Signify Health  

Healthcare doesn't begin when the patient enters the provider’s office — and it doesn’t end when s/he exits. Episodes of care programs are designed to address those financial and medical realities, bringing together comprehensive care and cost reduction through an approach that also improves the member experience. This ‘inclusivity’ makes the episodes of care experience greater than the sum of its parts.

Watch this video to learn how an episodes of care program that delivers guaranteed fixed prices, high-performing providers, and quality gates throughout the process can address 50% of medical spend and help to improve patient outcomes.

Learn more

• BLOG: Episodes of Care: A Better Path to Improved Clinical and Financial Outcomes

• PODCAST: Insights on employer demand for episodes of care and Centers of Excellence: An interview with AON Health & Benefits

Activate alternative payment models and value-based insurance design, all with one solution

• An episodes of care alternative payment model (APM) financially rewards providers based on the holistic health outcome of a patient over the entire course of treatment for a condition or illness. Episodes of care simplify healthcare financing by bundling all services and costs related to the treatment together under one guaranteed price tag.
• Value-based insurance design (VBID) aligns plan members’ out-of-pocket costs with the value of health services received while removing barriers to necessary care and introducing barriers to unnecessary care.  Value+ uses unique cost-sharing and incentive mechanisms to encourage plan members to seek high-value care providers.

How Value+ Plan Designs work 

• Activate a high-value provider network

Value+ Plan Designs identify, contract, and engage local, regional, and national high-value providers that are clinically and financially accountable for better outcomes over entire health episodes.  By pre-negotiating episode prices with participating Value+ providers – then steering members towards the highest-performing based on cost and quality – healthy competition is created by delivering high-quality care at a reasonable cost.

• Secure fixed, guaranteed prices

Value+ Plan Designs secure fixed prices for episodes that address 60% to 100% of total medical costs, depending on the plan sponsor’s configuration choices. We offer the widest breadth of episodes available today, spanning chronic conditions, procedures, maternity, behavioral health, substance abuse, and more.

• Incentivize high-value care

Customized and flexible incentives programs encourage plan members to seek the highest-value, episode-contracted providers when experiencing a qualified health episode.  These incentives are often in the form of significantly reduced out-of-pocket expenses and/or cash bonuses.  Plus, transparent quality and price information helps plan members make the right choices along the way.  When choosing a Value+ provider, plan members will never receive an unexpected bill for health care expenses - and despite the lower plan member cost-sharing, the plan can maintain its current actuarial value or even improve it.