Health Plan Risk and Reward | Solutions | Geneia

Outpace your competition. Strengthen your lead. Convert risk into value.

How will your organization continue to realize revenues while continuing to provide superb member benefits and care? Becoming flexible, adaptive, innovative, and prepared for the future requires deliberate choices today.

Choose Geneia’s Health Plan solution to:

  • Gain valuable insight into cost, utilization, and quality measures.
  • Evaluate Per Member, Per Month (PMPM) costs, provider network performance and physician peer-to-peer analysis.
  • Identify and address behavioral drivers of under- and high –performance, using care opportunities, high cost patient profiles, and outlier alerts. 
  • Guide priority-setting and strategic planning by viewing year-over-year trending. 
  • Design new contracts and unique benefit options for customer/employee satisfaction and retention, based on current utilization patterns and costs.
  • Drive quality improvement and hard savings for risk-sharing contracting by focusing on the areas of greatest impact.
  • Prepare for renewal conversations such as provider improvement and contract re-negotiation, through cost analyses and performance reporting.

Our payer and plan resources include:

  • A case study about a health plan that used the Theon® platform to improve the cost and quality within its accountable care arrangements and risk-sharing contracts, realizing yearly HEDIS® score improvements.

    Thought leadership articles:

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