Awards Recognize Health Plans’ Operational Excellence and Innovation to Drive Integrated Healthcare Management
NEWPORT BEACH, Calif.--(BUSINESS WIRE)-- The TriZetto Group, Inc., today announced that Blue Care Network of Michigan and MVP Health Care were awarded the second annual Integrated Healthcare Management (IHM) Power Awards in the categories of Operational Excellence and Innovation, respectively. The awards honor pioneering customers that demonstrate tangible success in the pursuit of IHM: The systematic application of processes, shared information, and aligned incentives to optimize the coordination of benefits and care for the healthcare consumer. The awards were presented at TriZetto's Annual Payer Conference in San Antonio, Texas.
“The IHM Power Awards program provides us the opportunity to celebrate important partnerships and recognize customer achievements in addressing administrative efficiency and strategic transformation,” said Jeff Margolis, chairman and chief executive officer of TriZetto. “Blue Care Network of Michigan and MVP Health Care have demonstrated success in leveraging TriZetto solutions to yield positive and measurable results across their enterprises. As is the case with each of our deserving nominees and our entire client community, we value Blue Care Network and MVP not only as customers, but as true partners working to meaningfully improve the healthcare system.”
Blue Care Network of Michigan (BCN), a non-profit HMO affiliated with Blue Cross Blue Shield of Michigan, was selected for the IHM Power Award for Operational Excellence for its exceptional use of TriZetto solutions to resolve a number of complex business challenges. BCN wanted to improve speed-to-market for new products and new or modified relationships with providers, to focus on strategic concerns instead of infrastructure, and to respond to and lead a highly competitive market. BCN found success using TriZetto’s Facets TM core enterprise platform, lowering its base administrative costs by nearly 28 percent, improving its first pass rate by 7 percent, increasing its system SLAs to 99.8 percent, and creating easy-to-configure benefit designs to help the company maintain strategic focus.
“Several years ago, we needed to consolidate four HMO subsidiaries into one organization, merging legacy systems so we could achieve greater efficiencies by improving our technology platform,” said Janet McQueen, chief information officer for BCN. “We chose TriZetto’s Facets system, and since then we have been on a steady track toward reducing administrative expense in addition to ‘bending the medical trend.’ Not only are our administrative numbers much improved, but we can configure many new products in only one day. This flexibility is paramount to our continued success.”
This year’s award for TriZetto’s IHM Power Award for Innovation went to MVP Health Care, a multi-state regional, not-for-profit health insurer based in Schenectady, N.Y., which took a highly innovative approach to tackling a difficult business challenge. MVP recognized that its market was changing rapidly, and although consumer-directed health (CDH) plans had not gained a strong foothold yet, this healthcare payer wanted to be the market leader. By launching the Facets CDH Account Management Module with the Facets CDH Adapter, MVP integrated a third-party payment system and used TriZetto’s Member Benefit Profile™ (MBP) solution to present financial information to members. This approach had not been attempted by a TriZetto customer previously, but it enabled MVP to partner with multiple banking organizations in a three-state region. The solution launched in the first state in January 2010, with plans to expand to two more states soon.
“We are very optimistic about meeting our long-term, innovative vision with TriZetto’s help and flexibility,” said Jack VanGraafeiland, chief information officer at MVP. “With TriZetto, we created an MBP solution that allowed us to give our members an advanced interface that could display their banking information. This information is passed by MBP to the CDH Adapter, which shares it with the Facets core enterprise platform. This inventive approach will help us integrate several CDH product offerings onto the Facets platform, while providing a solution that is effortless for our members and gives us a leading presence online.”
Additional successes by award nominees selected as finalists included: reducing claims inventory by 67 percent, reducing the number of necessary examiners by 45 percent, increasing the claims auto-adjudication rate from 62 percent to 94 percent, reducing claims turnaround times from 30 days to 10 days, submitting ANSI x12 5010 compliance plans to state regulators, and making available consistent and comprehensive options for members with complex and co-morbid medical conditions. More information about the other nominees and the IHM Power Awards is available at www.trizetto.com/IHMPowerAward.
About TriZetto
Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry, with its technology touching half of the U.S. insured population. TriZetto’s vision for the industry, Integrated Healthcare Management, is the optimized coordination of benefits and care for healthcare consumers to improve the value of every healthcare dollar spent. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing to market new products that drive competitive differentiation.
CONTACT:
The TriZetto Group
Rachel Tanner Lew, 303-495-7022
[email protected]
or
Schwartz Communications
Davida Dinerman, 781-684-0770
[email protected]
KEYWORDS: United States North America California Texas
INDUSTRY KEYWORDS: Technology Data Management Software Health Hospitals Professional Services Insurance General Health Managed Care
MEDIA: