Health plans, always on the look-out for effective ways to do business, reduce costs and meet the challenges of healthcare reform legislation, are seeking technologies that can do that.
The TriZetto Group today announced that it has enhanced its “benefits administration, care management and network management capabilities of its solutions platform,” the first in the 5.X series that will be introduced throughout 2012 to help healthcare companies accomplish these goals, according to a company press release.
The company said that its enhancements to its Facets enterprise core administration system include streamlining user interfaces to make them easier to use, and workers more productive; new payment and care delivery models such as patient-centered medical homes and payment bundling, and “improved functionality for vision lines of business,” according to the press release.
TriZetto said that its Facets system is in use by health plans covering millions of members, “about one-half of the nation’s insured population.”
The 5.0 release of TriZetto’s care-management solution, CareAdvance Enterprise, streamlines use, “disease and case management processes,” expands “analytic capabilities,” improves care work flow, and integrations with third-party systems to lower total cost of ownership.”
“Our 5.0 release for core administration, care and network management is an important milestone on our way to a consolidated suite that will help our clients optimize their investment in TriZetto technology,” said Pierre Samec, TriZetto’s executive vice president and chief technology officer. “The solutions take advanced, enterprise-wide functionality, scalability and quality to the next level.”
“We built TriZetto’s 5.0 enterprise platform to meet the challenges and opportunities presented by the trifecta of reform, regulation and retail,” added Dave Pinkert, senior vice president of product management at TriZetto, in the press release. “Reform requires a heightened focus by healthcare organizations on improved cost and quality of care delivery and even greater operational efficiency.
“New regulatory requirements such as ICD-10 and Medicare and Medicaid changes demand flexibility in payers’ technology and processes. And the growing retail market, driven by an emerging consumer perspective in benefits and care delivery, presents payers with new distribution channels such as state and private exchanges. TriZetto’s end-to-end 5.0 platform will further enable healthcare organizations to succeed in the changing healthcare industry.”
ICD-10 is a diagnostic coding system, which is used in almost every country in the world, except, interestingly enough, the United States. But that is changing with healthcare reform, which now requires the adoption of ICD-10 because it will help in identifying disease patterns and treatment outcomes, according to the AAPC, which defines itself as “credentialing the business side of medicine.”
All healthcare organizations must comply by October 1, 2013.
Edited by
Jennifer Russell
