Universal American Corp Meets Care Needs of Senior Members with TriZetto's CareAdvance Medicare

  
    
  
  
    
      The TriZetto Group Inc. (NASDAQ: TZIX) announced today that the 
      Universal American Corporation (NYSE: UAM) health plan is implementing 
      TriZetto’s CareAdvance Medicare™ 
      software module.
    
    
      “TriZetto recognizes that our senior members 
      are by far the most complex population we touch and that we need to be 
      equipped with the right tools to identify senior health risk issues as 
      early as possible,” said Patricia Salber, 
      M.D., chief medical officer and senior vice president, Universal 
      American – managed care division. “TriZetto’s 
      Clinical CareAdvance® 
      and CareAdvance Medicare applications will help us quickly identify 
      those members who require additional assistance and more efficiently 
      manage the quality and cost of care on a more routine basis.”
    
    
      “Statistics show that care management for 
      seniors is highly complex, with 82 percent of Medicare beneficiaries age 
      65 and older living with one or more chronic conditions and 65 percent 
      with multiple chronic conditions,” said Gene 
      Drabinski, TriZetto’s president of cost and 
      quality of care.* “CareAdvance Medicare 
      application’s high-risk member identification 
      tool was one of the many features Universal American sought to more 
      accurately and effectively manage its Medicare population.”
    
    
      The CareAdvance Medicare module is an optional component to TriZetto’s 
      Clinical CareAdvance application, the clinician-facing feature of the 
      CareAdvance Enterprise® 
      system. The CareAdvance Enterprise system is a care management system 
      that supports members and clinicians across the entire continuum of care 
      -- from utilization management to population health management. 
      Universal American, which serves a population of more than 240,000 
      seniors through its Medicare Advantage Plan, selected the CareAdvance 
      Medicare module to support the delivery of care for seniors that is 
      efficient and focused on geriatric diseases and syndromes.
    
    
      The tool uses 50 different rules to identify and stratify 
      senior-specific diseases from multiple sources, based on geriatric 
      syndromes including frailty, falls, decubitus ulcers, polypharmacy, 
      co-morbidity and safety. Universal American can enhance capabilities 
      further by incorporating predictive modeling and additional health risk 
      assessment data and biometrics.
    
    
      With the TriZetto Clinical CareAdvance and CareAdvance Medicare 
      applications, Universal American also has standard claims processing, 
      authorization, lab values and pharmacy tools that can help:
    
    
      
        Enhance administrative efficiency by improving care management 
        workflow;
      
      
        Support revenue goals by improving member retention, referrals and 
        satisfaction; and
      
      
        Reduce the cost of medical care by improving the management of 
        targeted conditions that are more common in older adults.
      
    
    
      “Medicare beneficiaries need special 
      attention from health plans because of chronic illnesses and geriatric 
      syndromes,” said Michael Cantor, M.D., J.D., 
      a Harvard Medical School professor and geriatrician who works with 
      health plans and other organizations to address the unique needs of the 
      Medicare population. “Without tailored 
      programs to provide senior-specific care, plans take on substantial risk 
      as health care costs continue to rise.” 
      Cantor, who also assisted TriZetto in developing the CareAdvance 
      Medicare module, added, “The senior 
      population continues to grow, and health plans such as those offered by 
      the subsidiaries of Universal American are planning for the future by 
      implementing effective care management tools to control care-related 
      costs and subsequently drive long-term success.”
    
    
      The TriZetto CareAdvance Enterprise system automates care management 
      workflows and personalizes member communications in support of case, 
      disease and population management. It enables the secure collection and 
      aggregation of member data in a single repository, so that data can be 
      shared by all entities involved in the member's care. Personalized 
      information and self-care tools help members make informed, effective 
      decisions about their own care. The CareAdvance Enterprise system 
      includes both the Clinical CareAdvance and the Personal CareAdvance® 
      applications.
    
    
      About Universal American Corp.
    
    
      Universal American offers a diverse range of healthcare products – 
      including health insurance, managed care and prescription drug benefits – 
      through its subsidiaries. Its companies are collectively among the 
      leading providers of Medicare Advantage and Medicare prescription drug 
      plans in the United States, as over 2 million seniors rely on Universal 
      American’s products for their health or 
      prescription drug coverage. For more information on Universal American, 
      visit its Web site at www.universalamerican.com.
    
    
      About TriZetto
    
    
      TriZetto is Powering Integrated Healthcare Management™. 
      With its technology touching nearly half of the U.S. insured population, 
      TriZetto is uniquely positioned to drive the convergence of health 
      benefit administration, care management and constituent engagement. The 
      company provides premier information technology solutions that enable 
      payers and other constituents in the healthcare supply chain to improve 
      the coordination of benefits and care for healthcare consumers. 
      Healthcare payers include national and regional health insurance plans, 
      and benefits administrators that provide transaction services to 
      self-insured employer groups. The company’s 
      payer-focused information technology offerings include enterprise and 
      component software, hosting and business process outsourcing services, 
      and consulting. Headquartered in Newport Beach, Calif., TriZetto can be 
      reached at 949-719-2200 or at www.trizetto.com.
    
    
      * Wolff, Jennifer L., M.H.S., Starfield, Barbara, M.D., M.P.H., and 
      Anderson, Gerald, Ph.D., “Prevalence, 
      Expenditures and Complications of Multiple Chronic Conditions in the 
      Elderly,” Arch Intern Med., American Medical 
      Association, Nov. 11, 2002, Vol. 162, pp. 2269-2276.