You can’t reform health care payments without reforming the claims process. And that is exactly what Aver Informatics just raised a bunch of money to go do. They want to help health care payments providers and insurers analyze and then take data already available through current claims systems to compartmentalize patient care services into bundled payments.
Aver Informatics has received $8.5 million in Series A funding led by Drive Capital and GE Ventures, according to a recent Gartner article. Aver sells software that it packages into “episodic bundles,” which are designed to simplify the payment process. It will then generate a bill for the entire process of treating a health condition, instead of producing a separate charge for each step in the process.
The $8.5 million is expected to help all parties involved in the health care payments process, including providers and patients. According to Aver, its new software significantly shortens the amount of time to implement bundled payments using existing claims infrastructure. Previously, that process took years, but Aver’s technology takes weeks.
Aver CEO Kurt Brenkus spoke with TechCrunch about his company’s approach to healthcare payments.
“The way that the healthcare system works today is a volume-based system,” Brenkus told the news source. “And there’s a perverse incentive in a volume-based system to do more services to make more money.”
According to Brenkus, Aver’s first client was a small, Wisconsin-based insurance firm, but Aver was able to help them save money almost immediately.
“Within the first three months of working with them we saved them a half a million bucks,” Brenkus told TechCrunch.
The CEO added that Aver’s current 15 customers are saving 10 percent to 50 percent on payments for treatments across their entire patient populations. The key is to simplify an overly complicated process, Brenkus explained.
“What it comes down to is that there are these billing systems running on these green-screen systems from the 1990s [and updating them] is like trying to change a jet engine in mid-flight,” Berkus told the news source. “You’ve got all of this legacy architecture and we’re literally reconfiguring this information on the fly.”
Moving Forward With Bundled Payments
In addition to raising $8.5 million, Aver also announced that the University of Pittsburgh Medical Center and Molina Healthcare as new customers.
Dr. Irene Krokos, Chief Medical officer for Molina Healthcare of New Mexico, explained to Gartner that Aver has delivered an “innovative approach to Medicaid payment reform.”
“Our health plans in New Mexico and Ohio have sophisticated episodic care definitions that are tailored to improving cost and quality outcomes in our most vulnerable populations,” Krokos said, adding that Aver’s bundle options are able to accommodate variations between different state programs.
GE Ventures Healthcare Director Jason Sibley also hailed the innovations that Aver has brought to the forefront in the health care field, saying that his company was impressed with Aver’s ability to use data exploration to navigate the health care system for businesses, consumers and patients.
“Healthcare innovation isn’t just about advances in scientific processes and devices. We are always seeking to partner with companies that provide practical solutions that drive down the costs for all of us to be healthy,” Sibley told Gartner. “It is important for companies to provide affordable and competitive healthcare benefits to employees.
This is not the first discussion of health care bundled payment options. Earlier this month, the Partnership for Home Quality Healthcare announced the proposal of a new payment structure for Medicare post-acute care (PAC). The proposed legislation would offer “pro-patient solutions” that support a more effective and efficient delivery of quality post-acute care services.
We’re always on the lookout for opportunities to partner with innovators and disruptors.
Learn More