Maine Community Health Options Partners with Valence Health to Support CO-OP Health Insurance Plan [Professional Services Close – Up]

Valence Health, a provider of clinical integration, population health and financial risk management solutions, announced it was selected by the Maine Community Health Options (MCHO) to provide operational support services and population health technology.

MCHO was among the first (CO-OPs) approved for loans by the Centers for Medicare and Medicaid Services (CMS).

Created by the Affordable Care Act, CO-OP plans are designed to give consumers and small businesses more health insurance choices, and will participate in states' health insurance marketplaces (or Exchanges). Today there are 24 CO-OP plans across the country, bringing ideas, platforms, and business approaches to the traditional health insurance market.

"We're very excited to partner with Valence Health to bring more insurance choices and better healthcare access to Maine," said Robert Hillman, MCHO's Chief Operating Officer. "We went through an extensive RFP and selection process, and chose Valence Health because they have a history of providing innovative organizations with operational and administrative services."

According to a release, CO-OPs will receive repayable loans to help them establish private, non-profit, consumer-governed health insurance companies. As consumer-directed organizations, CO-OPs are designed to be accountable to members and responsive to the specific healthcare needs of plan members by using profits to lower premiums, improve quality and expand benefits or enrollment.

"We've been providing risk analysis and operational services to leading healthcare organizations since 1996," said Valence Health CEO Phil Kamp. "MCHO is a leading example for other innovative stakeholders in the market. Working together with clients like MCHO, we see a very real opportunity to help redefine and expand health insurance to better serve consumers across the nation."

Under the agreement, Valence will provide MCHO with complete operational services including: medical management, medical-claims administration and customer service and data analytics. Additionally, MCHO will fully employ Valence Health's population analytics platform, Vision. These solutions, used by dozens of Valence Health clients and several provider-sponsored health plans, will integrate health information for all MCHO members and identify clinical areas of opportunity to increase the quality of care. The Valence vQuest cost and utilization module, which will also be deployed by MCHO, will provide an understanding of the economic impact of providing better care - both for the patient member and the health plan.

The partnership between Valence Health and MCHO helps ensure that MCHO will be able to operationally comply with the deadlines established under the CMS CO-OP program. All CO-OP awardees are required to begin fielding inquiries from potential plan members by October 2013 and to begin servicing members by January 2014.

Established under the Affordable Care Act, and funded in part by a loan from the Centers for Medicare and Medicaid Services, Maine Community Health Options (MCHO) is Maine's nonprofit, consumer operated and oriented health insurance plan (CO-OP).

More Information:

http://www.maineoptions.org

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