Leon Medical Centers Health Plans has selected TriZetto integrated technology-enabled solutions to improve administrative efficiency and the cost and quality of care, the company has announced.
Serving more than 37,000 Medicare Advantage members, Leon Medical Centers Health Plans operates a staff-model health maintenance organization (HMO). For the health plan, members and providers, the organization uses TriZetto's Facets enterprise core administration system; NetworX Pricer application, which automatically prices claims, regardless of complexity; and Constituent Engagement Solutions, a suite of web tools that automate transaction processing and information exchange, the company stated in a press release.
“Fragmentation drives up costs, increases errors, lowers quality, and reduces member and provider satisfaction,” said Jude Dieterman, TriZetto's executive vice president and payer markets president. “With TriZetto's integrated solutions, Leon Medical Centers Health Plans is addressing all of these issues. And as this approach becomes more prevalent throughout the industry, we as a nation will address the challenges of healthcare quality and affordability.”
With an electronic practice management/electronic medical records system used by clinicians affiliated with the HMO, TriZetto helped Leon Medical Centers Health Plans integrate the Facets platform. Through the interface, the administrative staff can quickly share data with clinicians and vice versa.
Leon Medical Centers Health Plans also has achieved an unusually high level of member retention. The member-disenrollment rate has remained below 5 percent per year, an indication of high satisfaction levels among members, since 2005. Immediately after a member enrolls in the health plan, the value of integration becomes evident.
Recently, the company announced that they’re entering into an agreement to give organizations for healthcare payments an enhanced system of integration that will automate and speed up sales, administration, and renewal of any small insurance policies. TriZetto and Connecture plan to come up with a demonstration of their integrated platform in the first half of this year, the company stated.
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Raju Shanbhag is a contributing editor for HealthTechZone. To read more of Raju’s articles, please visit his columnist page.Edited by
Jennifer Russell
