Avalon Saves Clients Millions, Sees Record Growth in 2023

Lab Insights company helps insurers deliver better care for members.

TAMPA, Fla., Feb. 27, 2024 /PRNewswire/ -- Avalon Healthcare Solutions, the world's first Lab Insights company, enjoyed record-setting growth in 2023 while helping its health insurer clients save money, improve operations, and ensure the highest quality care for their members. That year, Avalon clients realized approximately 10% to 20% savings on their outpatient lab spending across lines of business. Approximately 25% of those savings benefit member spending and member out-of-pocket costs.

Avalon helped clients achieve these savings by using clinical and evidence-based guidelines coupled with our automated policy adherence technology to evaluate the quality and utility of tests and by analyzing lab costs, compliance with health plans adopted policies, provider practice patterns and behaviors to reduce waste and overuse.

"More carriers last year realized the benefits of using lab testing insights to control their spend and ensure their members get the right clinical test at the right time," said Avalon CEO Bill Kerr. "As healthcare costs continue to rise, along with the expansion in the science of testing, we expect an even sharper focus on managing laboratory testing spend."

Due to this emphasis, Avalon experienced record growth in 2023. The company added service for 11 million members from December 2022 to December 2023 to reach more than 37 million member lives managed by Avalon and more than 39 million contracted by the end of the year. That is a year-over-year growth rate of 43%.

Last year, Avalon, earned recertifications from HITRUST and the National Committee for Quality Assurance (NCQA) for Utilization Management for its data handling, member protection, and quality service due to the priority it places on protecting member information and ensuring high-quality care without overusing resources.

Avalon also demonstrated that organizations could use lab value analytics to improve chronic kidney disease (CKD) diagnosis and management. In pilot programs with health insurance carriers, Avalon analyzed claims data and lab result values from multiple tests to identify and stratify high-risk CKD patients across all stages of the disease. Avalon successfully identified thousands of previously undiagnosed members who could be referred for diagnosis and treatment. Avalon believes its analytics models could be leveraged similarly for other diseases.

Also, in 2023, Avalon launched Precision Genetic Testing Management (PGTM), the next evolution of its genetic test management solution. It combines lab testing expertise with accurate claims data to produce a first-of-its-kind solution to manage genetic testing. Using evidence-based guidelines, PGTM helps health plans manage genetic testing spending across business lines with minimal abrasion.

"While 2023 was a year of highlights, we are confident 2024 will be even more successful for Avalon and our clients as the importance of lab benefits management continues to grow," Kerr said.

About Avalon Healthcare Solutions
Avalon Healthcare Solutions is the world's first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans nationwide, the company covers over 39+ million lives and delivers 9-20% outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Program that captures, digitizes, and analyzes lab results in real-time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and driving down overall costs. For more information about Avalon, visit www.avalonhcs.com.

Media Contacts:
Michele Norton MS, RN
SVP Product Marketing, Avalon Healthcare Solutions
[email protected]

Janet Mordecai
Amendola Communications for Avalon Healthcare Solutions
[email protected] 

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SOURCE Avalon Healthcare Solutions