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Rising healthcare costs demand more than just a standard benefits strategy to deliver sustainable, cost-efficient care in a complex healthcare ecosystem.
Increasingly, today’s employers are turning to innovative alternative health plans as a solution.
According to a Mercer study, more than a third of large employers offered alternative medical plans in 2025, with 29% considering the option in the future.
The reasons are obvious: As a replacement for traditional high-deductible and preferred provider organization (PPO) plans, alternative health plan models can deliver significantly higher cost containment and a better healthcare experience for all involved, thanks to the emphasis on value-based care and informed member decision making.
Vālenz Health® is proud to be leading that charge with an integrated model that engages early and often through innovative, member-first solutions that help support smarter, better, faster healthcare choices — a health benefits optimization platform we call ValenzONE.
Today, we’ll explain how this solution supports alternative health plan models by streamlining a path to high-value care options while minimizing costly claims, filling a critical gap in the traditional approach to health plan design.
Disclaimer: Vālenz Health® is not an insurance company. Coverage and benefits are determined by the health plan.
Table of Contents
- Understanding Alternative Health Insurance Plans: A Smarter Approach to Care Delivery
- How Vālenz Health® is Meeting the Moment with ValenzONE
- Explore Alternative Health Plan Strategies with Vālenz Health® Today
Understanding Alternative Health Insurance Plans: A Smarter Approach to Care Delivery
Healthcare spend has long been on an upward trajectory, with the total health benefit cost per employee expected to rise 6.5% on average in 2026, the highest increase since 2010. At the same time, Americans consistently report low satisfaction with the healthcare system at large, with 58% of insured adults in 2023 reporting they’d experienced a problem using their health insurance in the past 12 months.
Despite these challenges, innovation to the traditional American health benefits model has been historically slow. With the recent expiration of ACA enhanced subsidies, private insurers are planning for even higher premiums in 2026 to account for a sicker and more expensive risk pool — creating a sense of urgency for new, innovative plan designs that minimize both those costs and risks.
Alternative health plan models can be leveraged to do just that. Generally speaking, these models provide simpler plan designs that focus on reducing healthcare costs through earlier engagement and a cost-sharing model.
By encouraging members to choose higher-quality, lower-cost providers within a given network (through strategies such as dynamic copay models, rewards systems, and optimized provider networks), alternative health plan models simplify the care experience and put the power in the members’ hands, creating a sense of shared responsibility among patients, plans, and providers.
Alternative health plan designs are often tailored to meet the needs and goals of a specific organization, frequently incorporating the following features:
- Variable or dynamic copay pricing
- National or independent high-performance networks
- Cost and quality transparency tools
- Member engagement tools
- Integrated care delivery models
- Proactive, personalized care navigation
The plans that work best, however, have one thing in common: They deploy these features using a single integrated, easy-to-use platform — like our proprietary solution, ValenzONE.
How Vālenz Health® is Meeting the Moment with ValenzONE
As our alternative health plan optimization platform, ValenzONE fulfills the cost-containment and quality assurance needs of today’s employers and employers to help deliver a smarter, better, faster approach to healthcare.
Through the combination of a dynamic copay design and industry-leading cost and quality transparency, ValenzONE supports early engagement, better outcomes, and a streamlined path to high-value care options, all in a single, easily implemented platform.
ValenzONE also offers superior flexibility when compared to other alternative health plan support models. As an optimization platform, our solution can be deployed within any existing health plan network — easing the transition to a new, value-based plan strategy that serves patients, payers, providers, and plans in today’s complex healthcare environment.
Below, learn more about the key features of ValenzONE, selected specifically to address the value-based care principles members and plan sponsors are looking for in modern, alternative health plan designs.
Reducing Health Spend with Cost-Sharing Models
In line with other alternative health plan strategies, ValenzONE trades the traditional fee-for-service model for payment structures that reward providers for achieving positive health outcomes — in other words, embracing value over volume.
With this type of pay structure, providers are incentivized to coordinate care and deliver lower-cost, high-quality treatment. When payments are no longer linked to the number of services provided, care is delivered more efficiently, reducing healthcare costs for both members and plan payers.
ValenzONE actively incentivizes these high-value provider choices with a dynamic copay design: Valenz Variable Copay.
Leveraging the power of the Valenz Bluebook platform, Variable Copay maps more than 2,000 common medical procedures to a clear, predictable copay, determined by outcomes and performance data. Lower copays are assigned to providers who deliver higher-quality care at a lower cost, encouraging smarter care decisions that generate an average of 7–12% savings for employers.
In an improvement on existing variable copay models, the Valenz solution doesn’t just provide data to members. It also actively guides them to make higher-value choices through proactive engagement programming, rewards strategies, and other education campaigns.
As research shows, data alone does not change behavior. Incentives do — which is why the powerful combination of Variable Copay and the Valenz Bluebook transparency platform is the cornerstone of our alternative health plan support solution.
Supporting Smarter Care Choices with Cost and Quality Transparency
In an alternative health plan model where members are the drivers of their own healthcare journeys, clear information about provider pricing and quality ratings is critical to supporting informed care choices that reduce costs.
Valenz Bluebook offers all of this information in one place via an easy-to-use digital platform, giving members newfound confidence in their healthcare choices.
Using a color-coded, “green-yellow-red" ranking system, the Valenz Bluebook platform makes it easy for members to find high-quality care for the lowest comparable cost (what we call a Fair Price provider™) — providing an average $1,500 in savings per procedure.
Research shows time and time again that the majority of Americans are willing to shop for healthcare if pricing information was disclosed prior to services being rendered. Valenz Bluebook makes that possible, filling the gap left by other data transparency platforms that simply provide numbers with no actionable member education or engagement.
As a result, those who implement Valenz Bluebook as a standalone solution or as part of the ValenzONE integrated platform realize a significant improvement in both cost savings and care outcomes — such as the 2.6x first-year return on investment achieved by one of our long-term clients.
Identifying and Prioritizing High-Value Providers
Alternative health plan models often make high-quality care the default with high-performance networks, which are designed to fit a plan’s needs and emphasize care quality and outcomes rather than sheer provider quality.
ValenzONE does the same, using powerful data analytics to identify and highlight high-quality providers and facilities for some of the procedures costing plans and members the most.
Through the Valenz Precision Care solution, members scheduling complex or high-cost procedures are connected directly with leading facilities and providers. These Centers of Excellence are determined by objective, extensive datasets of quality outcomes, expertise, and cost-efficiency to optimize patient results.
At the same time, with Precision Care Surgical and Imaging Bundles, members benefit from predictable costs, vetted quality, and coordinated scheduling through pre-negotiated, all-inclusive bundled pricing.
When “managing high-cost claims” is cited as the top priority by employers facing astronomical plan spend, alternative health plan strategies like Precision Care offer a cost-effective solution — proactively connecting members to the right care at the right time (and at the right price) in a way that traditional health plan models have failed to do thus far.
Improving Outcomes with Guided Care Navigation
In 2025, 24% of employers in a Mercer survey reported that they used focused communications to higher-risk groups to promote use of preventative or diagnostic services.
When high-cost claims bear a disproportionate responsibility for overall plan spend today, that figure is shockingly low, which is why many alternative health plan designers have responded in turn with proactive care navigation solutions.
Care navigation — in which plan members connect directly with clinical experts for provider selection, care coordination, scheduling, and cost verification — have been proven to improve outcomes for underserved populations, preventive care uptake (in the form of cancer screenings), and health-related quality of life scores for elderly patients.
At Valenz, Precision Care Navigation also delivers significant cost containment, directing members to high-quality, low-cost providers and encouraging preventive care to minimize the expenses of long-term, chronic condition management.
Even more important: By incorporating proactive member outreach, Precision Care as a part of ValenzONE forgoes the reactive approach of traditional health plan design to instead engage early and often with the members who need it most — supporting smarter, better, faster healthcare choices that reduce spend without compromising quality of care received.
Explore Alternative Health Plan Strategies with Vālenz Health® Today
An alternative approach to health plan design has never been more urgent. Incremental changes can no longer hold off the relentless cost pressures facing today’s employers — and the time for transformative solutions is now.
Valenz is proud to lead our partners into the future of healthcare with our integrated ValenzONE platform. By combining all the key principles of value-based strategies, our health plan optimizer stands ready to meet the demands of patients, payers, and plans to support strong, vigorous, and healthy lives for all.
Whether your organization is looking for comprehensive support as you shift to an alternative health plan design, or you want to explore the potential of each ValenzONE solution as a standalone offering, the Valenz suite is scalable and flexible to meet your needs.
Explore how our intelligent plan design can turn insight into action — and action into measurable results for your organization — by connecting with one of our team members today.
