Bundled Payments
Easily design, administer and monitor complex payment programs

Bundled payments are quickly becoming the most sought after new plan design component for large employer groups and Medicare Advantage products, however most plans are struggling to deliver on value-based care through bundles. With Advalent’s payment solutions, plans can easily design a bundled program that works best to meet the needs of their customers, while also meeting their own business and quality objectives.

Key Features:
  • Program Design and Contract Targeting – Analytics help plans identify the best providers and episodes to target with bundled contracts to drive both savings and quality improvements.
  • Payment Adjudication – Automated, rules-based, real-time adjudication offers the flexibility to adjudicate bundled claims and bundle carve-outs prospectively, retrospectively or as a combination.
  • Fraud Prevention – Advanced analytics monitor performance and payments in real time, detecting and preventing duplicate payments before they happen.
  • Contract Management – Rules-based, smart contract templates allow plans to efficiently manage value-based payment programs of any type and enable the phasing in of value-based contract terms as their network becomes more adept at delivering value.
  • Patient Engagement – Virtual and automated patient engagement paired with advanced care coordination tools and services helps patients make healthy and appropriate choices, speeding up recovery time and improving overall satisfaction.
  • Provider Support – Provider decision support tools help guide patient steering and treatment appropriateness to maximize quality while keeping care affordable for patients.
  • Performance Metrics – Ongoing feedback on provider quality and patient outcomes provide valuable insight into quality and cost, allowing plans to drive continuous improvements of their programs.