Healthcare IT News - May 2008 - (Page 28)

28 Healthcare IT News ■ May 2008 PayERS www.HealthcareITNews.com claims processing, which eliminated production disruptions. Funk said the health plan is now in various stages of other data management implementations with Initiate Systems such as identification of data coming in-house, customer service applications through its portal, integration of transaction processing with its vendors and employee data protection. “BCBS of Minnesota wanted a holistic view of its members in order to provide better service for its members in such areas as claims efficiency and better information to members,” said Lorraine Fernandes, vice president of healthcare and industry ambassador for Initiate Systems. While MDM is a developing market, it is an important tool for payers because they sit on a tremendous amount of data, she said. Health plans are embracing MDM at an accelerated pace, she said. With the shift to a consumer-centric healthcare model, MDM helps drive up the quality of data and service. “There’s still confusion about what MDM is because it’s still an immature practice for now,” said Carl Doty, senior analyst at Forrester Research. But he sees that practice emerging in the healthcare industry. One reason for its emergence is the relatively recent technological ability to have software sit on top of systems and pull data from the systems without having to create a monolithic database. “This is mainly attributable to the maturity of service-oriented architecture,” he said. ■ More at HealthcareITnews.com e Connect: Data 0508 Centene to automate provider network daTa HEalTHCarE IT nEwS Staff Continued from page 1 – Centene Corp., a health plan that provides benefits to members who receive benefits under Medicaid, will automate its provider network processes. Centene officials have selected a technology platform developed by Philadelphiabased Portico Systems. Centene aims to streamline and ensure accuracy in credentialing, prospecting, new provider enrollment, provider information maintenance, ST. LOUIS, MO reporting and state file management. “Greater efficiency and quality will be enabled by moving the management of all provider information to the Portico platform,” said Patricia Darnley, senior vice president of operations for Centene. Centene operates health plans in Arizona, Georgia, Indiana, New Jersey, Ohio, South Carolina, Texas and Wisconsin. ■ More at HealthcareITnews.com e Connect: CeNteNe 0508 ● of members,” said Nathan Funk, system architect in the enterprise architecture services department. “We have multi-sources of resources and we needed consistency.” The implementation process took six months, but BCBS of Minnesota rolled out a demonstration to prove initial success and determine subsequent requirements for performance and scalability. The implementation’s success also hinged on the ability to use existing software and integrate the software with such systems as June 18-20, 2008 Moscone West San Francisco, California BIg ToPICS, BIg SPeakeRS 2008 is a paramount year in the health insurance industry, with health system reform at the forefront of this ever-important presidential campaign. Although the candidates talk about what’ll work and what won’t, what’s important and what’s not, Institute 2008 will continue to focus on real applications, real solutions, real results. That’s why it’s long been considered the nation’s leading health care conference. Featured Speakers Include: ● HUMana Continued from page 27 Health, Humanity, and Politics: Prospects for Reform Sponsored by Connecture Decision 2008: The Politics of Health Care Sponsored by Assurant Health John Breaux Former United States Senator, Co-Chairman of President’s Tax Reform Commission, and Expert on Social Security, Health Care, and Energy The Honorable William H. Frist, MD 18th Majority Leader, U.S. Senate (2003-2007); U.S. Senator from Tennessee (1995-2007); HeartLung Transplant Surgeon; “Citizen Legislator” Tommy g. Thompson Secretary of Health and Human Services (2001-2005); Governor, Wisconsin (1987-2001); Independent Chairman, Deloitte Center for Health Solutions; Partner, Akin Gump Strauss Hauer & Feld LLP Dan Bartlett Former Counselor to the President of the United States Terry Mcauliffe Former Chairman of the Democratic National Committee, Chairman of Hillary Clinton for President Value-based Purchasing of New Medical Technologies James C. Robinson, PhD, MPH Kaiser Permanente Professor of Health Economics at the University of California at Berkeley; chair of the Medical Technology Committee of the Integrated Healthcare Association; and Contributing Editor to Health Affairs Executive Roundtable Diagnosing the Disease: A Disruptive Remedy for Health Care Clayton M. Christensen Robert and Jane Cizik Professor of Business Administration at the Harvard Business School What Got You Here Won’t Get You There: Helping Successful Leaders Get Even Better Sponsored by Abbott (Attendance is strictly limited to ELP/ELP-MD Alumni and CEOs and senior management teams of AHIP member health insurance plans only.) It’s a Big Year. Be Part of It. Register Today. Visit www.ahip.org/conferences/Institute2008 or call 877.291.2247 for more information. Modernizing the Delivery System to Achieve 21st Century Value atul gawande, MD, MPH Surgeon at Brigham and Women’s Hospital; a New Yorker staff writer; and Author of Better: A Surgeon’s Notes on Performance Marshall goldsmith, PhD Bestselling Author and WorldRenowned Thought Leader in Leadership Development, Coaching, and Human Resources Sheilah kast Reporter and Anchor of public television, ABC News, and CNN Moderator of patients in a true patient-centric approach – to tailor communication and intervention. “We begin with the end in mind,” he said. “You don’t build a system that puts people into chronic disease buckets. That creates a breakage in the infrastructure.” The extensive systems integration combines data from three primary systems: clinical tracking, informatics/analytics and customer relationship management. The system outputs reporting, decisionsupport triggers and alerts, and ongoing outcomes monitoring. “The fundamental ROI proposition is if you deliver real intervention beyond the medical condition, you can change the trajectory of people’s health status and it costs less,” Wigginton said. He noted the market has a heightened focus on results. “Being able to attribute financial and clinical outcomes to specific interventions is vitally important,” he said. Lynne Dunbrack, program director at Health Industry Insights, said that according to HII’s 2008 Payers Top 10 Predictions Report, “Health Industry Insights projects that 75 percent of healthcare payers with more than 500,000 members will offer health education and coaching services by the end of 2008.” Investment in healthcare coaching exceeds investment in traditional disease and care management strategies and technologies, she said. Lubitz said it would take a year for Humana to see any changes. “We expect to see a decrease in complications and hospital admissions resulting from non-compliance with treatment plans,” he said. “Our goal is to achieve savings of at least twice the cost of the program.” ■ More at HealthcareITnews.com e Connect: HUMaNa 0508 Content and Design. AHIP—All Rights Reserved: © AHIP 2008 General Session Sponsors: Assurant Health, Connecture, ING Reinsurance, and RAM Technologies, Inc. ● http://www.HealthcareITNews.com http://HealthcareITnews.com http://www.healthcareitnews.com/story.cms?id=9179 http://www.ahip.org/conferences/Institute2008 http://HealthcareITnews.com http://www.healthcareitnews.com/story.cms?id=9142 http://www.ahip.org/conferences/Institute2008 http://HealthcareITnews.com http://www.healthcareitnews.com/story.cms?id=9174

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Healthcare IT News - May 2008 Contents Help Wanted Speeding Up Government Silos Privacy Pressures Tracking Disease Rah Rah Health! TriZetto Suit Outcomes Watch Ambulatory EHRs

Healthcare IT News - May 2008

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