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XpandVBB™: Design and Administer Benefits Efficiently.

The XpandVBB solution enables flexible and sophisticated benefit plan designs based on the value that a service or procedure provides to the consumer. As health plan administrators increasingly seek designs that align reimbursement, cost-sharing and consumer engagement, with clinical needs, clinical outcomes and clinical value, XpandVBB offers a solution for administrators to implement sophisticated value-based benefit designs. These designs are coordinated with specific care plan milestones, health management initiatives and other factors to incentivize the individual consumer to seek the appropriate care at the appropriate time with the appropriate provider.

A Closer Look at XpandVBB's Advantages

Because the solution closely integrates with the administrator’s core claims system, the solution requires little or no additional work to configure new products or adjudicate/adjust claims once the underlying business rules and events are defined. In addition, tight integration permits accurate benefit payments for a specific consumer based on the consumer’s specific behavior and the value of the service to the consumer’s health. In short, XpandVBB allows an administrator to design different solutions for different consumers, based on the right combination of design, incentives and clinical effectiveness.

XpandVBB's Bottom-Line Impact

  • Integrated
    Coordinates and synchronizes care plan requirements, core enrollment, benefit and claims data to provide consumers with a single, consistent product experience via the website and customer service

  • Scalable
    Service-Oriented Architecture reduces or eliminates technical and product limitations, making it easy to manage benefits for a specific group of members or even specific members

  • Enabling
    Facilitates desired value-based plan features by streamlining client and product configuration, integrating desired health management principles and optimizing wellness program integration

  • Real-Time
    Empowers timely and accurate customer service due to adjudicating claims simultaneously with the core claim system, treating the value-based design as part of standard benefits, with real-time accumulators and contribution/payment postings

  • Synchronized
    Expedites processing of medical claims based on specific value-based plan design elements, completing more accurate calculations in milliseconds, not days

  • Sophisticated
    Using configurable business rules and interfaces with health management and wellness programs, the solution processes claims accurately and appropriately based on the design elements of the program regardless of the complexity

XpandVBB Features

  • Integrated Design and Configuration
  • Coordinated Enrollment and Eligibility Management
  • Interfaces with Health Management
  • Support for Wellness Program Integration
  • Consolidated Financial Information
  • Simplified Customer Service Support
  • Administrative Console for Easy, Efficient Platform Management
  • Sophisticated, Customizable Client Reporting

To learn more about value-based benefits, please see the information in our Knowledge Center or contact us to learn more.