harnessing the necessary insights from it.
The EnlaceTM Opportunity Analyzer organizes and aggregates information to reveal where opportunities exists to improve pricing and quality. We score potential areas of improvement and highlight the greatest opportunities available.
Data has little meaning without context. Whether you are looking for insights related to an episode, a provider group, or by facility, the Opportunity Analyzer provides the context needed to answer complex questions and determine the impact of your value-based care initiative.
As you continue to move to a value-based care ecosystem you will need to be prepared to skillfully manage clinical and financial risk.
The EnlaceTM Program Builder allows you to run standard methodologies, modify standard methodologies or develop completely custom episodes of care. This gives you the insight of how your payment policies will impact your business financials and performance outcomes.
These data-backed insights provides the ability to project the savings that are available for each episode of care and drill down even further to focus on specific populations.
Creating a value-based care culture means having the ability to view the complete picture of their program.
EnlaceTM Pricing Modeler drills into specific areas of each opportunity to provide cost savings insights. Once there is a clear, data-driven value-based care foundation, you can use the Pricing Modeler to make confident decisions around the terms of your contracts.
The Pricing Modeler empowers you to launch the right initiatives at the right time, ensure continuous improvement across the care continuum.
Whether you are looking at the broader value-based care program or a specific data point, our powerful reporting tools has the flexibility to provide actionable data to ensure your program’s success.
The EnlaceTM Reporting Monitor assesses ongoing performance and the growth of value-based initiatives. Once an episode is live, this tracking and reconciliation solution monitors and regularly reports retrospective data that enables you to finalize key parameters for a contracted program.
Claims Payments alleviates burden in the administrations of VBC payments. Enlace Health understands that clients have different entry points into the VBC space. Enlace enables our client partners to manage multiple VBC contracted programs and helps in the adjudication of these programs. Moreover, Enlace also is able to help and oversee the disbursement of funds to the appropriate contracted entities on behalf of our client partners. Our Claims Payment platform scales to fit any VBC model.
The Claims Payment platform is a natural extension of Enlace’s administrative offering, including our Claims Administrator. VBC payments can be generated and submitted on a timed cadence or can be event-based. Clients will be able to track and monitor payments, as well as have access to the appropriate operational dashboards to track program performance.
The Claims Platform offers end-to-end tools for our provider and payer partners, from initiation of payments, to full program reconciliation. Our team will also provide necessary support to answer questions.
Claims Administrator gives our client partners the ability to operationalize and scale any value-based care program through direct communication with our fully customizable Program Builder module. Via a one-time seamless integration with existing claims system, the Claims Administrator manages claims-related reporting and reconciliation and communicates with the claims or finance system on the amount to be paid to the provider.
Once the integration is completed, the Enlace Claims Administrator will scale to store and manage multiple contracts, including bundles or Episodes of Care(EoCs) and other VBP programs, such as capitation, ACO programs, total cost of care (TCoC), etc. The Claims Administrator platform provides the solutions needed to manage the complexities of building and managing a value-based care ecosystem. This platform promotes real-time program administration, providing a natural extension of fee-for-service claims administration without additional interruption.
Enlace partner clients will be able to track and manage patients throughout the VBC program lifecycle to ensure proper care management pathways are being adhered to, while avoiding pathways that result in poor quality or lower savings. The power and flexibility to handle multiple risk arrangements in near real-time alleviates burdensome “pay and chase” scenarios and offers full reconciliation support.
Operational dashboards are developed and configured in close collaboration with the client. The reports provide transparency and key insights, including contract networking, finance, and operations. The suite of operational reports is available in an interactive portal that is accessible by SSO or portal login.