New NextGen Benefits program to certify high-performance health care vendors

New NextGen Benefits program to certify high-performance health care vendors

NextGen Benefits and Health Rosetta, which provide a revolutionary new model for health care benefits, are creating massive disruption in employer-sponsored health care. How can the progressive NextGen and Rosetta advisers select with confidence the high-performance vendors for their NextGen/Rosetta health plans?

Thanks to the new, industry-first vendor certification, Certified NextGen Benefits Solution Provider, from the NextGen Benefits Network, in partnership with the Validation Institute, these advisers can be confident in their choices.

Premier vendors such as Ault International Medical Management (AIMM), Green Imaging, and TrueLifeCare have been awarded the prestigious designation of Certified NextGen Benefits Solution Provider.

NextGen/Rosetta health care plans reduce employers’ year-over-year costs by as much as 40 percent or more annually. Additionally, these plans reduce – and often eliminate – employees’ out-of-pocket health care expenses, making their health care affordable again.

The vendor factor

But the right vendors, or solution providers – e.g., third-party administrators, pharmacy benefit managers, stop-loss insurance carriers, medical utilization managers, specialty drug cost mitigation programs, and reference-based pricing vendors – provide much of the heavy lifting in a NextGen/Rosetta health plan to ensure high-quality care and lower costs.

So selecting the right solution providers is critical to the success of the health plan.

How do vendors who actually deploy NextGen/Rosetta strategies differentiate themselves from posers that only implement these strategies by brochure? How do vendors who are delivering real results separate themselves from their lesser competition? How do advisers tell the difference?

Until now, high-performance vendors have been forced into a “Trust me” position, able to offer only unsupported assurances of NextGen/Rosetta strategies and having nothing more than unvalidated case studies to support their claims of cost savings or other outcomes. But with competing vendors falsely making the same claims and assurances, the best vendors often find it difficult to convince advisers of their superior solutions.

Vendor differentiation and competitive advantage

Serving high-performance vendors in multiple ways to help them compete in the marketplace, designation as a Certified NextGen Benefits Solution Provider:

  • confirms a vendor as truly NextGen;
  • offers independent, expert third-party validation of the vendor’s performance claims; and
  • provides the competitive advantage and market differentiation that certification confers.

NextGen Certified vendors AIMM, which provides medical utilization management, and TrueLifeCare, a diabetes management program, both use the NextGen strategy of evidence-based medicine in their approach. AIMM, TrueLifeCare, and Green Imaging, a national network of diagnostic imaging centers, all manage various components in the health care supply chain, a foundational NextGen strategy.

To become NextGen Certified, vendors invest in a rigorous two-phase certification process:

  • Confirmation of the vendor’s adherence to NextGen/Rosetta principles and strategy; and
  • Validation of the vendor’s actual outcomes and results, an objective, data-centric process performed by the data scientists at the Validation Institute.

The NextGen Benefits Network is proud to partner with the Validation Institute, the leading organization in health care benefits providing unbiased, data-driven insights on health care solutions and services through performance claims validation.

Certified as NextGen and validated for results, NextGen Certified solution providers like AIMM (validation report), TrueLifeCare (validation report), and Green Imaging (validation report), vendors that actually deliver cost savings using NextGen strategies, separate and distinguish themselves from the confusing mass of “me, too!” vendors.

Injecting certainty into the vendor decision

Until now, NextGen and Rosetta advisers either had to trust vendor marketing claims or the experience of other advisers or were forced to vet dozens of vendors to find (hopefully) the right solution provider partners. And thoughtful, independent advisers prefer to make their own choices from a wide range of vendor options, unwilling to settle for a limited, pre-packaged selection.

The Certified NextGen Benefits Solution Provider designation assures advisers that a vendor has been vetted and validated. It provides advisers the confidence that a NextGen Certified vendor will deliver the cost-savings and/or other result(s) necessary to the success of their NextGen/Rosetta health care plan.

And when an adviser puts compensation at risk to guarantee employer cost savings and/or works for a percentage of those savings, vendor performance in the health plan is absolutely critical to the mutual success of the financially aligned employer and adviser.

By relying on NextGen Certification, advisers will save valuable time and effort not having to vet dozens of vendors in a category but, instead, vetting just the NextGen Certified vendors for best fit with their plan and client.

NextGen/Rosetta advisers soon will be requiring their vendors to be NextGen Certified. It won’t be long before the Certified NextGen Benefits Solution Provider Badge is the health care benefits equivalent of the Good Housekeeping Seal of Approval.

For information on how to become NextGen Certified or on the Certified NextGen Benefits Solution Provider program, contact Kyndall McDorman Kyndall@insurancebottomline.com.