CHICAGO, IL--(Marketwire - Dec 5, 2012) - Valence Health, a leading supplier of population-management and reimbursement risk-management services and technology for healthcare providers, today announced it was selected by newly created New Mexico Health Connections health plan to provide operational support services and population health technology. New Mexico Health Connections (NMHC) was among the first Consumer Oriented and Operated Plans (CO-OPs) approved earlier this year 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 state-sponsored online insurance exchanges.
"We're very excited Valence Health is our partner in bringing more insurance choices and better healthcare access to the citizens of New Mexico," said Anne Sapon, NMHC 's Chief Operating Officer. "We went through an extensive RFP and selection process, and chose Valence Health because they have a proven track record of providing operational and administrative services to health plans."
"We've been providing risk analysis and operational services to leading healthcare organizations since 1996," said Valence Health CEO Phil Kamp. "We are excited to have been selected by Dr. Martin Hickey, CEO of NMHC and the New Mexico Health Connections' team -- leaders who are helping to define these new CO-OP plans. We're very much looking forward to helping them and other recipients of CMS CO-OP awards redefine and expand health insurance to better serve consumers across the nation."
Funded by the Affordable Care Act, 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 health-care needs of plan members by using profits to lower premiums, improve quality, and expand benefits or enrollment.
Under the agreement, Valence will provide NMHC with full operational services including: medical management, medical-claims administration, customer service and data analytics. Additionally, NMHC will fully employ Valence Health's population health management solution. The solution, used by dozens of Valence Health clients including Cleveland Clinic and several health plans, will integrate health information for all NMHC members and identify clinical areas of opportunity to increase the quality of care.
The partnership between Valence Health and NMHC helps ensure that NMHC will be able to operationally comply with certain deadlines established under the CMS program. All CO-OP awardees are required to begin to field inquiries from potential plan members by October 2013, and to begin servicing members by January 2014. Currently there are 23 CO-OP plans around the nation that have been awarded loans by CMS.
About Valence Health:
Valence Health is among the nation's leading companies in helping healthcare providers better manage their patient populations and accept financial responsibility for the quality of the care they provide. With unique data collection and analysis tools, Valence Health has emerged as a leader in population management, serving dozens of clients from small physician groups to Cleveland Clinic. At the same time, in-depth actuarial analysis combined with operational excellence allows Valence to not only advise but also provide ongoing services to provider organizations operating under various value-based reimbursement models. From risk-based contracting to accountable care organizations (ACOs) to administering provider-sponsored health plans, Valence has been helping providers appropriately accept and manage financial responsibility while improving clinical quality since 1996. With headquarters in Chicago, and three other office locations, Valence Health helps manage the health of more than 13 million patients nationwide. For more information visit www.valencehealth.com.
About New Mexico Health Connections:
Established under the Affordable Care Act, and funded in part by a loan from the Centers for Medicare and Medicaid Services, New Mexico Health Connections (NMHC) is a non-profit consumer-oriented and operated health plan. The NMHC plans will be sold through New Mexico's Health Insurance Exchange, alongside other commercial insurance plans. NMHC will be governed by experts in health care, consumer protection and medicine and will comply with all essential benefits and regulations defined by state and federal law. For more information about NMHC visit New Mexico Health Connections (https://sites.google.com/site/newmexicohealthconnections/).