Health Plan of San Joaquin Selects TriZetto’s QNXT System to Expand Business, Grow Membership and Migrate to ICD-10

NEWPORT BEACH, Calif.--(BUSINESS WIRE)-- The TriZetto Group, Inc. today announced that Health Plan of San Joaquin (HPSJ), a community plan with more than 100,000 members, is implementing TriZetto’s QNXT^TM 4.7 enterprise administration system. The new platform will help the payer organization further improve administrative efficiency, support expansion of its commercial business, scale to significant membership growth and enable compliance with HIPAA 5010, ICD-10 and other regulatory mandates.

“TriZetto’s QNXT system will position us to take advantage of opportunities presented by healthcare reform,” said John Hackworth, Ph.D., chief executive officer of HPSJ. “One such opportunity will be insurance exchanges, and the QNXT platform’s demonstrated strength in both commercial and Medicaid lines of business will enable us pursue this emerging opportunity while continuing to improve the administrative efficiency of our established group and state-sponsored products, as well as our third-party administration services.

“With our continued focus on the diversification of our product mix and a vision toward capitalizing on healthcare reform opportunities, we expect to more than double our membership, and we know TriZetto’s QNXT system can scale to support this growth,” Hackworth added. “TriZetto will not only ease our 5010 and ICD-10 migrations, but enable us to use these migrations to make broader, strategic improvements in benefits and care administration.”

“TriZetto’s QNXT platform is a demonstrated leader in Medicaid administration and so is well suited to HPSJ, the leading Medi-Cal managed care plan in San Joaquin County,” said Rob Scavo, president of emerging markets at TriZetto. “Plus, our QNXT application will offer unequaled support to HPSJ as it expands its commercial lines of business.”

Scavo added that news of the HPSJ contract continues TriZetto’s rapid growth in the community health plan market. “The broad functionality, scalability and attractive price point of our QNXT product helps these payer organizations compete with their larger counterparts on a more level playing field and leverage their nimbleness and local presence to win.”

About Health Plan of San Joaquin (HPSJ)

HPSJ, a not-for-profit health plan initiated by San Joaquin County in 1994, began offering managed healthcare services to San Joaquin County Medi-Cal recipients in February 1996. Celebrating over a decade of success, the health plan is the leading Medi-Cal managed care provider in San Joaquin County, serving more than 73,000 members through its Medi-Cal program. In 2003, the health plan received state licensure to offer commercial insurance products, leading to the development of the Healthy Kids Program for more than 2,300 children without public or private coverage. In July 2006, HPSJ began serving members in Stanislaus and Merced Counties and positioning the plan as the largest Healthy Families provider in the service area with over 17,000 members. The expansion also allowed for the launch of Network+, a large-group commercial option for Stanislaus County employers, in 2008. Doing business as San Joaquin Health Administrators, HPSJ also acts as a licensed third-party administrator to San Joaquin County’s own employee health plan. For more information, call 1-888-936-PLAN (7526) or visit www.hpsj.com.

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 systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. 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.

The TriZetto Group
Loren Finkelstein, 303-542-2460
[email protected]
or
Schwartz Communications
Melissa Bruno, 781-684-0770
[email protected]

Source: The TriZetto Group, Inc.