Supercharging Value-Based Program Growth with Edifecs

AN EDIFECS CASE STUDY

The healthcare industry as a whole is steadily moving towards value-based care. Depending on the member population, complexity of value-based contracts, and the ability to collect and harness the vast amounts of data needed to deliver value-based care, some health plans can take longer than others to make the transition.

Our customer, a member-owned health insurer serving over 20 million members nationwide, faced challenges in all three areas. To meet the needs of their large and diverse member base, the plan needed to implement a variety of complex value-based contracts—and establish a unified data infrastructure that could handle it all.

In this case study, we share how our Population Payment Management solution helped streamline value-based contracting and administration, enabling the plan to grow their value-based contracts by over 1300%.