Value-Based Care Enablement Services 2024
Services Firm Guide

Overview of VBC Enablement Services Firms

Below are brief summaries of how each firm currently positions their VBC enablement services in the US market. The summaries are based on firm-provided and publicly available information and do not represent any KLAS-validated performance data or other findings. Note that although all firms were invited by KLAS to provide information, some firms did not respond; in these cases, displayed information comes from publicly available resources online.

agilon health
agilon health offers a platform with tools for PHM, care coordination, and financial risk management. Additionally, agilon health aims to help organizations enhance care delivery and achieve financial sustainability in VBC environments by providing support for quality improvement, patient engagement, and performance analytics.

Aledade
Aledade reports that their ACOs (1) integrate data insights from the nation’s largest network of independent primary care providers and (2) show important point-of-care data using Aledade’s EHR-agnostic app. The firm’s VBC support consists primarily of workflow development and clinical coaching for improving preventative care. Aledade also says they invest in patient engagement through programs like personalized advanced care planning and kidney care management.

CareAllies
CareAllies has 25 years’ experience in simplifying the journey to more rewarding healthcare. CareAllies provides physician organizations with business advisory, care coordination, and management services unique to their needs. CareAllies provides people, processes, and technology with the aim of reducing administrative burden, empowering physicians, and promoting financial success. Collaboration with CareAllies is meant to help physicians deliver more accessible and affordable care while allowing them to focus on their most rewarding endeavor: improving patient health outcomes.

Conifer Health Solutions
Conifer Health Solutions assists organizations by offering RCM and VBC services. Their platform supports data integration, analytics, and care management, helping clients to optimize financial and clinical performance. The firm offers services for risk adjustment, quality reporting, and care coordination to help organizations navigate the complexities of VBC models.

Evolent
Evolent’s platform integrates clinical and administrative data to support organizations’ PHM and improve their patient outcomes; the analytics tools help clients identify high-risk patients and tailor interventions accordingly. In addition to the software, Evolent aims to help organizations optimize care delivery and financial performance under value-based contracts by providing services that include care management, risk adjustment, and performance improvement.

Guidehealth
Guidehealth partners with health systems to scale value-based care by integrating specialized clinical staff, back office support services, and advanced technology (including AI) into existing infrastructures and EHRs. The firm’s remotely embedded Healthguides aim to enhance patient engagement and care coordination, supporting practices at all levels of financial risk across all lines of business. Guidehealth states that this approach improves quality metrics and reduces medical expewnses, leading to improved patient outcomes, increased revenue, and cost efficiency for health systems.

Health Catalyst
Health Catalyst offers a broad suite of tools to help organizations develop and execute their VBC transformation strategy and protect them against revenue volatility. Included functionalities are intended for risk adjustment improvement, total cost of care management, quality measure performance analysis, and patient population stratification. Health Catalyst reports that their tools offer data-driven insights to support care management workflows, reduce costs, and improve patient outcomes.

Imperium Health
Imperium Health aids provider organizations—specifically ACOs—as they move toward a VBC model. Imperium Health provides (1) technology solutions for data integration, analytics, and care management and (2) services that include risk stratification, quality reporting, and performance improvement.

Lumeris
Lumeris’ Accountable Delivery System Platform (ADSP) facilitates data integration and analytics to enhance care coordination and patient engagement. With a focus on aligning incentives and optimizing care delivery processes, Lumeris offers strategic guidance and operational support to help organizations manage risk and improve clinical outcomes.

Medical Home Network
Medical Home Network (MHN) is a value-based care enabler partnering with safety net providers (e.g., Federally Qualified Health Centers) to drive performance and provide opportunities to participate in value-based contracts. MHN states their team-based care model connects care management to community-based primary care and is enabled by real-time data, performance analytics, a proprietary technology platform, and local clinical governance. MHN’s comprehensive approach to care transformation builds capabilities aimed at driving operational efficiencies and improving patient engagement, outcomes, and quality.

Navvis
Navvis partners with provider organizations by offering a comprehensive ecosystem of services and technology, including for PHM, care coordination, and patient engagement strategies. The firm provides analytics and insights to drive clinical and financial performance improvements, helping clients manage risk and deliver high-quality care. Navvis’ services are intended to support the transformation of healthcare delivery systems so they can achieve sustainable value-based outcomes.

Pearl Health
Pearl Health seeks to support organizations’ VBC transition by addressing challenges around program selection, financial engagement, and patient care. With patient-focused recommendations across programs, the firm aims to help clients choose and optimize participation in Medicare VBC programs; they offer data-driven insights and facilitate alignment around organizational priorities and risk tolerance. Also, the firm provides financial incentives for organizations transitioning to a VBC model and rewards organizations for proactive care, mitigating delays in shared savings payouts and enhancing provider engagement.

Premier
Premier’s platform includes data analytics and performance improvement tools that aim to enhance care delivery and patient outcomes. Premier also provides strategic guidance and operational support to help organizations manage risk and achieve financial and clinical goals under value-based contracts, focusing on quality improvement and cost reduction.

Signify Health
Signify Health’s platform combines in-home health evaluations with advanced analytics. The technology enables organizations to identify and address SDOH factors, thus improving patient engagement and care outcomes. Signify Health also offers services that include care coordination and episode-based payment models; these services aim to help clients manage risk and optimize care delivery under value-based arrangements.

Vytalize Health
Vytalize Health is a fast-growing company that helps organizations meet VBC metrics by focusing on Medicare patients. The firm allows practices that are part of their ACOs to leverage their proprietary technology to identify care gaps and glean actionable insights from clinical notes, claims, SDOH data, and hospital feeds. Due to Vytalize Health’s partnership with NetSuite’s integrated business systems, the firm can support fast insight generation.

Firms Are Focusing on Addressing Organizations’ Challenges Around Scalability & Performance

While VBC enablement services firms offer a variety of services to help clients move to a VBC model, the ones in this guide say they are focusing on certain areas that are the biggest challenges for clients. Most firms are using generative AI and machine learning to improve their ability to generate insights and identify action items for clients. Additionally, the firms are especially focusing on scaling care management models and optimizing revenue via risk adjustment; data aggregation and integration are less of a focus.

About KLAS Research

Driven by a mission to improve healthcare, KLAS publishes research data intended to help healthcare providers, health plans, and employers make informed purchasing decisions. With the collective insights from thousands of these organizations, KLAS seeks to create transparency in the healthcare market and act as a catalyst to help vendors and firms improve their products and services.