TriZetto’s innovative technology solutions for payers are regularly written about by the media. We at TriZetto are proud of the accomplishments and good work our customers are doing to provide and improve America's healthcare. Following are highlights of press coverage about TriZetto and its customers:

Managed Care Outlook – December 1, 2011
Population Health Management, Informed by Clinical Analytics, Can Bend Cost Trend and Improve Outcomes
In this contributed article, TriZetto’s Jerry Osband, M.D., writes that population health management (PHM) can help manage the cost and quality of care for the millions of additional people entering the U.S. healthcare system as a result of reform. Important considerations, suggests Dr. Osband, are the use of clinical analytics to drive PHM; the adoption of Systematic Health ManagementTM, a broader, anticipatory approach to PHM; and the implementation of an integrated technology platform that supports care management, value-based benefits and reimbursement, and clinical analytics. "Useful, accurate information – in the right place and at the right time in the healthcare system – is required for effective population health management," Dr. Osband writes. "The good news is that technology-enabled solutions, informed by meaningful clinical analytics and available today, can meet this requirement for healthcare payer organizations large and small." [read article - PDF]

HealthTechZone – November 4, 2011
Systematic Health Management Can Improve Cost and Quality and Strengthen Payers’ Role in U.S. Healthcare
Healthcare reform legislation creates new opportunities to improve the quality of care and reduce healthcare costs, and in response, payer organizations are evaluating strategies that align incentives to reward quality outcomes instead of volume. One new strategy, writes TriZetto’s Jerry Osband, M.D., in this contributed article, prizes clinical value over volume. A unique approach to population health management, Systematic Health ManagementTM “leverages a suite of technology-enabled solutions to help payers implement innovative new delivery and reimbursement models, improve the coordination of care and benefits, align incentives, modify behaviors, improve outcomes, and reduce costs.” [read article – PDF, read article online]

Managed Care Magazine – October 2011
Five Threats to Value-Based insurance Design
In this in-depth article by reporter Michael Dalzell, TriZetto’s Katie Neben and Jay Sultan share their deep expertise concerning value-based benefit design and provider reimbursement strategies. Neben counsels that meaningful member incentives are necessary and that it’s critical to target conditions for which behavior change can make a positive impact both in cost and clinical outcomes. In espousing value over volume and a move away from the prevailing fee-for-service model, Sultan says “The conventional system was designed to pay for procedures and diagnostics. It does not pay for quality, for prevention, for care coordination, for wellness, for appropriate use, or for the hospitalization that was prevented. It is not designed to pay for accountable care, or for quality, or for any of the other things that would address unwarranted consumption of care.” [read article online]

InformationWeek Healthcare – September 20, 2011
Health Insurance Exchanges Change Game
With new rules capping profits and administrative expenses and state health-insurance exchanges on the horizon, healthcare payer organizations must do more than incrementally reduce administrative costs, says TriZetto’s Dan Spirek in this article by the leading technology trade publication. “You’ve got to attack the cost of care or you’re not going to be in the game.” Spirek explains the three categories of IT systems: core administration, care management and constituent engagement. He says that those TriZetto health plan customers that have invested in new technology across these categories have been three times more profitable than those that have not, and their medical-loss ratios have been better, as well. “The more they invested in technology,” according to Spirek, “the better they did.” [read article - PDF]

HealthTechZone – June 20, 2011
Transforming Your Business in an Era of Healthcare Reform (Parts 1 and 2)
With the passage of the healthcare reform law, healthcare payer organizations must address four challenges to succeed in today’s changing and evolving industry, suggests TriZetto’s Dan Spirek, in his two-part contributed article. In listening to its broad customer base, TriZetto believes the four challenges for payers are comply with reform, increase administrative efficiency, improve cost and quality of care and compete to win. Spirek argues that to comply with reform, health plans need a healthcare IT partner that can provide flexible and scalable enterprise-wide administrative solutions, maximize efficiencies to meet new medical-loss-ratio requirements and help them meet the HIPAA 5010 and ICD-10 mandates and even exploit them for strategic advantage. [read article – PDF 1, PDF 2, read article online]

Managed Healthcare Executive – June 16, 2011
Show Coverage: Affordability Still the Sticking Point
During America’s Health Insurance Plans’ Institute 2011 in San Francisco, reporter Mari Edlin sat down with TriZetto’s Dan Spirek to discuss ways healthcare payer organizations can prosper in a post-reform business climate. He encouraged compliance with reform, further administrative efficiency, improved cost and quality of care, and competing to win. “Labor strategies [such as the use of onshore and mixed-shore models] have generally not been deployed beyond mailroom operations. If [health plans] apply these initiatives to enrollment, billing, claims processing and benefit design, we can cut labor costs by as much as 50 percent.” [read article online]

American Health & Drug Benefits – May/June 2011
Systematic Health Management: The Time Has Come to Do the Right Thing for Each Person
In this contributed article, TriZetto’s Jeff Rideout, M.D., says the time has come for Systematic Health ManagementTM, or population health management, an approach that can help address the $600 billion to $800 billion in annual waste, or unwarranted variations in care, in U.S. healthcare. “All stakeholders in healthcare – including patients, clinicians, payers and employers – claim to be ready for change. Benefits and care that match the specific needs of a patient are highly regarded by consumers, payers, clinicians and employers alike. Furthermore, when such approaches are taken, they routinely show dramatic improvements in quality, cost and patient satisfaction. Finally, many new solutions and care-delivery models are available, such as patient-centered medical homes, accountable care organizations, payment bundling, value-based benefits, member-centric care management and highly predictive analytics, each of which can now be delivered in a scalable and automated fashion.” [read article - PDF]

Group Practice Journal – January 2011
Payer-Based Processes and Technology Improve Efficiency and Outcomes
TriZetto’s co-founder, Dan Spirek, explains how an unlikely alliance of healthcare payers and providers would improve the U.S. healthcare system significantly by helping achieve sustainable affordability and by enhancing both the administrative efficiency of group practices and clinical outcomes of patients. The foundation of this alliance? New web-based software applications and processes available to group practices through health plans. “Payer organizations have a rich repository of patient health information that is already digitized and that spans across facilities,” writes Spirek, who authored this contributed article. “Information technology is turning silos of payer information on their sides and sharing data with group practices and consumers.” [read article - PDF]

FierceHealthPayer – January 28, 2011
Administrative Efficiency, Value-Based Designs Ensure Economic Survival
Writer Dina Overland reports on remarks by TriZetto’s Larry Bridge during a webinar hosted by America’s Health Insurance Plans. Overland writes that Bridge touched on Integrated Healthcare Management, TriZetto’s vision for the industry; value-based insurance design, including benefit plans and provider-reimbursement strategies; and member engagement. According to Bridge, all of these approaches will be key to payers’ success in charting a path toward timely compliance with the health reform law, increasing administrative efficiency and competing successfully to win. [read article - PDF]

TechRockies – January 26, 2011
Interview With Trace Devanny, TriZetto Group
In this one-on-one conversation, TechRockies Editor Ben Kuo sits down with TriZetto’s CEO, Trace Devanny, to learn more about his first days at TriZetto and vision for the company’s future. Devanny stresses that technology – and specifically TriZetto’s software and services solutions – figures to play an even more prominent role in healthcare organizations during the post-reform era. “As President Obama tees up healthcare reform, you see players that are historically enemies in the marketplace--insurers and providers--being forced to work together, being marched toward a much more collegial and compatible view of bringing together disparate players,” says Devanny. Additionally, he sets forth TriZetto’s plans for organic and inorganic growth. [read article - PDF]

Managed Care Outlook – January 1, 2011
Choosing Integration Over Compliance: ICD-10 and the Advantages of System Overhaul
In an effort to meet the Jan. 1, 2011, testing deadline for implementing the ANSI 5010 Version X12 format, some healthcare payers postponed their ICD-10 planning. Other health plans are working on both migrations concurrently but use only the General Equivalence Mapping tool, which cannot provide one-on-one correlations between today’s ICD-9 and tomorrow’s ICD-10 codes. In this contributed byline, TriZetto’s David MacLeod argues that both approaches are short-sighted. Whether health plans upgrade to a new system, replace or consolidate multiple systems or remediate their current system, integration of the expanded code sets of ICD-10 “may be the biggest opportunity in a generation for payers to more effectively manage care and run an efficient health plan,” he writes. “Choosing the best strategy … can help payers utilize more sophisticated analytics to drive more interactive care and incentive programs, support new business functionality needed to leverage ICD-10 code data, easily integrate with new technologies, and offer value-based benefits and value-based reimbursement programs ….” [read article - PDF]

Managed Care Outlook – December 15, 2010
New Technologies Can Improve Payer-Provider Connectivity and Relieve Bad Debt Issues
Bad debt hurts providers, but the pain is shared due to resulting increased prices across the board. Both payers and providers would agree that current revenue-cycle processes are inefficient, and in this article, co-authors Tim Hascall of TriZetto and Maggie Fox of BlueCross BlueShield of Tennessee point to products and processes that enable point-of-service, real-time claims adjudication and help address bad debt, reduce healthcare costs and improve service and clinical outcomes for the member. Some providers already benefit from  TriZetto’s web-based Provider POS DirectTM application, which can accurately calculate a patient’s final financial liability and enable real-time claims submission at the point of service. Over the next few years, say Hascall and Fox, more BCBS plans across the country will begin responding in real-time to other BCBS plans that request member liability information and real-time adjudication for members who are treated outside their service areas. [read article - PDF]

Health Management Technology – December 2010
Navigating ICD-10: How to Get From Point A to Point B
TriZetto’s Greg Larson and El Paso First Health Plans’ Sharon Perkins team to co-author this article about the joint effort by the two firms to evaluate El Paso’s entire business from top to bottom, reviewing ways ICD-10 and 5010 could impact even the least likely business unit. The effort, say Larson and Perkins, proved a valuable path for change and growth. “It enabled El Paso to move forward with a clear course to follow for change,” they write, “and allowed the company to maximize the coming regulatory changes for the business.” [read article - PDF]

CDHC Solutions – December 2010
CDHC and VBID: Clash of the Titans or a Powerful New Hybrid for Improved Health Care?
In this magazine read broadly by health plan executives and benefit administrators, TriZetto’s Gail Knopf suggests that new healthcare IT makes it possible for two seemingly opposite approaches – consumer-driven healthcare and value-based insurance design – to combine rather than combat and, as a powerful new hybrid, dramatically improve U.S. healthcare. “Think not of an HDHP, but of a VBHP – a variable-benefit health plan,” says Knopf. “The more clinically beneficial the therapy for a particular patient, the lower that patient’s cost share; the less clinically beneficial, the higher the patient’s share.” [read article - PDF]

JAZD Healthcare Insights – November 30, 2010
Data Analytics Help Turn Healthcare Insights Into Action
TriZetto’s Jerry Osband, M.D., visits with blogger Jeff Kelly. Dr. Osband explains that MEDai’s data management and analytics capabilities paired with TriZetto’s CareAdvance Enterprise platform make it easier for payer organizations to stratify patients by risk level and kick off a chain of actions to best serve them. Actions, he said, might include suggestions to join a disease management program in exchange for reduced medication co-pays. The technology might prompt the mailing of basic wellness guidelines or a simple call from a nurse. [read article - PDF]

Managed Care Outlook – October 15, 2010
There's Gold in Exchanges – Here’s How to Stake Your Claim
Eric Grossman of TriZetto authored this primer article for health insurers looking to participate in health insurance exchanges, scheduled to debut in 2014. About 24 million Americans will enter the healthcare market through these heavily financed state exchanges, says Grossman, making them a major player in the distribution system for individual and small-group health insurance. Grossman shares guidance on how payers can optimize integrated systems, sales and transaction efficiencies, applied business intelligence and constituent engagement to take advantage of the influx of customers.. [read article - PDF]

InformationWeek Healthcare – August 12, 2010
TriZetto Intros Disease Management Platform for Insurers
Nicole Lewis reports that TriZetto launches its Value-Based Benefits Solution to enable payers to identify and reduce out-of-pocket costs for proven, effective pharmacy and medical services for chronically ill patients. “Our Value-Based Benefits Solution targets patients with select clinical diagnoses and lowers co-payments or coinsurance for specific, high-value medical and pharmacy services as consumers take positive action, not at some fixed point in time such as open enrollment,” explains TriZetto’s Gail Knopf. The automated solution from TriZetto removes the financial barriers to patients obtaining doctor visits, procedures and medications that can help manage their health and mitigate more acute, expensive episodic care. [read article - PDF]

Insurance & Technology – August 11, 2010
TriZetto Releases Value-Based Benefits Solution
Writer Nathan Golia reports the general availability of TriZetto’s Value-Based Benefits Solution, health benefits administration and incentive management software that uses the company’s Facets and QNXT core systems to customize benefits and incent member choices based on their health status, chronic conditions, and health and wellness activity. “TriZetto’s solution can certainly handle basic value-based design requirements, but it also can provide value-based insurance designs in advanced forms, including multiple incentives that are member- and condition-specific,” says Gail Knopf, vice president of enterprise strategy at TriZetto. “Our Value-Based Benefits Solution targets patients with select clinical diagnoses and lowers co-payments or coinsurance for specific, high-value medical and pharmacy services as consumers take positive action, not at some fixed point in time such as open enrollment. TriZetto’s product automates what historically has been a very labor-intensive, individualized adjudication of medical claims.” [read article - PDF]

Insurance & Technology – August 2, 2010
PHRs Gain Popularity Among Insurers
This article acknowledges that the uptake of practice- and hospital-based electronic records will take considerable time as providers implement new technology infrastructure. Meanwhile, healthcare payers are stepping in to meet the need with personal health records (PHRs), patient-controlled health itineraries that are auto-populated by data in the claim systems of health plans. “Payers have had the most comprehensive data collection within their systems and processes for years,” explains Prudence Kuai, TriZetto’s senior vice president of product management. “The payer has medical information, pharma, lab information – as long as it’s a service that’s been provided to a member. They have very direct access and very timely access to the data set.” [read article - PDF]

Managed Care Outlook – August 1, 2010
Survey Indicates Readiness for Value-Based Care Models
This article highlights some of the findings of TriZetto’s constituent survey, which gauged readiness for value-based insurance design (VBID). The story reports that 70 percent or more of each constituency -- physicians, health insurers, consumers, employers and brokers – say they are ready and willing to adopt VBID plan models. “The support for VBID in the recent reform bill, coupled with the broad constituent support for VBID reflected in the TriZetto survey, supports rapid adoption,” says Jeff Rideout, M.D., TriZetto’s senior vice president of care and cost management and chief medical officer. [read article - PDF]

Federal Telemedicine News – July 21, 2010
Updates on Key Issues
Editor Carolyn Bloch reports that TriZetto’s Jeff Rideout, M.D., and Gail Knopf presented at a Capitol Hill briefing on how value-based insurance design (VBID) can effectively reduce the healthcare spend and improve health outcomes. Bloch writes that “Knopf described how VBID can actually work to help people get preventive and effective patient care. This is accomplished by providing incentives and rewards to the consumer for making the right choices and discouraging procedures proven to be ineffective or dangerous.” [read article - PDF]

Denver Business Journal – July 15, 2010
Health-Software Company TriZetto Moving HQ to Colorado
Reporter Mark Harden writes that TriZetto has named Trace Devanny its new chief executive officer and relocated headquarters to its Greenwood Village, Colo., offices. [read article - PDF]

Orange County Business Journal – July 14, 2010
TriZetto Names New CEO; Headquarters to Colorado
Reporter Vita Reed shares news that TriZetto has named Trace Devanny its new chief executive officer and relocated headquarters to its Greenwood Village, Colo., offices. [read article - PDF]

The Medical News - July 1, 2010
Constituents of the U.S. Healthcare System Ready to Adopt Value-Based Insurance Designs: Study
“TriZetto’s survey finds all constituents of U.S. healthcare in rare agreement,” notes TriZetto’s Jeff Rideout, M.D., in this article. “They concur that a systematic, collaborative approach will cultivate better health, reduce delivery of unwarranted care, promote patients’ compliance with health improvement plans and reduce overall healthcare costs.” The company’s study showed broad support by physicians, employers and others not only for value-based insurance designs, but also value-based reimbursement and systematic health management (SHM). An approach among clinicians, payers and consumers, SHM helps address the health and wellness needs of an entire population, whether it is a health plan’s membership, an employer’s workforce or a physician’s patient panel. [read article - PDF]

Benefits Selling - June 2010
Ready Welcome Predicted for Value-Based Benefits
Doctors, insurers and consumers are “ready and willing” to adopt value-based insurance designs, which use information and financial incentives to guide healthier lifestyle choices and compliance with proven, patient-appropriate medical services and medications. So say findings of a survey of more than 1,700 constituents commissioned by TriZetto, writes reporter Danielle Andrus. Employers, brokers and payers see value-based benefits as a competitive advantage. Doctors support such plan designs to help improve the overall health of their patients while directing them to appropriate care. Constituents across all categories agree that direct financial incentives are the best way to motivate behavior changes. Half of brokers say premium reductions are the best incentives that can be offered, but other groups agree that cash is most effective. [read article - PDF]

Healthcare IT News – May 2010
Constituents of the U.S. Healthcare System Ready to Adopt Value-Based Insurance Designs: Study
“could use an SaaS service to model the impact of ICD-10 and provider contracts,” says TriZetto’s Greg Larson in this article reporting on TriZetto’s association with 3M Health Information Systems. “Few payers will invest in episodic solutions like this because they don’t use it every day, but an SaaS model provides the ideal on-demand environment for a payer to evaluate contracts as needed.” [read article - PDF]

Health IT Law & Industry Report – May 25, 2010
PHRs Assuming Their Rightful Place in the Alphabet Soup Of Digital Health Records
The payer-based personal health record (PHR) presents a tremendous opportunity to improve healthcare dramatically in the near term, while the physician practice-based electronic health record and hospital-based electronic medical record become more widely implemented, suggests TriZetto’s Jeff Margolis in this contributed article. “Advancing PHRs at this time in no way impedes those other record systems; rather it helps all three models grow together toward fully Integrated Healthcare Management – IHM – in the United States.” [read article - PDF]

The AIS Report on Blue Cross and Blue Shield Plans – May 19, 2010
Blues CIOs Will Have to Split Resources Between ICD-10 and Reform
Executive Editor Jill Brown notes that the work of complying with changes mandated by healthcare reform won’t divert the attention of Blues from the 10th revision to the International Statistical Classification of Diseases and Related Health Problems, more commonly known as ICD-10 diagnostic codes. TriZetto’s Tim Hascall explains that the new reform legislation is expected to add 30 million people to insurance policies. “That’s a lot of volume. There will be a lot of scrutiny on medical loss ratios and administrative costs … at the same time as processes have to be able to scale up to handle lots of new members.” [read article - PDF]

For the Record - May 10, 2010
Choosing Integration Over Compliance: ICD-10 and the Advantages of System Overhaul
In a contributed article, TriZetto’s Dave MacLeod writes, “Although migrating to ICD-10 codes is likely to give most health plans a headache, it also should spur great imagination for realigning business goals, creating enterprise-wide change and transforming healthcare in this country.” He makes a compelling case for a migration strategy that helps healthcare payers use increasingly sophisticated analytics to drive more interactive care and incentive programs, support new business functionality needed to leverage ICD-10 code data, easily integrate with news technologies, and offer value-based benefit and value-based reimbursement programs. Such an approach, said MacLeod, “will determine a payer’s long-term success and help it achieve its strategic goals.” [read article - PDF]

Health Management Technology – May 1, 2010
An ICD-10 Road Map
Several experts provide ideas for successful implementations, including upfront planning and training considered important factors in the transition to this coding system. TriZetto’s Dave MacLeod suggests that, “If planned for properly, transitioning to ICD-10 can be the biggest opportunity in a generation for payers to more effectively manage care and run an efficient health plan.” He cautions healthcare payers that they cannot afford to miss this opportunity. “The healthcare industry is at a crossroads, and making the right decisions now will ensure a successful journey into our collective future.” [read article - PDF]

Managed Care Outlook - April 15, 2010
What Constitutes High-Quality Health Care to Consumers?
While initiatives to measure quality care are predominantly academically and clinically oriented, consumers advocate entirely different, lay definitions, and providers and health plans would be wise to embrace these mostly nonclinical metrics. TriZetto’s founding chief executive, Jeff Margolis, authors this article encouraging payer organizations to leverage information technology – personal health records, benefit cost modelers, treatment cost tools and more -- to meet and even exceed consumer-defined measures of quality care. [read article - PDF]

Healthcare IT News – March 19, 2010
TriZetto, 3M Partner to Speed ICD-10 for Payers
Reporter Mike Miliard writes that TriZetto and 3M Health Information Systems announce an agreement that gives TriZetto certain exclusivity to include 3M’s ICD-10 Code Translation tool with several new services for payers under its TriZetto Advantage 10 Services. TriZetto’s integration of 3M’s technology will help streamline and simplify healthcare payers’ efforts to comply with the ICD-10 and HIPAA 5010 requirements and leverage the code migration to improve the cost and quality of care for members. A 3M executive describes the partnership of the two organizations as “the best minds coming together.” TriZetto’s Greg Larson says, “Using the 3M tool for our payer services gives our Advantage 10 offerings unique value for TriZetto’s customers, giving them a competitive advantage for faster, more reliable migration and services for their members and network providers.” [read article - PDF]

AHIP Hi-Wire – March 16, 2010
IT Providers Target VBBD Data Challenges
Reporter George Miller notes that with the release of TriZetto’s Value-Based Benefit Solution, version 4.7 of TriZetto’s Facets enterprise administration system “will automate two tasks: the tailoring of benefits and claims adjudication to specific clinical conditions for high-risk members and rewarding member participation in health, wellness and condition-management programs.” His article further notes that TriZetto’s new solution will help payers and their employer customers administer value-based benefits programs and members view their incentive options and activity. [read article at this link]

Managed Healthcare Executive - March 1, 2010
Take Steps to Prepare for Insurance Exchanges: Transaction Efficiency Needed
A byline article penned by Eric Grossman for this publication targeting senior-level decision makers positions TriZetto's suite of sales and service automation tools in discussing the "no regret" investments payers can take now to prepare for health insurance exchanges. These no-regret investments come in three broad areas: sales and service transaction efficiency, applied business intelligence and constituent engagement. "Without these investments," warns Grossman, "payers may find themselves unable to compete for and profit from the expanding and sizable individual and micro-group market." [read article - PDF]

Reducing Healthcare Costs for Employers – February 28, 2010
Getting More Bang for Your TPA Buck: Questions Employers Should Ask Before Paying
Employers are changing how they conduct due diligence on third-party administrators (TPAs), evaluating them not just on the cost of their services, but on the TPA’s ability to expand or adjust services later and its ability to provide more comprehensive programs. Joe Manheim, TriZetto’s president of benefits administration, stresses this point in suggesting 12 questions that employers should ask to help ensure their TPAs are doing all they can to manage fees and risk, align incentives and provide value-adding services that go beyond administering underlying self-funded claims. [read article - PDF]

Insurance Finance & Investment – February 15, 2010
Predictions of the Evolving Healthcare Landscape
TriZetto’s founding CEO and author of the book The Information Cure, Jeff Margolis, sets forth his 2010 predictions for the healthcare industry. Evidence-based medicine, the alphabet soup of electronic records, care management, consumer measures of quality and the evolving payer-provider relationship are all addressed in this wide-ranging, farsighted piece by the nation’s leading innovator in and proponent of the discipline of systems science for U.S. healthcare. Published twice monthly, Insurance Finance & Investment is read by more than 10,000 predominantly C-suite executives. [read article - PDF]

Smart Business Orange County - February 2010
Business as Usual: How Jeff Margolis Maintained Normalcy as He Took The TriZetto Group Private
Smart Business Orange County is a management journal providing insight, advice and strategy for C-level executives of fast-growth, middle-market and large companies. In this cover story, reporter Brooke Bates probes TriZetto's founding CEO Jeff Margolis on his approach to taking TriZetto private in 2008. He shares his guidance on candid, timely, strategic communication with all stakeholders, stressing the importance of keeping employees focused, "walking in your customers' shoes" and explaining clearly your reasoning and timeline for the transition. Suggests Margolis: "Make sure you talk to the employees like adults, not like children. Don't sugarcoat the potential things that could happen." "When it comes to customers, you have to be, first and foremost, honest about any changes that could impact them. You need to think about what their biggest fears or concerns might be." [read article - pdf]  [visit web site]

Neil Versel's Healthcare IT Blog - January 22, 2010
Podcast: TriZetto's Jeff Margolis
On Sept. 9, 2009, President Barack Obama pitched his healthcare bill to a joint session of Congress. The next day, respected healthcare IT reporter Neil Versel sat down with TriZetto's Jeff Margolis. Margolis explained his nonpartisan prescription for fixing what ails U.S. healthcare: Integrated Healthcare Management. This podcast interview includes a short brief about Margolis's book, The Information Cure; some discussion about healthcare legislation; a link to purchase Margolis's book; and a detailed outline of each section within the podcast. The final running time is about 35 minutes. [watch the podcast]

AHIP Hi-Wire – January 5, 2010
Software Tackles VBBD Math
Reporter George Miller reports that TriZetto is launching its Value-Based Benefits Solution, a software application that could play a big role in helping up to 106 million Americans manage their health more effectively. The application, explains TriZetto’s Gail Knopf, vice president for enterprise strategy, will automatically “individualize benefits and claims adjudication to the clinical conditions of each high-risk member and reward participation in condition-management programs.” The Value-Based Benefits Solution will run on TriZetto’s Facets and QNXT enterprise administration systems, which are used by healthcare payer organizations that provide coverage to more than a third of the U.S. population. [read article at this link]

Healthcare Finance News - November 9, 2009
Pacific Northwest Payer Helps Speed Up Provider Payments
Provider feedback has been "very good," this story reports, in response to the rollout of TriZetto's Provider POS Direct product by PacificSource Health Plans. According to the story, the Northwest carrier launched TriZetto's application to further enhance its communications with and support of providers. TriZetto's Dave Pinkert explains that Provider POS Direct especially supports the consumer-directed health plans that PacificSource and other payers offer. The application helps providers efficiently manage collections and claim submissions to ensure full payment in a timely manner. [read article - PDF]

Healthcare IT News - November 2009
Oregon Calls for Transparency
The Oregon legislature has mandated health plans provide the cost of 35 different treatments to consumers. Using TriZetto's Treatment Cost Navigator application, reports this publication, PacificSource has delivered to members nearly 1,000 estimates for 50 unique treatments and has since expanded this number. Dave Pinkert of TriZetto says that payers are deploying TriZetto's Treatment Cost Navigator and other tools that reduce complexity and make it easier for members to know what particular services cost. Health plans, Pinkert explains, can analyze the data and see how members are using their system, which can inform payers' business strategy and help "bend the cost of healthcare." [read article - PDF]

For the Record – November 2009
Web Exclusive: Q&A With Jeff Margolis
In this wide-ranging web exclusive with For The Record, TriZetto's Jeff Margolis discusses the motivation for his book, The Information Cure; stimulus funding for healthcare IT; a systems approach to improving U.S. healthcare; and driving adoption of payer-based personal health records. "Einstein said that the definition of insanity is doing the same thing over and over again while expecting a different answer," said Margolis. "I wrote The Information Cure and documented the vision of Integrated Healthcare Management because the problems we are trying to solve are complex, and we will not create a sustainable, affordable healthcare system by following the same rationale that has plagued the healthcare debate for decades. [read article at this link]

Healthcare IT News - June 2009
Payers See ICD-10 as IT Driver
Surveys commissioned by The TriZetto Group show that the commitment to use ICD-10 migration to drive additional IT system changes and achieve strategic advantage is growing among health plans large and small. TriZetto's Rob Scavo, senior vice president of core administration solutions, notes that, "Many of them plan to leverage ICD-10 to drive broader system and operational changes that improve their connectivity to providers, members and brokers, reduce costs and enhance clinical outcomes. In effect, they are using ICD-10 to power their IHM (Integrated Healthcare Management) strategies." [read article - PDF]

Orange County Business Journal - – June 1-7, 2009
Private TriZetto Has More Space to Grow
Founder, Chairman and CEO Jeff Margolis updates the Orange County Business Journal on developments since going private. He explains that TriZetto has been focusing on its "base strategy" of Integrated Healthcare Management. He also says that the go-private transaction has allowed TriZetto to focus on developing products and services without the quarterly earnings scrutiny of investors. While acknowledging his support for provider-based medical records, Margolis advocates the importance of payer-based personal health records, given the rich repository of benefits and claims information residing in the information systems of health plans. [read article - PDF]

Benefits Selling - June 2009
I, Broker: Automation of Health Plan Distribution Can Support Broker Innovation During These Uncertain Times
TriZetto Founder, Chairman and CEO Jeff Margolis and Vice President Eric Grossman suggest that information technology (IT) – specifically, greater automation in health plan distribution – will support producers' own efforts to meet myriad business challenges. The authors state that such innovation in IT will redirect both the broker's time and the premium dollar toward health advocacy. Margolis and Grossman envision a one-stop web portal where brokers will search, quote, apply and bind health insurance and ancillary policies online from a choice of local and leading payers. They further anticipate the complete automation of payers' processes to sell and renew customers, and bind cases. [read article - PDF]

Healthcare Finance News - March 2009
TriZetto Eyes ICD-10 Onslaught
Although the government extended deadlines for migrations to ICD-10 diagnosis codes and ANSI 5010 HIPAA transaction codes, TriZetto counsels healthcare payers to begin assessments and planning now. TriZetto's Rob Scavo, Maureen O'Hara and Kim Rosengren argue that health plans should act now to explore how migrations can not only ensure compliance but serve as a catalyst to seize strategic advantage. [read article - PDF]

Managed Care Outlook - February 1, 2009
Six Predictions for 2009 Herald Challenges for U.S. Healthcare Industry
TriZetto Founder, Chairman and CEO Jeff Margolis expounds on his six predictions for 2009. While these predictions underscore significant challenges, he is "most certain that the U.S. healthcare industry is up to meeting these challenges head on and vastly improving the delivery of benefits and care in our country." [read article - PDF]

Managed Care Outlook - January 15, 2009
The Road Ahead: New Emphasis on Prevention Key to Reducing Fraud
A growing number of payers realize that the traditional approach to fraud abatement – one which relies almost exclusively on "pay and chase," or retrospective investigations and recovery – has had little, if any, effect on preventing fraud from reoccurring. Rob McGinley, vice president of detection & recovery services for TriZetto's Plan Data Management division, describes a new framework taking shape that harnesses a variety of tools to achieve true fraud prevention. [read article - PDF]

Managed Care Outlook - December 15, 2008
From Disparate Data Points to Better Business Decisions
Despite the enormous volume of data that healthcare payers process daily, most health plans are challenged with cost-effectively and efficiently converting the data into useful information that supports business decision making. TriZetto's Tim Hascall, executive vice president of professional services, explains that payers that understand how to derive meaningful information that supports collaborative interactions with providers, consumers and other healthcare constituents bring themselves one step closer to Integrated Healthcare Management and the U.S. healthcare system one step closer to radical improvement. [read article - PDF]

For the Record – November 24, 2008
Real-Time Adjudication
Claims processing needn't take weeks or months, and providers needn't endure the uncertainty of payment. Real-time adjudication is fast becoming reality, and industry experts, according to this article, say the idea has gained momentum. Dave Pinkert, TriZetto's senior vice president of constituent web solutions, weighs in on growing interest among providers and the many benefits of real-time adjudication, not just to medical practices but to payer organizations as well. [read article - PDF]

Managed Care Outlook – September 2008

The Healthcare Savings Chronicle – October 1, 2008
Selecting the Right Technology Platform to Couple Care Management With CDHPs
Despite impressive early results, consumer-driven plans are no panacea for rising healthcare costs. In a contributed article appearing in both and Healthcare Savings Chronicle, Joe Manheim, TriZetto's senior vice president of benefits administration and care management, makes a well-researched argument that if payers and employers couple CDHPs with comprehensive care management programs, they can reduce the growth in their healthcare spend. In evaluating a care management software system to support this approach, the payer organization should ask itself eight questions, suggests Manheim. [read Managed Care Outlook article - PDF]  [read Healthcare Savings Chronicle article - PDF]  

Healthcare Finance News - July 2008
New Deals Fuel TriZetto's Growth
This business newspaper for healthcare financial managers reports on TriZetto's acquisition by Apax Partners, as well as its alliance with Microsoft's HealthVault platform and expansion to Europe through a deal with Dutch-based Unisys Nederland NV. Commenting on the transaction with Apax Partners, TriZetto Chairman and CEO Jeff Margolis said: "I … believe that going private will give us greater flexibility in thinking about longer-term investments in product development, acquisitions and partnerships that will benefit our customers." [read article - PDF]

Digital HealthCare & Productivity - June 3, 2008
TriZetto Inks Unisys Deal to Boost European Presence
This e-newsletter reports on TriZetto's selection of Unisys Nederland NV to sell, distribute and maintain its products in the Netherlands, a country with a competitive, private health insurance market within a universal health system for 17 million inhabitants. "Health insurers here are taking a strategic, progressive view, wanting not just to adjudicate payments for medical services, but to help manage members' health," says Unisys Nederland account executive Hans van der Zweth. [read article - PDF]  [visit web site]

E-Health Europe – June 3, 2008
TriZetto Signs Netherlands Marketing Deal
Writer Neil Versel reports that TriZetto signs an agreement for Unisys Nederland NV to market, distribute and maintain TriZetto products to Dutch health insurance organizations. Commenting on the five-year deal, the company's first international channel partner agreement, Vice President of Strategic Alliances Chuck Sanders says, "I think Europe is a tremendous growth opportunity for us. We're not just going to sit back and wait for an RFP." [read article - PDF]  [visit web site]

The Healthcare Savings Chronicle – May 19, 2008
The Road Ahead: New Emphasis on Prevention Key to Reducing Fraud
Some industry estimates put the total annual loss in U.S. healthcare from fraud and abuse somewhere between $63 billion and $210 billion. In this bylined article, co-authors Robert McGinley and James McCall, TriZetto vice presidents, write that a growing number of payers now realize that the traditional "pay-and-chase" approach to fraud abatement isn't working. They explain and advocate a framework that harnesses a variety of tools to achieve true fraud prevention. "This approach emphasizes cooperation and communication with providers, greater member buy-in through improved education and industry-wide transparency to allow for easier identification of aberrant behavior." [read article - PDF]  [visit web site]

Healthcare IT News - March 2008
QualChoice Gets Tough on Fraud
By using TriZetto's Plan Data Management as its special investigator unit and utilizing TriZetto's Facets claim adjudication system, QualChoice of Arkansas, a managed care company and health benefits administrator, takes an integrated approach to managing fraud, waste and abuse, according to Haley Wilson, QualChoice's CIO. Robert McGinley, vice president of detection and recovery services for TriZetto's Plan Data Management division, notes that such integration is vital "because the biggest hurdles in fraud detection are the inhibited flow of clean data and lack of clean data itself." [read article - PDF]

Physicians' Financial News – March 24, 2008
RCTA Helps Medical Practices Streamline Operations
Real-time claims adjudication (RTCA) processes are simplifying administrative tasks and helping physicians obtain payment for services from patients at the time care is provided. Quoted extensively throughout this article, Dawn Burriss, vice president of integrated provider solutions for TriZetto, explains how RTCA helps physicians improve cash flow, reduce days in accounts receivable and prevent bad debt as much as possible. [read article - PDF]  [visit web site]

Healthcare Finance News - February 2008
Integrated Management is Answer to the Crisis
A new way of managing the flow of benefit and care information and the incentives built into the U.S. healthcare system has the potential to benefit every participant by improving the availability of relevant information, improving the quality of medical care and reducing costs. TriZetto Co-Founder, Executive Vice President and Chief Solutions Officer Dan Spirek explains "integrated healthcare management" and how payers are ideally positioned to lead toward this new model because they are the organizers of both benefits and care. [read article - PDF]

Managed Healthcare Executive - March 1, 2008
Payers Start to Leverage Social Networking Media
In the emerging world of consumer retail healthcare, organizers of systems of care – healthcare payers – will increasingly begin to participate in social networks in 2008 to stay in step with the consumers they ultimately serve. Read more about this prediction in an article authored by Chairman and CEO Jeff Margolis. [read article - PDF]

Managed Care Outlook - January 15, 2008
Predictions for the Health Care Payer Market in 2008: The Rise of Integrated Healthcare Management
As 2008 began, the health care industry entered a new era of integrated healthcare management (IHM) – the systematic application of processes and shared information to optimize the coordination of benefits and care for the health care consumer. Jeff Margolis, chairman and CEO, presents six predictions in this bylined article. These six challenges and changes, he argues, can be met by payers that embrace IHM. [read article - PDF]

Consumer-Focused Healthcare - October 3, 2007
Dan Spirek Weighs in on the Direction of Consumerism in Healthcare
Consumers don't want to actually take control of healthcare, much as they didn't want control over their retirement funds. But employer survival is forcing the transition. This is one of several observations on consumerism captured in a podcast featuring Dan Spirek, TriZetto's executive vice president, integrated health solutions and chief solutions officer, and posted on the blog of Vijay Goel, M.D. Blogger Goel previously was a consultant at McKinsey & Co, where he worked with payers, providers, banks and employers to think through the implications of healthcare consumerism. [read blog]

The Healthcare Savings Chronicle – September 2007
Imagine a Time
Imagine a time when every patient has access to all the information needed to make sound health and healthcare decisions. A patient would leave each physician visit with a summary of that interaction, including self-management advice. In this bylined article, TriZetto's Gene Drabinski, president of cost and quality of care, explains how we get from here to there and how payers can take a leading, more relevant role. [read article - PDF]

Healthcare Finance News - June 1, 2007
Debt Collection Can Be Nasty, But It's Necessary
This leading health care IT monthly magazine features an article about providers' frustration with rising collection debt and how new technology can help reduce those lost costs. This article features quotes from TriZetto's Dawn Burriss. [read article - PDF]

Nashville Business Journal - May 4, 2007
Easing the Pain of High-Deductible Health Plans
This Tennessee business journal article focuses on Blue Cross Blue Shield of Tennessee and the success they've seen since implementing TriZetto's Provider POS Direct real-time estimation tool. [read article - PDF]

Advance for Health Information Executives - March 1, 2007
Paying as Medicare Pays
This featured byline by TriZetto expert Larry Bridge addresses the business and technology challenges that health plans face when offering Medicare Advantage private-fee-for-service benefits. [read article]

Managed Care Weekly - February 12, 2007
Jeff Margolis Predicts Profound Changes to U.S. Healthcare System in 2007
TriZetto's CEO, a 20-year leader in developing information-technology systems for the managed care industry, offers his top healthcare predictions for 2007 and beyond. [read summary]

Healthcare Finance News - February 1, 2007
BCBST Buys POS Product for Providers
This leading health care IT monthly magazine features an article on BlueCross BlueShield of Tennessee's deployment of TriZetto's Provider POS Direct software, which provides accurate patient liability at the point of care in support of consumer-directed health plan products. [read article - PDF]

Managed Healthcare Executive - February 1, 2007
Change in Guard = Change in Medicaid?
This monthly publication written for executives in the managed care industry includes expert commentary from TriZetto's Larry Bridge on changes in the Medicaid market and the related opportunities for health plans. [read article]

Investor's Business Daily – January 19, 2007
Healthy Growth for Health Care Services
The nation's top newspaper for both professional and individual investors provides an industry snapshot of the booming health care services industry, featuring the healthcare information-technology services offered by TriZetto and expert commentary from analyst Gene Mannheimer of Caris & Co. [visit home page]

Managed Care Outlook - January 1, 2007
Debit Cards and Benefit Plan Administration
This targeted bi-weekly publication, which addresses cutting-edge trends and techniques in the managed care industry, features an article by TriZetto's Joseph Manheim on the key issues surrounding debit cards and the need for a tightly integrated consumer benefit payment platform. [visit Managed Care Outlook]

Investor's Business Daily – December 5, 2006
Outsource Model Key To E-Health Records
The nation's top newspaper for both professional and individual investors examines the technology strategies behind e-health records, with expert commentary from TriZetto. [visit home page]

Healthcare Savings Chronicle – December 2006
Transparency: The Key to Un-Locking Consumer-Directed Care
This targeted monthly publication, which covers companies in the forefront of the healthcare marketplace, features an article by TriZetto's Gail Knopf on the critical importance of data transparency and the role of the payer given the emerging retail model in healthcare. [read article]

Consumer Driven Healthcare – November 2006
Beyond Plan Design: BCBSIL, TriZetto Collaboration Focuses on Delivering Timely, Targeted Information
This cutting-edge monthly publication profiles the partnership between Blue Cross Blue Shield of Illinois and TriZetto, including how TriZetto's CareAdvance Enterprise software is helping the health plan to succeed in a consumer-driven market. [request a copy]

Orange County Business Journal - November 27, 2006
Insurer Acquisitions Spur TriZetto Gains
This weekly business journal profiles TriZetto's continued growth amid strategic acquisitions. [read article]

Managed Healthcare Executive - October 2006
State of the Industry: 2007
This monthly publication written for executives in the managed care industry includes CEO Jeff Margolis' predictions for consumer directed healthcare in 2007. [read article]

Healthcare IT News - October 17, 2006
CMS to Put Medicare Part D Data to Work
This leading healthcare IT monthly magazine examines how CMS and the industry's leading healthcare IT vendors, like TriZetto are putting Medicare Part D data to work. [read article]

Forbes.com - October 3, 2006
Five Smart Analyst Plays
This high-level website offering hard-hitting financial and national news digs deep into the companies the Wall Street consensus deems as "5 Smart Analyst Plays." [read article]

CIO Magazine - October 1, 2006
Cure for the Blues
This leading-edge magazine written for Chief Information Officers examines the industry of health insurance plans, with a special focus on Blue Cross and Blue Shield of Kansas City, a partner of the TriZetto Group. [read article]

Healthcare IT News - October 1, 2006
TriZetto Acquisition Follows a Trend
This leading healthcare IT monthly magazine explores the announcement of TriZetto's $145 million acquisition of Quality Care Solutions Inc. and how it follows a trend of tighter integration of claims processing and claims editing systems and synergy between products and companies. [read article]

Managed Healthcare Executive - September 2006
Real-Time, Point-of-Service Financial Settlement: Why Health Plans will Lead the Next Revolution in Healthcare
This monthly publication written for executives in the managed care industry features an article on health plans leading the next revolution in healthcare, written by Dawn Burriss of TriZetto. [read article - PDF]

Los Angeles Times - October 23, 2006
Business News: Promotions and Appointments
The primary newspaper representing the city of Los Angeles and its suburbs includes a news brief on TriZetto naming Gene Drabinski president of the cost unit. [visit business section]

Health Data Management - October 1, 2006
Sprucing Up Practice Management
This respected healthcare IT trade explores the new functions being added to software and bringing new efficiencies within practice management. TriZetto provides expert commentary within the article. [read article]

BusinessWeek Online - October 27, 2006
Financial News
This online news portal from the one of the leading news publications in the country features a news brief on TriZetto's acquisition of Plan Data Management. [visit home page]

Houston Chronicle - September 2006
Business News
This daily newspaper explores the partnership between TriZetto and Plan Data Management. [visit home page]

Wall Street Journal - October 27, 2006
TriZetto Signs Pact To Buy Plan Data Mgmt Inc.
The national daily newspaper explores the partnership between Plan Data Management and TriZetto. [read article]

Health Management Technology - September 2006
Claiming Victory
This respected healthcare IT trade explores claims and coding efficiencies with expert commentary from TriZetto customer APS Healthcare and information about the TriZetto product, Facets. [read article]

Advance for Health Information Executives - July 2006
Cementing New Relationships
Larry Bridge of TriZetto offers a thought leadership byline on the Medicare Modernization Act. [read article]

Managed Healthcare Executive
Hi-Tech Contracting from December Special Report, December 2005
Technology is an important factor in effecting successful contractual relationships between insurers and providers, but mostly from an administrative viewpoint. The Trizetto Group... [more...]

Managed Healthcare Executive
Web Service Improves New Mexico's Largest Health Plan, June 2005
In late 1999, we at Presbyterian Health Plan made a commitment to boost our business use of the Internet. Our executive team began outlining a Web strategy to strengthen operations... [more...]

Managed Healthcare Executive
Commentary: Substance Must Come Before Style in Consumer-driven Plan, by Jeff Margolis, CEO, TriZetto,
March 2005
In his book, The Tipping Point, Malcolm Gladwell explains that momentous shifts in behavior are preceded by incremental changes, which build until they reach a critical mass. Well, hold on to your hats, because healthcare's about to tip... [more...]

Managed Healthcare Executive
Consumer-Directed Healthcare and Meeting the IT Challenge, September 2004
The demand for consumer-directed healthcare (CDH) is growing. Once just an idea tossed around in health plan boardrooms and industry think tanks, CDH is now taking root... [more...]

Healthcare IT News
Payers Keen for the Right Data, June 2004
IT vendors, fresh from the National Managed Health Care Congress, are focusing on providing greater integration and added functionality to their managed care products this year... [more...]

Healthcare IT News
Buyers' Guide – Managed Care Information Systems, June 2004
GETTING COSTS OUT and operating efficiencies are driving the market for managed care information systems (MCIS), according to Steve O'Dell, vice president... [more...]

Disease Management News
Predictive Modeling Strategy Yields Savings for TN Blues, February 25, 2004
Adding a predictive modeling tool to its data mining activities has helped Blue Cross Blue Shield of Tennessee save money and enhance its disease management services... [more...]

Health Management Technology
The Health Plan of Tomorrow, by Jeff Margolis, CEO, TriZetto, January 2004
The increased role of consumers, along with increased healthcare costs, will compel health plans to use technology so everyone in the equation comes out a winner. Ready or not, the age of consumerism has descended upon healthcare... [more...]