Lab Insights Solutions

An estimated 70% of clinical decisions are based on lab testing and the results have a disproportionate impact on spending throughout the care continuum.¹

Historically health plans use claims data to profile membership for population health management including stratification of the population into high-, medium-, and low-risk groups. Claims data tells you what was done (CPT code) and the presumptive condition diagnosis (ICD 10 code) and potentially prescription data from pharmacy claims. Claims data generally tells you what happened in the past and is useful for measuring historical performance.

For health plans and your stakeholders, it’s not just about the right test and right reimbursement. It’s about ensuring that the test results provide optimal value by informing patient care and treatment. For the first time ever, Avalon’s Lab Values Management solution can capture, digitize, and analyze lab results in real time to deliver on this vision.

With Avalon as your partner, you have the data to better collaborate with your physicians to ensure the right care. This eliminates downstream waste and negative clinical impact from ordering the wrong test.

Avalon digitizes lab values data in real time, applies algorithms, and creates actionable insights for the health plan and physician. This intelligence accelerates value-driven care success:

• Early identification of members with emerging health risks 
• Codification of providers’ behavior and adherence to clinical pathways 
• Production of decision support recommendations