TriZetto's Products and Services Are Powering Integrated Healthcare ManagementTM

Integrated Healthcare Management (IHM) brings together the best of benefits and the best of care, at the right place, at the right time for the healthcare consumer. TriZetto's vision for IHM drives ongoing investment in a long-term architectural approach. A key objective of this approach is to enhance payer performance by converging core benefit administration, care management and constituent engagement.

With technology solutions touching nearly half of the U.S. insured population, TriZetto is uniquely positioned to drive this convergence. TriZetto provides premier information technology solutions that enable payers and other constituents in the healthcare supply chain to optimize benefits and care for healthcare consumers.

Core Benefit Administration - Promote Growth With a Strong Foundation

Healthcare costs continue to rise, turning up the heat on payers to provide innovative and cost effective benefit plans. To stay competitive, payers need a robust enterprise-wide core administration system - one that can increase efficiencies, create and manage the new and diverse benefit products today's markets demand, and help improve care without increasing costs.

More than 100 payers, ranging from small Medicare Special Needs Plans to the largest national commercial health plans, use TriZetto core administration solutions, representing over 100 million lives. These solutions enable our customers to:

• Enhance revenue growth and sustain market leadership through highly configurable and flexible benefit design and fast introduction of new products.
• Become a consumer retail leader by quickly developing and supporting innovative products and offering sophisticated self-service.
• Reduce administrative costs through greater auto-adjudication and reduced manual labor.
• Lower medical costs with integrated care management and business intelligence.
• Seamlessly integrate with other TriZetto component and third-party solutions to facilitate information flow in a way that serves all constituents.
• Administer multiple Lines-of-Business - including commercial medical, individual, consumer, government and specialty business.

Care Management - Lower Costs While Improving Quality of Care

TriZetto's solutions in Network and Care Management address the cost and quality crisis payers face head on:

• 20% to 30% of medical costs are attributable to care patients do not want or need.
• 7% to 10% can be saved through whole-person care management processes.

To manage medical costs and retain key providers, payers must negotiate complex contracts that include the tailored terms that top providers demand. TriZetto's NetworX Suite is a group of software applications to help automate the contract management and claims pricing process. NetworX Modeler enables payers to project the financial implications of provider contracts before they are signed. NetworX Pricer improves the speed and accuracy of claims pricing, with automation rates reaching above 90 percent.

These solutions help payers:

• Increase the automation of the provider contract analysis and renewal processes.
• Negotiate contracts that drive provider satisfaction while keeping medical costs under control.
• Enable full automation of claims pricing regardless of the number or complexity of contracts.
• Replace paper filing cabinets with well-organized and automated contract management systems.

Meeting member needs in utilization, case, disease and population management are within reach on a single platform. TriZetto's CareAdvance Enterprise solution transforms care management from a traditional, health plan-focused model, to a data-driven enterprise that facilitates personalized interventions, enhanced outcomes, reduced costs and improved quality for members. CareAdvance Enterprise helps payers:

• Improve productivity and workflow on a single, integrated platform.
• Enable proactive identification and stratification of members for care management programs.
• Provide targeted, clinical resources and interventions to members, including multimedia health libraries and condition centers, drug information, wellness information and more.
• Offer members ongoing health monitoring through personalized health risk assessments, health trackers and other tools.

Constituent Web Solutions - Engage Constituents and Deliver the Right Experience

Health plans have a complex job, knitting together a healthcare delivery and financing system through a series of contracts with consumers, providers, employers and brokers, each of whom we consider a constituent of the payer. Despite having a well-funded healthcare system, the United States faces a crisis of cost, quality, consistency, and availability of coverage. Consumers are contributing more, employers are shifting costs, and providers are at greater risk for carrying bad debt. Understanding constituent needs and delivering the information and technologies that foster greater interaction between the health plan and their constituents can help through the use of the Web.

TriZetto Constituent Web Solutions are a comprehensive suite of Web applications that help empower consumers, providers, employers and brokers with information, real-time transaction processing and self-service capabilities seamlessly - an offering no other vendor or solution can match. Constituent Web Solutions remove the complexity and foster the right interactions between you and your constituents:

• Differentiation - Expand upon and support the delivery of a common look and feel and improve it through a more personalized, familiar Web experience for members, providers, employers and brokers.
• Administrative Cost Efficiency - Reverse the traditional role of customer service by offering constituents instant access to information online. The result: health plan employees become more productive and efficient, and your customers enjoy a higher-quality, self-guided experience.
• Complete Solution - Unlike point solutions, TriZetto delivers an end-to-end Web offering that helps ease the pain of Web-portal integration with total plug and play solutions that install and upgrade seamlessly, increase speed to market without sacrificing overall quality, and relieve the need for long-term maintenance and multiple vendor management.

TriZetto Services - The Skills to Get It Done, the Experience to Get It Done Right

The healthcare playing field is defined by rapid change, increased competition and an accelerated need to get things done right. Technology plays an important role in helping payers succeed in this environment. And the ability to implement, manage and optimize technology for your business greatly enhances the value of that software. TriZetto offers the comprehensive services and experience payers need in order to compete successfully in this new market and get on the road to achieving the vision of Integrated Healthcare Management.

To succeed in a challenging environment, payers need to get new products to market faster, improve the availability and performance of applications, reduce costs and make better use of the information in their systems. TriZetto Services can help. Over the past three years, TriZetto has provided services including implementations, upgrades, application optimization and management, hosting and business process outsourcing, training and business integration services to more than 200 health plans.

TriZetto has the right skills and experience to quickly and cost-effectively drive payers' desired business outcomes. TriZetto Services help payers:

• Accelerate time-to-market with implementations and upgrades.
• Reduce ongoing management costs and make them more predictable.
• Optimize application and operational performance to reduce downtime and errors and get more from technology investments.

Information

For more detailed information, please call 1-800-569-1222 or click on the link below. Request more information     Contact a sales rep