LINKING PEOPLE TO IMPROVE HEALTHCARE

The most successful care management programs optimize the connections among care managers, members and providers. The result: personalized healthcare interventions, enhanced outcomes, improved quality of care and reduced costs. 

Achieving these goals can be difficult, but automating and integrating as many processes as possible can make meeting them feasible.

Our approach to care management starts with Clinical CareAdvance® and CareAdvance Provider®, solutions that together deliver full care management capabilities across utilization, case and disease management. These solutions transform care management into an automated, data-driven activity that delivers more targeted, effective health information and wellness campaigns. The outcome is improved interactions with members and providers. 

Our Value-Based Benefits solution, the second part of our care management portfolio, provides an automated and integrated solution for designing and administering member incentive programs. Our newest care management solution, TriZetto® Touchless Authorization Processing (TTAP), enables fully automated prior authorization via provider portal, including integrated clinical criteria and pre-built integration to QNXT™.

Because our CareAdvance and Value-Based Benefits solutions share a member portal, these solutions can use the same rules. This approach automates your plan’s workflows and leverages real-time coordination between systems. While both are core product-agnostic, each solution can also be fully integrated with both Facets® and QNXT solutions.    

INTEGRATING CARE AND OUTCOMES

Our Care Management solutions helps healthcare organizations enhance revenue growth, drive efficiency and improve cost and quality of care. Your benefits include:

• Increased efficiencies via a streamlined utilization, case and disease management experience.
• Reduced risk and total cost of ownership by integrating both Facets and QNXT.
• Efficient workflows through consolidated application screens and an interface that allows easy navigation and access to important member information.
• An open analytics platform that you can customize and integrate them with any advanced analytics solution to improve clinical outcomes.
• The ability to engage members to manage chronic conditions effectively and improve overall health status by participating in programs for chronic conditions, prevention and wellness.