NEWPORT BEACH, Calif. & ARLINGTON, Va.--(BUSINESS WIRE)-- The TriZetto Group, Inc. and the National Association of Health Underwriters (NAHU) today published the results of a new study that identifies current manual processes as the main impediment to efficient sales of small-group and individual policies and shows agreement among healthcare payers and brokers that technology can provide the biggest improvement. Both see small-group and individual sales as strategic to their growth strategies.

Health plans and producers say that rising healthcare costs and an economic slowdown are increasing the importance of small-group and individual policy sales, that improvement in the sales cycle is needed, and that integrated sales automation and exchanges would bring efficiencies that reduce costs and increase revenue for all.

These were the broad findings of a study of healthcare payers and brokers in late 2008, conducted by Gantry Group, LLC, and commissioned by The TriZetto Group, Inc. A software and IT services firm, TriZetto helps healthcare organizations move toward Integrated Healthcare Management, the systematic application of processes, shared information and aligned incentives to optimize the coordination of benefits and care for the healthcare consumer. The brokers were surveyed in conjunction with NAHU, a membership organization representing 100,000 licensed health insurance agents, brokers, consultants and benefit professionals in more than 200 chapters across the country.

Highlights of the study include:

• 89 percent of brokers and 80 percent of payers indicate interest in a fully integrated sales automation platform (i.e., enabling cases to be quoted and bound online).
• 90 percent of brokers and 65 percent of payers indicate interest in a multi-payer online exchange.
• 89 percent of health plans see brokers as valuable partners in serving this market and have no plans for disintermediation or commission reductions.
• More than 80 percent of payers and brokers view the small-group segment as strategically important for growth.
• 64 percent of payers believe products that enable customers and brokers to purchase policies online through integrated sales automation would have a high payoff and give producers more time to provide value-added services needed to grow revenue.
• More than half of the producers surveyed - 58 percent - say streamlining case installation would provide the biggest return on investment, or ROI.
• 40 percent of brokers report that the time to bind a case stands the greatest need for improvement; they say it takes 18 to 29 days, twice as long as they would like, to bind cases for small-group and individual customers.

A research report on the findings of the study is available at http://integratedhealth.trizetto.com.


In this difficult economic climate, small-group and individual and family plans represent a vitally important revenue source, offering payers higher growth and profit margins than those of other employer-sponsored policy sales, said Eric Grossman, TriZetto's vice president of product management. The study shows that payers and brokers agree on the need for a more integrated solution. However, the technology must be integrated with payers' core administration systems to truly impact efficiencies and drive broker adoption. Integration gives the ability to quote and bind online and reduce the paper-intensive process associated with small-group and individual sales.

The study shows concurrence among health plans and producers that further automation of health plan distribution would increase the time brokers have to serve as healthcare advocates for their customers, added Janet Trautwein, chief executive officer and executive vice president of NAHU. What's exciting is that distribution technology would free brokers and agents to broaden the important services they provide as customer healthcare advocates.

For payers, technology can deliver the greatest value by streamlining enrollment and underwriting. Most health plan executives surveyed by Gantry, 76 percent, said that further automation of these two processes would be more beneficial than the automation of other capabilities. A majority of brokers, 58 percent, agreed. Sales automation gives payers and producers what they value most, according to this TriZetto survey: streamlined enrollment and underwriting, which can significantly reduce administrative processes and costs by increasing accuracy and give brokers more time to focus on servicing customers and growing sales.

The study demonstrates strong market support for last month's announcement by TriZetto and HealthConnect Systems, Inc., of their partnership to develop a next-generation sales automation solution that helps payers, health insurance brokers and general agents improve the entire sales life cycle. Under the partnership, TriZetto^® Quote2Card will integrate TriZetto's Facets^® enterprise administration system with HealthConnect's broadly adopted broker portal and sales automation tools.

Set to debut in late 2009, TriZetto Quote2Card will give brokers and general agents a multi-payer web portal with the ability to sell and complete the enrollment process, including generating a member identification card from the desktop. The platform will help lower administrative costs by streamlining administration and improve broker sales and retention by freeing up time now spent on resolving administrative problems to focus on customer advocacy and sales. With TriZetto's national footprint touching half of the U.S. insured population, and a 17-state multi-payer quoting capability, Grossman said the company is strategically positioned to operate a multi-payer exchange in an efficient and unparalleled manner.


About the Surveys

In late 2008, TriZetto commissioned Gantry Group to survey payers and brokers to assess distribution and sales challenges and opportunities.

The online study collected feedback from 82 payer participants, with survey results having a confidence level of 95 percent, plus or minus 9 percent. Health plan participants represented a balance of four segments based on membership size: 150,000-500,000, 500,000-2 million, 2 million-8 million and more than 8 million members; and three types of plan: Blues, national and regional. Participants included executive management, sales executives and other operational executives.

In partnership with NAHU, Gantry also collected feedback online from 277 brokers, with survey results having a confidence level of 95 percent, plus or minus 6 percent. Brokers represented nine states: Massachusetts, New York, Pennsylvania, Florida, Tennessee, Michigan, Texas, California and Washington. Participants were licensed health insurance agents with strategic decision authority within their agencies, and small group/individual policy sales were an important revenue source.

About Gantry Group

Gantry Group is a strategic consulting firm that guides technology-based solution providers to build offerings that capitalize on urgent market needs and challenges. For the past decade, Gantry Group's customer satisfaction, primary market research and ROI/TCO measurement services have armed the world's leading technology vendors with targeted market intelligence to support their strategic business decisions and inform their solution roadmaps. Backed by over 25 years of experience, Gantry Group delivers to business executives the firsthand customer metrics, market insights and predictive measurement capabilities that allow them to accurately quantify the business opportunity and position themselves to seize the greatest market share. Additional information about Gantry Group can be found at www.gantrygroup.com.

About NAHU

The National Association of Health Underwriters is an association representing 100,000 health insurance agents, brokers and benefit specialists from every state in the country. NAHU members work with both individual and corporate health insurance consumers to help provide them with high-quality and affordable health insurance specifically suited to their unique needs.

About TriZetto

Founded in 1997, TriZetto is the leading privately held healthcare information technology company to the healthcare payer industry. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare Managementâ„¢, the systematic application of processes and shared information to optimize the coordination of benefits and care for the healthcare consumer. The company's offerings include enterprise and component software, hosting, outsourcing services and consulting that help payers implement and optimize their operations and minimize the risk of bringing new products to market that drive competitive differentiation.






TriZetto Contact:

Schwartz Communications

Melissa Bruno, 781-684-0770

trizetto@schwartz-pr.com

or

NAHU Contact:

Kelly Loussedes, 703-276-3835

Vice President of Public Relations

kloussedes@nahu.org

Source: TriZetto