TriZetto’s CareAdvance Essentials Makes Care Management Implementations Easier, More Affordable for Emerging Health Plans

GREENWOOD VILLAGE, Colo.--(BUSINESS WIRE)-- The TriZetto Group, Inc. today announced the availability of CareAdvance EssentialsTM, a software and services solution specially designed for health plans with 250,000 or fewer members, to make care management system implementations by healthcare payer organizations easier, faster and more cost-effective.

The solution includes TriZetto’s Clinical CareAdvance® platform, rapid product implementation, pre-configured care management programs, full-service application hosting and management services, ongoing consulting and configuration services, and customer training. Designed for a four-month deployment, the unique offering for an affordable, predictable monthly fee fits within the budgets of smaller, emerging health plans.

“Just like larger payer organizations, emerging health plans require robust care management technology to support the increasingly sophisticated population health management needs of their employer customers,” said Rob Scavo, emerging market president for TriZetto. “But some emerging plans may have neither the staffing to manage the technology nor financial resources to make a large upfront investment. TriZetto’s CareAdvance Essentials solution delivers a reliable application used by dozens of payers serving nearly 40 million members for a very competitive monthly subscription fee and frees payers to redeploy their IT staff to other important business requirements.”

Scavo added that the TriZetto CareAdvance Essentials solution helps small but growing health plans migrate from older, often internally developed care management systems that may not be able to scale to meet regulatory requirements. Such migrations are encouraged by industry analysts.

“To better position the organization for the impact of U.S. health reform, health insurers must invest in new innovative approaches that support the natural workflow processes of the care management spectrum,” wrote analyst Joanne Galimi in a Gartner report.* “Key areas of focus should include a new care management platform, robust analytics, collaborative communication and health and wellness.”

TriZetto’s CareAdvance Essentials solution includes the following components:

  • Software: TriZetto’s Clinical CareAdvance system, which automates and streamlines case and disease management tasks that traditionally have required extensive manual labor by care management nurses.
  • Standard Clinical Content Programs: Includes choices from 10 standard care management programs (e.g., asthma, diabetes), in addition to a general wellness program. These programs help identify specific members for care management through the CareAdvance Analytical Rules Engine and include automated assessments, guidelines, actions and letters.
  • Implementation: Training and consulting services to support successful implementation typically over a four-month period, using the TriZetto Advantage FrameworkTM implementation methodology.
  • Application management and hosting: Includes application hosting services, hardware, infrastructure, 24/7 support, updates and disaster recovery.
  • Recurring consulting and configuration support.
  • Customer training to optimize the use of TriZetto’s Clinical CareAdvance system, as well as the CareAdvance configuration tool, enabling customers to create and customize their own care management programs.

Optional, add-on services include product upgrades; customer development for interfaces, extracts and extensions; enhanced disaster recovery options; advanced product training; additional care management programs; and integration with TriZetto’s FacetsTM or QNXTTM enterprise core administration platform.


* Galimi, Joanne, “Care Management: A Linchpin for U.S. Health Reform,” industry research report by Gartner, Inc., June 2010.

About TriZetto

TriZetto provides world-class healthcare IT software and service solutions, including patented and patent-pending innovations, that drive administrative efficiency, improve the cost and quality of care, and increase payer and provider collaboration and connectivity. TriZetto’s solutions touch half of the U.S. insured population and reach more than 21,000 physician practices representing more than 75,000 practitioners. The company’s payer offerings include enterprise and component software, application hosting and management, business process outsourcing services and consulting that help transform and optimize operations. TriZetto’s provider offerings through Gateway EDI, a wholly owned subsidiary, include advanced tools and proactive services to monitor, catch and fix claims issues before they can impact a practice. TriZetto’s integrated payer-provider platform will enable the deployment of promising new models of post-reform healthcare. TriZetto is committed to the integration and convergence of technology systems that enable its vision of Integrated Healthcare Management, the coordination of benefits and healthcare to drive more value from every healthcare dollar spent. For more information, visit


The TriZetto Group
Loren Finkelstein, 303-542-2460
[email protected]
Schwartz Communications
Davida Dinerman/Alex Parrella, 781-684-0770
[email protected]

KEYWORDS:   United States  North America  Colorado

INDUSTRY KEYWORDS:   Technology  Data Management  Software  Practice Management  Health  General Health  Managed Care




Fuel Top Line Growth and Increase Membership

In this webinar, payers can learn how to accelerate the sales pipeline and grow membership across all health insurance market segments using comprehensive sales technologies.