In an effort to help members better manage their acute and chronic diseases, Arkansas Blue Cross and Blue Shield will use a care management system from The TriZetto Group.
The Little Rock-based health insurer will deploy Trizetto's Clinical CareAdvance system, which is designed to consolidate data from three legacy systems and integrate several manual processes currently used by Arkansas BCBS to streamline and improve processes.
The system will track each activity and provide an audit trail to help extend the reach and benefit of Arkansas BCBS' high-touch case and disease management programs.
Arkansas BCBS, an independent licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in the state, serving approximately one-third of the fully insured market.
The system is expected to go live in about a year.
"We believe TriZetto's Clinical CareAdvance application will help us reach more members more effectively and ensure they are getting the right healthcare service at the right time," said Steve Abell, vice president of enterprise networks for Arkansas BCBS. "Long term, we believe that as our members get more personalized attention and information, it will improve their health and the healthcare system. Clinical CareAdvance will help improve the efficiency of our care management programs, support a significantly increased caseload for our nurses, improve reporting and service for our customers and enhance care for our members."
TriZetto's Clinical CareAdvance applies clinical algorithms that create targeted interventions to help improve members' health. According officials at the Newport Beach, Calif.-based company, the system was designed to be open and flexible, with the idea being that health plans using various core administrative systems would be able to benefit from the technology's functionality. Clinical CareAdvance will provide Arkansas BCBS with comprehensive health monitoring and reporting tools; provider and nurse-manager alerting; template-based, secure messaging between provider(s) and the health plan; real-time member identification and stratification; customized real-time statistics and reports; and outbound communication methods tailored to its member.
"Arkansas Blue Cross' current care management programs already have reduced hospitalizations, decreased lengths of stay and lowered emergency room utilization," said Joe Manheim, senior vice president of CareAdvance and benefits administration at TriZetto. "With TriZetto's Clinical CareAdvance system, the organization can take its impressive results to the next level with a single data source for real-time risk stratification that identifies members who change health status, for better analytics and for more robust reporting to employers and states."