background

Value-Based Clinical Enablement

Mastering the Shift to Value

At Avanta, our Value-Based Clinical Enablement expertise is the foundation of our healthcare commitment. We serve as the Management Services Organization (MSO) partner dedicated to transitioning physician groups from fee-for-service to profitable Value-Based Care (VBC) models. This function is about providing the strategic framework, technology, and administrative relief providers need to focus on what they do best: delivering high-quality, patient-centered care.

Our Strategic Mandate

We don't just manage the transition; we guarantee success in performance-based contracts. Our primary focus is on generating superior clinical quality while controlling the total cost of care.

Core Objectives:

  • Maximize Provider Performance: Equip physicians with the tools and data to excel in VBC quality metrics (e.g., HEDIS and Star Ratings).
  • Ensure Financial Predictability: Optimize contract performance under risk- and capitation-based agreements to drive shared savings.
  • Enhance Practice Efficiency: Streamline administrative and operational burdens, freeing clinical teams to focus on patient needs.

Key Service Pillars

Our enablement strategy is delivered through three interconnected service pillars

VBC Strategy and Contract Management

We handle the complex financial and legal landscape of risk-based healthcare, allowing practices to participate confidently.

  • Payer Relations & Negotiation: Expert negotiation and optimization of contracts with health plans, ensuring favorable terms for shared savings and risk adjustment.
  • Risk Model Expertise: Deep understanding of complex payment models, including ACOs, CINs, and bundled payments, to maximize revenue capture and minimize downside risk.
  • Financial Reporting & Benchmarking: Providing transparent, real-time analytics to track performance against contract targets and industry benchmarks.

Clinical Workflow and Quality Optimization

We implement proven clinical protocols and best practices to drive measurably better patient outcomes.

  • Clinical Protocol Implementation: Deploying best-practice guidelines for preventative health, chronic disease management, and transitional care.
  • Quality Metrics Program (HEDIS/Star): Focused programs and support to systematically improve key quality measures, directly impacting plan revenue and provider bonuses.
  • Care Coordination Infrastructure: Establishing seamless systems for referrals, follow-up care, and managing high-risk patient populations.

Administrative and Practice Operations

We lift the administrative burden, allowing practices to operate more efficiently and sustainably.

  • Practice Management Support: Assisting with non-clinical operations, including scheduling, billing oversight, and patient engagement strategies.
  • Compliance and Regulatory Support: Ensuring all practices adhere to complex federal and state healthcare regulations, minimizing compliance risk.
  • Provider Engagement & Training: Continuous education and support programs to ensure the entire clinical team is aligned with VBC goals and utilizing enablement tools effectively.

The Avanta Advantage

By integrating this clinical enablement expertise with our Benefits Commerce platform and Unified Data Intelligence, we create a closed-loop system that is superior to standard MSOs. We don't just tell physicians what to do; we provide the operational support and the data on patient-level resource utilization to guarantee their success in a Value-Based Care future.