Value Based Care Enablement Solutions

Services, resources, and tools for payers and providers who seek to improve patient care outcomes and efficiencies as they transition to value-based care and reimbursement.

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Speed Your Transition to Value-Based Care and Reimbursement


Expert guidance for your journey

This is a critical time for healthcare in the United States. Payers and providers alike recognize the shift to value-based care, but most are struggling to make the significant adjustments needed to achieve success.

At Change Healthcare, we strive to be a catalyst for the national shift to improve the quality of care and patient engagement.

By working directly with our payers and providers, we help organizations experience success from the initial pilot stages to full-scale implementation.


Assess, automate, and expand your care models

Leading payers are shifting to alternative care and payment models focused on value. Change Healthcare helps payers evaluate and design value-focused initiatives, providing you with the data, tools, and support you need to engage providers and administer successful programs.

We leverage advanced analytic tools to evaluate claims and member needs to identify the value-based models most likely to deliver high-quality, cost-efficient care within your specific provider base. Once implemented, we provide ongoing analytic and clinical expertise to help you evolve and expand the benefits of your value-based programs.

Through a combination of analytic tools and care coordination services, we help providers reach their patient populations to help improve outcomes, enhance the patient experience, and increase revenue — a critical step on the path to value-based care delivery.

 Improve Outcomes and Increase Revenue

  Bundle Claims in Real Time
Scale prospective bundled payment programs

With real-time visibility into episode activities, payers can influence the outcomes of active episodes. Our Episode Management product helps you develop, manage, and scale prospective bundled payment programs, working within your current claim workflows to automate value-based programs.

As a result, you're able to scale your programs by bundling claims in real time, as they come in. The flexible system uses claims adjudication logic to help you increase bundled payment auto-adjudication.

Manage Alternative Payment Models
Reduce costs with configurable analytics

Monitoring alternative payment models is time-consuming and complex. Our HealthQx is a software as a service (SaaS) healthcare analytics platform designed to simplify the design and administration of bundled payments, ACOs and other at-risk arrangements.

HealthQx is a certified HCI3 Prometheus Analytics platform that helps you reduce medical costs by increasing clinical efficacy, improving over and under-utilization, and more. Drill-down dashboards support provider engagement and contract negotiation.

HealthQx helps customers reduce administrative tasks for value-based payment programs by approximately 20-30%.

 Develop a Care Coordination Program
Improve care quality and patient engagement

Approximately 93% of Medicare spending is on beneficiaries with multiple chronic conditions. Time constraints make it difficult for providers to manage this population, especially between office visits.

Our care coordination services can help you improve patient engagement and quality of care, while receiving payment through the CMS chronic care management program. Our services help you meet CMS billing requirements for chronic care management, complex chronic care management, and the Merit-based Incentive Payment System (MIPS).

Achieve Better Outcomes
Manage your ACO business

Our Accountable Care Services consultants guide you through initial applications and contract negotiations and provide daily operational management assistance. Services include care coordination and utilization management; claims, finances, and call center management; and provider aggregation, care-quality management, and reporting.

Our advanced data warehouse and decision support tools, including population health management, can help you ensure patients receive the care they need.