Trizetto Grp. (MM) (NASDAQ:TZIX)
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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.