Insurance News - TriZetto’s Dan Spirek Explains Four Post-Reform Challenges for Healthcare Payers at AHIP’s Institute 2011
Insurance News - TriZetto’s Dan Spirek Explains Four Post-Reform Challenges for Healthcare Payers at AHIP’s Institute 2011
GREENWOOD VILLAGE, Colo.--(BUSINESS WIRE)-- With the passage of the healthcare reform law, healthcare payer organizations must address four challenges to succeed in today’s changing and evolving industry, said Dan Spirek, executive vice president and chief strategy and marketing officer of The TriZetto Group, Inc., in remarks during last week’s Institute 2011 in San Francisco. The Institute is an annual gathering of health insurers and vendor companies staged by America’s Health Insurance Plans.
“In listening to our broad customer base, we believe the four challenges for payers are comply with reform, increase administrative efficiency, improve cost and quality of care and compete to win,” Spirek said. “To comply with reform, health plans need a healthcare IT partner that can provide flexible and scalable enterprise-wide administrative solutions, maximize efficiencies to meet new medical-loss-ratio requirements and help them meet the HIPAA 5010 and ICD-10 mandates and even exploit them for strategic advantage.”
To increase administrative efficiency, payers need enterprise systems that further automate tasks and reduce manual configurations, as well as application hosting and business-process outsourcing services. Spirek said that the right healthcare IT partner can help payers improve the cost and quality of care through innovative value-based strategies that support emerging care delivery models such as patient-centered medical homes and accountable care organizations.
“Technology available today enables value-based insurance design, which incents members to use proven, high-value healthcare services and reimburses providers for the coordinated, quality delivery of care,” said Spirek. “New solutions also enable clinical analytics, which greatly enable the stratification and identification of members by health risk and support the participation of members in programs that can help improve their health.”
GREENWOOD VILLAGE, Colo.--(BUSINESS WIRE)-- With the passage of the healthcare reform law, healthcare payer organizations must address four challenges to succeed in today’s changing and evolving industry, said Dan Spirek, executive vice president and chief strategy and marketing officer of The TriZetto Group, Inc., in remarks during last week’s Institute 2011 in San Francisco. The Institute is an annual gathering of health insurers and vendor companies staged by America’s Health Insurance Plans.
“In listening to our broad customer base, we believe the four challenges for payers are comply with reform, increase administrative efficiency, improve cost and quality of care and compete to win,” Spirek said. “To comply with reform, health plans need a healthcare IT partner that can provide flexible and scalable enterprise-wide administrative solutions, maximize efficiencies to meet new medical-loss-ratio requirements and help them meet the HIPAA 5010 and ICD-10 mandates and even exploit them for strategic advantage.”
To increase administrative efficiency, payers need enterprise systems that further automate tasks and reduce manual configurations, as well as application hosting and business-process outsourcing services. Spirek said that the right healthcare IT partner can help payers improve the cost and quality of care through innovative value-based strategies that support emerging care delivery models such as patient-centered medical homes and accountable care organizations.
“Technology available today enables value-based insurance design, which incents members to use proven, high-value healthcare services and reimburses providers for the coordinated, quality delivery of care,” said Spirek. “New solutions also enable clinical analytics, which greatly enable the stratification and identification of members by health risk and support the participation of members in programs that can help improve their health.”
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