The TriZetto Group has announced plans to enhance its care management and value-based solutions for health plan members and their providers through a strategic partnership with clinical analytics developer MEDai.
Under the collaboration, MEDai analytics will provide TriZetto's care management and value-based solutions with enhanced features such as clinical risk modeling, identification and stratification, patient compliance monitoring, provider cost and utilization analysis and comparison, and cohort analysis.
"Robust, member-centric analytics are crucial for plan and provider organizations alike," said Jeff Rideout, MD, chief medical officer for Greenwood Village, Colo.-based TriZetto. "With the emphasis in reform legislation on broader coverage, community rating and accountable care organizations, as well as new definitions of qualifying medical expenses in the pending MLR rules, analytics become critical – not just helpful – for any healthcare organization that wants to thrive."
Plans call for these capabilities to be included in TriZetto's Clinical CareAdvance and Value-Based Benefits Solution sometime next year. The companies also plan to include the analytics capabilities in TriZetto's core administration and patient-centered medical home offerings.
For TriZetto, the enhancements to its value-based benefits offering comes as the company is making a sizeable push into providing deeper insight for payers into their data as they look for ways to incorporate value-based insurance design in the coming years.
"The integrated analytics will let payers work more effectively with their employer customers to manage member health and appropriately manage costs," said Jerry Osband, MD, vice president of product management, clinical strategy and analytics for TriZetto. "This sophisticated approach to integrating clinical analytics with care management and value-based member and provider solutions supports the foundation for patient-centered medical homes and value-based care delivery models."
In July, the company announced it was partnering with the Value-Based Insurance Design Institute to incorporate treatment templates for five chronic diseases – diabetes, coronary artery disease, asthma, a smoking habit and depression. Deeper analytics capabilities will allow payers and providers to better deliver the "nuanced" care required of effective value-based programs.
"TriZetto's systems will greatly enrich the analytics application on both the front and back ends," said Swati Abbott, president and CEO of MEDai, of Tampa, Fla. "On the front end, in the case of healthcare payers that use TriZetto's Facets and QNXT enterprise administration applications, these systems will feed the analytics software a rich repository of member health information. On the back end, TriZetto's care management and value-based benefits systems will utilize Risk Navigator's analytics to help physicians and members manage patient health through proven, high-value medical services."