NEWPORT BEACH, Calif. - March 4, 2010 - At the recent "Strategically Transitioning to ICD-10 for Providers and Plans" conference, Dr. David MacLeod, vice president of research and development for TriZetto Services, and a 30-year veteran of the healthcare technology industry, emphasized the obligations healthcare payers have to implement ICD-10 codes, as well as the opportunities they can leverage if they make those changes now.

"Imagine going to sleep one night with a 17,000 word vocabulary, and waking up the next morning to a world with 155,000 words, new rules of grammar and new sentence structures," said MacLeod, who also co-chaired the conference. "That is what ICD-10 will be to under-prepared healthcare providers and payers. Healthcare entities can either decide only to learn the bare minimum of the new language and squeak by, or they can learn a new way of speaking and leverage the richness of data available with the new ICD-10 codes for many new opportunities."

MacLeod continued that payers have an obligation to use the fullness of the ICD-10 transformation to drive "health, wealth, and wellness." In particular, the granularity of data available from the ICD-10 codes will give payers the best opportunity to implement the care management programs-value-based benefits and reimbursement, wellness programs, and others-that are necessary to stay competitive and to drive greater value for consumers and employers.

Finally, MacLeod emphasized that payers and providers should not look at ICD-10 transformation as a simple claims system fix. Instead, they should understand that this change will affect every element of their business, from claims administration to provider contracts.

"Right now, someone in your office is writing a new contract with a doctor," MacLeod told the audience. "But if that contract is based on ICD-9, you are setting yourself up for cost risks and are missing huge opportunities. For example, new codes for external causation, activities and places of occurrence will create new subrogation opportunities."

About David MacLeod

With nearly 30 years experience in healthcare information technology systems design and development, including appointments to advise the federal HHS department the national healthcare infrastructure, David MacLeod, Ph.D., FHIMMS, CISSP, is TriZetto's expert for ICD-10 migration. He is the Vice President of Research and Development and Technology Architecture at TriZetto, focusing on Integrated Healthcare Management solutions. MacLeod is a fellow of the Healthcare Information Systems Society and a Certified Information Systems Security Professional.

About TriZetto's ICD-10 Services

The TriZetto Group is helping payers become ICD-10 compliant through both software and services. In anticipation of upcoming federal deadlines, TriZetto has released updated versions of two enterprise administration suites-the Facets™ and QNXT™ software systems-to provide payers an easy and rapid path to install, test and move into production with systems tools that assist them with their ICD-10-compliance objectives. These new software upgrades can help payers increase performance, improve efficiency, and support new benefit designs through value-based benefits that reward consumers for healthy lifestyles and behaviors.

In addition to software, TriZetto can provide customers with tailored services that help them leverage the new ICD-10 code data and develop more complex benefit designs. A team of certified employees from the TriZetto Advantage 10 Compliance Plus™ upgrade service can work with payers to ensure they are utilizing ICD-10 data for strategic initiatives, such as wellness programs.

About TriZetto

Founded in 1997, TriZetto is a 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 Management®, 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 to market new products that drive competitive differentiation.

Media Contacts:

Rachel Tanner Lew
The TriZetto Group
303-495-7022
rachel.lew@trizetto.com

Melissa Bruno
Schwartz Communications
781-684-0770
trizetto@schwartz-pr.com