Avalon Healthcare Solutions
Software & Data
Tampa, Florida

Overall Rank: 63
Category: Software & Data
Category Rank: 25


  • Top HealthTech Company of 2022


Avalon Healthcare Solutions, the world’s first and only Lab Insights company, brings together proven lab benefit management solutions, lab science expertise, digitized lab values, and proprietary analytics to help insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes.

Avalon, headquartered in Tampa, Florida, was co-founded in 2013 by CEO Bill Kerr, MD, and Adam Boehler. With 175 associates. Avalon has experienced 3x revenue growth in each of the past two years. Working with health plans across the U.S., Avalon covers more than 33 million lives and delivers 7-12% outpatient lab benefit savings. In 2021, Avalon helped payers achieve $39 million in annual member out-of-pocket savings.

Optum recently selected Avalon for its new lab benefit management solution to reduce unnecessary testing and ensure patients receive the screenings that truly inform the right care and a timely diagnosis. The tool helps align lab tests with clinical guidance and automates large parts of lab benefit administration. Meanwhile, Avalon continues to innovate. Its Lab Insights Platform is pioneering a new era of value-driven care by capturing, digitizing, and analyzing lab results in real-time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and reducing overall costs.

Visit www.avalonhcs.com

Key Products

Lab Insights Platform

Lab benefit management has traditionally been focused on removing waste and abuse from lab testing, helping to navigate the increasing complexities of genetic testing, and helping health plans reduce their independent network unit cost. While this has a proven value, it really ends with adjudication of the lab claim and delivery of the result to the physician.

Lab Insights Solutions

Avalon has years of expertise in managing lab benefits and now is leveraging digitized lab results to drive quality clinical outcomes and proven savings. This is the first-of-its-kind suite of solutions to help you achieve the Triple Aim of improving the patient experience of care, improving the health of populations, and reducing the per-member cost of healthcare.

Specialty Pharmacy Solution

Avalon has adapted its proven automated policy enforcement lab claims editing system to apply a health plan’s medical specialty pharmacy clinical and administrative policies in real-time.

Customer Insights

“…our relationship [with Avalon] has resulted in significant savings for our health plan and our customers. We could not be more pleased with the results provided with the implementation of the program.” — Martha Owens Perry, Vice President – Health Care Service (Retired), BlueCross BlueShield South Carolina