Two Industry Innovators Partner to Reduce Healthcare Administrative Costs and Address the Challenges of Healthcare Reform

Group Health Cooperative, a Pioneer in Healthcare Delivery, Selects ikaEnterprise from Technology Innovator ikaSystems to Facilitate Real-Time Information Flow Across Commercial, Medicare and Medicaid Lines of Business

SOUTHBOROUGH, Mass.--(BUSINESS WIRE)-- Group Health Cooperative, one of America’s oldest, largest and most respected consumer-governed healthcare organizations, has selected administrative cost containment solutions from ikaSystems, the nation’s premier provider of enterprise-level cloud computing solutions to insurance plans, to provide an integrated Web-based technology platform across its commercial, Medicare and Medicaid lines of business. The platform is expected to facilitate real-time information flow to all parts of the organization, increasing administrative efficiency while fueling more effective decision making.

Heralded as a national model for healthcare that actually focuses on and delivers better health, Group Health is a consumer-governed, nonprofit healthcare system that coordinates care and coverage. Founded in 1947 and based in Seattle, Washington, Group Health and its subsidiary health carriers, Group Health Options, Inc., and KPS Health Plans, serve more than 640,000 residents of Washington and Idaho.

“Current market drivers, including healthcare reform, led Group Health to closely examine our existing technology and assess its ability to support and leverage our core competencies as a large, complex integrated delivery system with multiple health plan offerings,” explained Joel Suelzle, vice president, health plan operations, at Group Health. “When we reached the decision to pursue a more agile technology platform, the goal was to find a highly user-configurable solution that could meet a wide range of business needs while providing self-service portals for all of our constituents: members/patients, healthcare providers, employers and insurance brokers. We found what we were looking for in ikaEnterprise.”

ikaEnterprise is a fully Web-deployed, end-to-end solution for health plan business process optimization and intelligence management, including full sales-cycle automation, core claims adjudication, care management and proactive quality measurement and reporting with self-service portals for sales, administrative, employer, member and provider use. ikaEnterprise has been successfully deployed, typically in a software-as-a-service model (SaaS), in some of the nation’s finest health plans to reduce administrative and medical costs in their commercial, Medicare and Medicaid business lines.

“Group Health has always been an industry pioneer, developing consumer-governed, prepaid group medical coverage over 60 years ago to ensure broader healthcare coverage for members of its community. Today, that innovation has extended to leadership in addressing the challenges and opportunities of healthcare reform, piloting accountable care organizations and bringing providers together to share responsibility for cost and quality,” said Ravi Ika, chief executive officer of ikaSystems. “Our organizations have a natural affinity due to the common commitment to breaking new ground in healthcare, rather than following in others’ footsteps, and we look forward to a strong and productive partnership.”

Group Health will deploy systems for marketing and sales automation, data exchange with the Centers for Medicare and Medicaid (CMS), billing and commission management, claims administration, authorization and referral management, data warehousing, utilization analytics and provider performance measurement, as well as self-service portals for members, providers, employers, and sales and administrative staff.

About Group Health Cooperative

Marking its 63rd year, Group Health Cooperative is an innovative, consumer-governed, nonprofit health care system that integrates care and coverage. Along with its subsidiary carriers, Group Health Options, Inc. and KPS Health Plans, Group Health works to improve the health of more than 616,000 plan members in Washington and Idaho. Group Health Cooperative is ranked “Highest in Member Satisfaction among Commercial Health Plans in the Northwest Region” by J.D. Power and Associates.

More than 9,000 staff employed by Group Health and Group Health Permanente, its contracted, multispecialty group practice, provide patient-centered, evidence-based care to members and the broader community through medical centers, a charitable foundation, and a nationally recognized research center.

About ikaSystems Corp.

ikaSystems is healthcare payers’ premier provider of enterprise-level cloud computing technologies for commercial, Medicare and Medicaid lines of business. ikaEnterprise, the company’s flagship product, automates all key processes in the payer business cycle — from marketing and sales through claims administration and customer service to care and quality management — all on a single integrated platform. Using our agile, modular technology, organizations can proactively move to lower administrative and medical care expenses and thrive in even the most challenging environments. To learn more, please visit


Sandy Cummings, 774-249-9066
Senior Vice President, Marketing
[email protected]

KEYWORDS:   United States  North America  Massachusetts

INDUSTRY KEYWORDS:   Technology  Data Management  Software  Practice Management  Health  Hospitals  Other Health  Professional Services  Insurance