PRODUCTS THAT GROW MEDICARE MARKETS

With more than 30 percent of all Medicare Advantage and Part D lives processed on our core systems, our experience and capabilities can help you effectively address your Medicare administration needs and respond quickly to evolving mandates and regulatory requirements.

The number of people receiving Medicare benefits is projected to rise nearly 60% by 2030. For health plans serving this market, long-term success demands increased system efficiencies to support this rapid growth. Medicare market success also requires tools that enable continued compliance with changes in Medicare reporting rules, complex CMS regulations and the MLR requirement.

The Cognizant line of TriZetto Healthcare Products provides an extensive portfolio of capabilities to meet the specific needs of your Medicare Advantage business. This comprehensive and highly effective combination of advanced technology and services offerings can help you lower administrative costs, increase speed to market and decrease total cost of ownership. Other capabilities work to:

• Generate and edit required RAPS and encounter data submissions for Medicare
• Accurately enroll and reconcile Medicare members
• Enhance risk score accuracy to receive proper reimbursement
• Identify where members have hierarchical condition categories (HCC)
• Utilize analytics to improve your Five-Star Quality Rating 
• Coordinate and improve care for Medicare members
• Administer new reimbursement and care models