TriZetto Survey: Use of health plans ICD-10 to Drive Strateg

NEWPORT BEACH, Calif. - (BUSINESS WIRE) - A growing number of health plans believe that the transition to ICD-10 and the diagnostic procedure coding system is an opportunity to achieve a competitive advantage by using the migration as a catalyst for organizing strategic improvements.

That is one conclusion of a 2009 survey commissioned by The TriZetto Group, Inc., a manufacturer of software and IT services company that helps payers of health care and other constituents towards the integrated management of health care (HMI): the convergence of benefits administration, care management and constituent engagement of information and incentives to improve health care in the United States. This second in a series of longitudinal surveys monitoring payer transitions of ICD-10 was conducted by the portico Group, LLC, a strategic consulting and research company. The first survey, conducted in October 2008, the basis for comparison.

The first survey TriZetto to the second, the commitment to use the ICD-10 migration route system information and make strategic changes has increased, especially among health plans on both ends of the continuum of the composition - large and small members. Commitment is increased from 31 percent to 48 percent between plans under 50,000 members, while it increased by 36 per cent to 75 per cent for taxpayers with more than 8 million covered lives.

"Surveys show that what we heard from customers,"? said Rob Scavo, Senior Vice President of Administration of basic solutions. "Many of them plan to ICD-10 as a lever to drive the system and operational changes that improve their connectivity with suppliers, brokers and members, reduce costs and improve clinical outcomes. In Indeed, they use the ICD-10 to the power of their strategies for HCI. "?

Surveys show payers are not the postponement of the ICD-10 preparation, even if the federal government has extended the deadlines for January 1, 2012 for the x12 ANSI v.5010 HIPAA electronic transaction standards and 1 October 2013, the ICD-10 code set. Thirteen percent of health plans increased from inaction to action on migration, according to two studies by TriZetto, any ICD-10 began to increase 29 per cent. The number of taxpayers plans or implement plans rose from 41 percent to 54 percent. Sixty-three percent of health plans in the most recent survey TriZetto that the period of extension will not affect their planning or simply slow the pace of adoption.


Intensification of ICD-10 is an activity more and more health care from the taxpayers of the scope of work to perform the migration. From first to second study, taxpayers increasingly said that the effort would be comparable to the HIPAA effort (14 per cent in the first study to 24 per cent in the second), while 26 percent plans health continue to believe that the ICD-10 will be a bigger effort to HIPAA compliance. Health plans who believe that the ICD-10 will be a greater effort of will Y2K has increased from 19 percent to 28 percent.

"As payers have begun to plan the ICD-10 sites, they became aware that the scope goes far beyond claims coding,"? Scavo said. "They are what the ICD-10 will have an impact on all health plan operations - from product development to revenue management, customer service, reimbursement management, finance and administration, care management, network management and risk management - and thus their care management, provider networks and component systems and major applications of Directors. "?

TriZetto, "said Scavo, provides a number of taxpayers will use the ICD-10 as an opportunity to replace outdated base platforms administration faster and hopefully provide a basis for the GUI. He said that health plans that already have state of the art systems to use the ICD-10 migration route for changes in their demand for health care and as to take better advantage of the intelligence of new coding structure provides.

A 2008 survey conducted by insurance industry research firm Gartner Inc. found that the number of core administrative systems that insurers to keep health care has remained high. Seventy percent of respondents indicated they had more than two core administrative systems, and 32 percent of them have more than four core administrative systems. (Source: Galimi, and Joanne O'Neill, Maureen, "many core administrative systems continue to plague the insurers of health care?" Gartner, Inc., Dec. 9, 2008.) After that, many systems core administrative challenge will be to ICD-10 migration efforts, because each system must be updated to ICD-10 or replaced.

TriZetto's Facets ® and QNXTTM administration platforms basis, as well as care and its constituent applications will ICD-10-compliant, well before the 2013 deadline, according to Scavo. Timely compliance systems, he said, will allow its customers to pay for health care focused on updating their products, network and care management technology and processes, operations and service to customers "to achieve the full benefits of ICD-10 migration and the competitive advantages of MMI. ?

The portico TriZetto Group commissioned to provide a baseline level of health attitudes and perceptions about the ICD-10 and follow the evolution of these views as taxpayers conduct their updates. Participants in this longitudinal study in the size ranges from less than 50,000 members in more than $ 8 million. Role of the groups were broken by terms of size and included C-suite, Vice President, director, manager and specialist in analyst with 100 employees in health care organizations pay.

About ICD-10

When seeing a patient, a doctor of collecting historical information and physical and recommends measures to improve the health and perhaps some medical procedures. All this is coded using a taxonomy of diagnosis, the World Health Organization of the International Statistical Classification of Diseases and Related Health Problems (ICD). The codes are used to monitor morbidity and mortality and to claim reimbursement of health. In 2013, health plans and providers must move from ICD-9 coding to ICD-10, a more complex classification of diseases, which reflects recent advances in detection and treatment of diseases and is used by all other countries in the industrialized world.


About Gantry Group

The Portico Group is a strategic consulting firm that guides technology based solution providers to build offerings that capitalize on the urgency of market needs and challenges. During the last decade, the portico of the customer satisfaction, primary market research and ROI / TCO measurement services have armed the world's leading provider of technology focused on the markets to support their decisions strategic business and inform their roadmaps of the solution. With more than 25 years of experience, the portal offers business executives the customer first, a market overview and forecast of measurement capabilities that allow them to accurately quantify the business opportunity and to position itself to capture the largest market share. Additional information on Gantry Group can be found at www.gantrygroup.com.

About TriZetto

Founded in 1997, TriZetto is a privately held health care information technology in the United States with its technology to reach half of the U.S. insured population, TriZetto Integrated Healthcare is switched Managementâ "¢. TriZetto provides solutions that enable health insurance payers and other constituents of the supply chain of health care to improve the coordination of health care benefits and care for consumers. The company offers businesses and component software, hosting and outsourcing services business process and consultation.






TriZetto

Government Relations Contact:

Brad Samson, 949-719-2220

brad.samson @ trizetto.com

or

Media Contact:

Melissa Bruno, 781-684-0770

trizetto@schwartz-pr.com



Source: TriZetto