Health plans face unprecedented changes to their business models: value-based purchasing, new flavors of consumer directed health care, accountable care organizations (ACOs), payment reform and more. Regulatory changes such as implementation of ICD-10 and imposition of minimum medical loss ratios are also high on the priority list.
Traditionally, health plans have been reluctant to move away from legacy systems such as TriZetto, because risks seemed too high relative to the benefits. However, the changing environment makes staying the course riskier, and that’s providing an opening for players such as HealthEdge, that position themselves to address the new business models with efficient, effective, automated solutions.
HealthEdge Sales & Marketing EVP Ray Desrochers provides his take in this podcast interview.