CHICAGO, October 14, 2020 – Apervita, a trusted healthcare technology leader delivering innovative technology solutions to payers, providers and other stakeholders, today announced an enhancement to QPay™, its recently launched contract performance management solution. This new capability captures and stores key terms in value-based contracts which are applied to the calculations in QPay for performance insights and guidance for anticipating final settlement results.
These shared-risk payment models require the ability to maintain and manage a growing number of contract terms. Key terms that figure into the final reconciliation of value-based contracts can include cost targets, excluded services such as behavioral health services or pharmacy claims, and stop-loss methodology. The benefits of this new capability include the ability to organize value-based contract terms and streamline information flows marooned in spreadsheets and static documents, and to actively manage the ever-changing physician rosters.
QPay now includes a powerful feature that solves a major pain point for payers and providers: viewing and managing provider rosters. Being able to capture the relationship between a physician or provider practice and a health system is critical to ensure the appropriate health system is held accountable for the patients and is properly reimbursed. There can be much physician movement in and out of health systems during a contract period. Having a reliable way to track this significantly reduces the administrative burden for both payers and providers. It also eliminates the question of whether the right physicians were measured and paid based on their relationship to a health system at a given point in time.
With this feature, QPay now automatically applies the captured contract terms to the performance analytics, offering actionable insights for a provider to act upon, which can influence and ultimately change the outcome of the final reconciliation. This fosters and strengthens payer-provider collaboration, leading to financial success for both parties. This transparency yields a better understanding of what will be included in the final reconciliation for the contract model for all parties involved during the measurement period, prior to final reconciliation.
“Our value optimization solutions remove the black box effect from value-based contracts,” said Kevin Hutchinson, Apervita CEO. “This new capability enables QPay to be further differentiated in the market. It removes difficult operational barriers that payers and providers wrestle with daily. Understanding the key terms, methods and contractual targets and knowing which providers are at risk with the provider roster creates a single solution, enabling all parties to focus less on administrative tasks and more on improving healthcare.”
Apervita agrees with current industry feedback that COVID-19 is driving increased interest in value-based contract arrangements. QPay enables payers and providers to understand the anticipated financial results, which builds confidence to adopt these value-based models. This aligns with our goal to put payers and providers on the same team, strengthen their collaboration and ultimately improve quality of care.
Apervita is the trusted healthcare collaboration platform for quality measurement, clinical intelligence, value optimization and interoperability. We empower payers and providers and other stakeholders to more efficiently and effectively measure clinical and financial performance, improve clinical quality and administer and run analytics on value-based contracts. By providing an independent, secure, trusted platform to perform shared analyses, Apervita uniquely allows stakeholders to gain mutual, continuous clinical and financial insights and integrate those insights in various systems and workflows simultaneously and at scale. Serving more than one in three hospitals in the United States and several nationally recognized health plans, Apervita conducts more than 10 billion value-based computations and insights for our clients every year. The company is headquartered in Chicago.