Advalent Network360™ – Network Transformation Solution
Cost Analytics Powered By Milliman Advanced Risk Adjusters (MARA™)

Advalent Network360 allows measurement of provider performance variation from a multi-dimensional perspective (Quality, Risk Score Accuracy, Care, Costs and Utilization) thereby allowing payers and risk bearing providers – to deploy the right kind of value-based contracts with the provider community. In addition, the platform presents actionable and integrated gaps (quality, care, RAF/HCC, predicted adverse events) attributed to providers – to improve clinical and financial performance.

  • Identify the right providers for value-based contracting

    Measure provider efficiencies to design networks that meet population characteristics and plans financial and clinical goals

  • Draw performance comparisons by tapping into benchmark data

    Comparative Analytics and multi-dimensional indexing to perform peer group comparisons using regional and national benchmarks

  • Pinpoint the areas for attention within each group or hospital in the network

    Identify the right performance metrics along with targets for the right providers to drive performance improvement

  • Track provider performance across all the contracts

    Continuously measure provider performance (as against the metrics and targets) during the benefit-years to offer proactive support

  • Improve Clinical and Financial Performance

    Actionable provider level insights across care, quality, risk score accuracy, costs and utilization for provider engagement

Advalent Network360™ Features
  • Measure provider/network performance variation from a multi-dimensional perspective connecting Quality, Risk Score Accuracy, Care, Costs and Utilization

  • Draw peer-group comparisons by identifying outliers and pinpoint providers that can address majority of the plan inefficiencies

  • Create actionable list of members to drive comprehensive gap closure activities targeting the providers

  • Identify contract optimization opportunities to enable value-based contracting and deploy the right provider collaboration programs

  • Out-of-the-box provider attribution and risk-adjustment algorithms along with ability to configure plan-design characteristics

Benefits

HOLISTIC Provider/NETWORK EVALUATION

Holistic profiling and benchmarking of physician performance and efficiencies – quality, care, cost, utilization and risk score accuracy trends – using advanced data visualization and analytics methodologies

Drive Integrated Quality, Risk Adjustment and Population Health Programs

Identify quality/care gaps, RAF/HCC gaps, and potential adverse events (ER utilization, readmissions, preference sensitive treatments etc) and drive provider engagement to improve plan-level clinical and financial performance.

Optimize Provider Networks

Significantly improve network efficiencies by leveraging top performers and supporting low-performing providers through varied provider collaboration strategies.

Understand and Design Value-Based Contracts

Proprietary analytical models enable decision makers to identify suitable value-based contracting arrangements and support providers in their journey toward value based care.

Enhanced Network and Clinical Performance

Enhanced provider governance and targeted recommendations facilitated via performance reports to act on “low-hanging” opportunities to improve health outcomes.