Avalon Healthcare Solutions

Avalon Healthcare Solutions is a national laboratory benefits management company that combines deep domain expertise in the specialty benefits management space with an approach to lab that emphasizes evidence-based medicine, focus, and scale to create better outcomes for patient and significant value to our health plan partners.

Patient safety is very important to Avalon. Lab tests are the starting point of what ultimately becomes the patient plan of care. Getting the right test at the right time can often be the start of a successful treatment outcome. Conversely, getting unnecessary testing (overutilization), or missing a key screening test (underutilization), can cause serious problems. It can also lead to expensive and unneeded follow-up care, or worse, complications arising from unnecessary care.

Avalon is poised to improve the quality of care and decrease lab related costs to payers and members by reducing unnecessary and redundant testing as well as by optimizing lab networks. Avalon exclusively manages lab care and represents an opportunity for payers to shift plan administrative costs appropriately to the medical expense line on their profit and loss statements; a benefit to all plans facing tremendous MLR threshold pressure. In addition to providing an opportunity for savings, Avalon, through its accomplished Clinical Advisory Board, also identifies tests that are medically appropriate, but currently underutilized, in order to improve clinical quality and outcomes. Further, Avalon, with its ability to capture, analyze, and distribute lab values, is positioned to help members, referring providers, and payers navigate an increasingly complex and clinically challenging testing landscape. Avalon uses a customizable and collaborative approach with each health plan and financially benefits only through measurable improvement.