What Do You Need?

Get Ready to Operate a Provider-Sponsored Health Plan (PSHP)

Provider-sponsored health plans (PSHPs) represent the most comprehensive of value-based healthcare models. Because PSHPs collect the insurance premium directly from employers or individuals, PSHPs epitomize the furthest upstream that a provider can get in terms of financial control. The benefits of sponsoring a health plan are clear, but with greater responsibilities, new capabilities are required. Since 1996, Valence Health has been partnering with clients to provide the services and capabilities necessary to create and operate successful PSHPs. Understanding the financial, operational and competitive risks is key to hospitals and health systems when laying the groundwork for implementing these arrangements.

How Valence Health Helps Clients Get Started

We work with clients to assess the business case, strategize, design, implement and operate provider-sponsored plans. Typically the first step in the process, the business case assessment, accomplishes the following:

  • Identifies the potential network size and types of providers needed
  • Assesses market position and local competition
  • Gauges payor reaction
  • Gauges community receptiveness
  • Evaluates regulatory environment
  • Defines cost and financial position
  • Anticipates organization and leadership strengths and needs
  • Evaluates the care continuum