TriZetto Showcases New Solutions and Approaches at Recent Customer Conference to Arm Customers for Success

Huckabee and Goldsmith Underscore Challenges and Opportunities for Healthcare Payers

GREENWOOD VILLAGE, Colo.--(BUSINESS WIRE)-- The TriZetto Group, Inc. highlighted the industry’s broadest set of enhanced software and service solutions for healthcare payer organizations at its recent 2011 Payer Conference in Orlando, Fla., before record attendance of more than 400 health plan executives.

“New challenges in the healthcare industry demand new solutions,” said Trace Devanny, chief executive officer of TriZetto. “During the 2011 Payer Conference, we shared agile, advanced software and service solutions that can help health plans improve efficiency, leverage healthcare reform for strategic advantage, improve the cost and quality of care, and more effectively connect and collaborate with providers. The showcase, workshops and interactive forums provided hands-on demonstrations of innovative solutions to help meet these challenges and a forum for the frank exchange of new ideas, case studies and best practices.”

TriZetto’s 2011 Payer Conference spotlighted:

• A game-changing plan for delivering payer-provider connectivity through TriZetto’s acquisition of Gateway EDI, driving increased efficiency and collaboration in provider interactions and reducing the inefficiency, waste, paperwork and phone traffic inherent in today’s fragmented system.
• Systematic Healthcare Management™, TriZetto’s unique approach to and solutions for population health management, which can help health plans improve the cost and quality of care. These include analytic capabilities, value-based insurance design solutions and value-based reimbursement solutions that support new payment and care-delivery models such as the accountable care organization (ACO) and patient-centered medical home.
• TriZetto Advantage Services™ offerings that deliver a cost-effective methodology to help payer organizations meet their business objectives more quickly, with higher quality and less risk.
• New releases of TriZetto’s software solutions, with continued enhancements to functionality, technology and performance to position payers to meet the challenges of today’s healthcare environment.
• Winners of this year’s IHM Power Awards, Cox HealthPlans and Leon Medical Centers Health Plans of Florida, in the categories of Operational Excellence and Innovation, respectively. IHM, or Integrated Healthcare Management, is the systematic coordination of health benefits and care delivery to provide more value for every healthcare dollar spent.

“Value, in fact, was the operative word in a ‘power session’ on healthcare reform,” said Dan Spirek, TriZetto’s executive vice president and chief strategy and marketing officer. “During the session, government and industry leaders stressed that ACOs and other post-reform models of care delivery present payer organizations with opportunities to incent members and reimburse providers for quality, coordinated care based on proven, evidence-based medical services, and to evolve from the current, ineffective fee-for-service, one-size-fits-all model.”

“Health plan executives saw a new, greatly expanded TriZetto this year,” said Tony Bellomo, president of TriZetto. “The breadth of our software and service solutions, coupled with more than 20 partner solutions on display, helps hundreds of payer organizations streamline administrative tasks across virtually their entire operations. More than this, attendees saw a new TriZetto that further serves the payer community with solutions for group practices in the provider community. They saw firsthand how claims-cleansing by Gateway EDI’s provider-facing systems, for instance, can help make payer operations even more efficient.”

Greater payer-provider connectivity and collaboration can improve the coordination of care, and coordinated care can begin to address “a weighty problem” highlighted by former Arkansas governor Mike Huckabee in his first public appearance since announcing he would not run for president in 2012.

“Dig up an old picture of your third-grade class and compare that to many third-graders today, anywhere in the country, and you’ll immediately see the problem,” said Huckabee in his keynote remarks at the TriZetto conference. “We’re raising a generation of type 2 diabetics, two-thirds of us are overweight or obese, and obesity increases the risk of diabetes and many of the other chronic diseases that drive 75 to 80 percent of our healthcare costs. America simply cannot afford its obesity epidemic.”

He said most healthcare costs are due to the “controllable behaviors” of overeating, smoking and physical inactivity. Huckabee commended payer organizations for encouraging better choices with incentives and consumer-driven plans in which members have more skin in the game. “When payer and player are one and the same, you get better results.”

Huckabee said health plans also should continue to use member and physician incentives to promote preventive care and help the nation change from a culture of cure to one of prevention. “Why spend money to build a trauma center at the bottom of a cliff when you can build a fence at the top that prevents people from falling in the first place?”

In another keynote presentation during TriZetto’s annual conference, futurist Jeff Goldsmith criticized the healthcare reform law as “deeply flawed legislation.”

“It excessively expanded Medicaid, which is basically bankrupting every state in the country right now,” said Goldsmith. “The legislation punted on malpractice reform, punted on cleaning up some conflicts of interest in medicine and punted on meaningful changes to reduce healthcare costs. The law’s most crucial flaw, perhaps, is that no one actually signs up for coverage until 2014. Medicare took only 18 months, Massachusetts just seven. This is going to take three and a half years, two election cycles – political eternity.”

Looking ahead, Goldsmith foresees a tripling of the individual market, due to reform-law subsidies, declining employer-group enrollment and aging baby-boomers. With this increase in “the retail component of the risk pool,” health plans must shift their focus from business-to-business to business-to-consumer.

“If you can save customers money and give them intelligent choices, you will succeed and create customers for life,” said Goldsmith. “How effective you are as consumer companies will have a great deal to do with whether your organizations grow or shrink.”

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 www.trizetto.com.

The TriZetto GroupLoren Finkelstein, 303-542-2460
[email protected]
or
Schwartz CommunicationsDavida Dinerman, 781-684-0770
[email protected]

Source: The TriZetto Group, Inc.