VBP CONTRACT MODELER FOR HEALTH PLANS

Transforming the way health plans develop, implement, and manage value-based payment contracts.

Better insights. Better contracts. Better performance.

The SpectraMedix VBP Contract Modeler with financial reconciliation enables health plans to create better value-based contracts by automating the modeling and development of multiple contract types — including pay for quality (PFQ), shared savings, shared risk, capitation, MLR arrangements, and total cost of care — across diverse contract portfolios.

It helps payers to actively identify and manage the value levers that have the biggest impact on network performance and contractual revenue, and empower their provider networks with these insights to improve outcomes and reduce costs.

How It Works

The SpectraMedix VBP Contract Modeler provides health plans and their provider networks with a collaborative solution to model, implement, analyze, and advance mutually beneficial contracts.

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Model Terms

Model alternative financial and quality performance scoring methodologies, risk assumption options, and other contract terms for your commercial, Medicare, Medicare Advantage, and Medicaid business lines.

Empower Providers

Identify, evaluate, and pull the “value levers” that impact utilization, cost, and quality. Identify and implement opportunities for improvement, including creating narrow networks or high-performance networks.

Maximize ROI

Project and maximize return on investment for value-based contracts with our ROI modeling capability that identifies the key areas that impact your bottom line and assists you in addressing them.

Features

Flexible Market Definitions

For defining contract terms including line of business, product line, and geography.

Custom Attribution Models

Build custom attribution models that combine both plurality-based algorithms and voluntary alignment.

Network Creation

Create high-performance networks, including determining a common measure set, quality benchmarks, cost benchmarks, and anchoring them to VBP contracts.

User-Defined Contract Terms

Base your contracts on the terms that matter most, including alternative budget methodologies, stop-loss limits, shared savings-loss corridors, and quality scoring.

Standard VBP Contract Templates

Test alternative contract terms to come up with an agreement to offer to a specific group or to use as a standard contract.

Adaptability and Flexibility

VBC arrangements are continuously evolving — the VBC Contract Modeler is regularly updated and configured to serve existing and changing requirements.

SDoH and Behavioral Health

Integration of behavioral health and SDoH measures within populations.

Benefits

EFFICIENT — Enables users to model a value-based contract in under an hour.

SIMPLE — Provides a means to painlessly implement a value-based contract.

ACCURATE — Delivers a proven methodology to model a value-based contract.

CONSISTENT — Avoids the variability of manual modeling efforts.

PERMANENT — Provides for the storage of contract terms, both used and unused.

TRANSPARENT — Shares methods and assumptions with provider groups.

INTEROPERABLE — Shares data with our analytics and cohort manager solutions.

SUPPORTIVE — Identifies candidates for expansion and growth efforts.

Value-Based Savings Calculator

SpectraMedix has created a savings calculator that estimates the amount a health plan can save by utilizing our VBP Contract Modeler in its contract(s) development process.

Learn More About Our Value-Based Contracting Capabilities

Download an overview of our value-based care solutions for payers to see how your health plan and provider network can achieve better contracts and performance.

How can we assist you?

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