NEWPORT BEACH, Calif. - November 2, 2009 - The TriZetto Group, Inc. today announced the general availability of QNXT EssentialsTM, a software and services package specially designed for health plans with fewer than 50,000 members, to make core administration system upgrades easier, faster and more cost-effective. The first customer, MD Care Healthplan, a new plan serving 8,000 Medicare patients in Los Angeles, Orange and Riverside counties (and San Bernardino County next year) will go live on QNXT Essentials in early 2010.

The QNXT Essentials package includes TriZetto's entire QNXTTM enterprise administration system, accelerated product implementation and full-service application hosting and management services. The unique offering, designed for six-month deployment, includes a low, predictable monthly fee that fits within the budget of any health plan.

"We wanted greater efficiency and automation in our claims adjudication and other operations, and we sought a solution that would allow us to enter the game at a lower price and scale with membership growth," said Don Phan, chairman of MD Care. "With QNXT Essentials, we get the best of all worlds -- a proven platform, rapid implementation and expert application hosting -- without major upfront investment. We believe QNXT Essentials will enable us to quickly achieve our business goals and compete toe-to-toe with much larger plans."

"Just like their larger counterparts, smaller health plans require robust business functionality and technical capabilities," explained Rob Scavo, TriZetto's senior vice president of core administration systems. "But, unlike larger payers, emerging plans often have neither the same level of resources and expertise to manage their core administration systems nor the ability to make large upfront investments. With QNXT Essentials, we're arming these payers with a proven solution, enabling them to compete at the same level."

TriZetto's QNXT Essentials meets a need among small but growing health plans to migrate from older, often internally developed core administration systems to newer technologies.

"There is an inflection point at which investment in the older applications produces much less value than investment in newer technologies and/or newer technology delivery and management strategies," wrote Janice Young in an IDC Health Insights' June 2009 white paper sponsored by TriZetto, Small Healthcare Payers: Opportunities and Challenges in the Emerging Market. "Most small healthcare payers have likely reached or will shortly reach this inflection point …. Most will find a need to migrate to newer, more agile environments, particularly those that support strong integration, web services and information management. Many healthcare payers will seek greater partnerships, if not outsourcing, for service, support and maintenance."1

TriZetto's QNXT Essentials includes the following components:

• The complete QNXT enterprise administration system, a rules-driven, user-configurable application, with .NET architecture, that automates and supports all core plan administrative processes, including membership enrollment, premium billing, claims adjudication and customer support.
• Application management and hosting, including hardware, infrastructure, 24/7 support, updates, upgrades and disaster recovery.
• A proven implementation methodology with a rapid go-live; pre-configured quick-start templates for plans, contracts, benefits and policies; data-conversion support and other technical assistance; modeled reports; project oversight; and user training.

The QNXT Essentials Web package also includes TriZetto's new Member and Provider Service real-time portal applications, while the QNXT Essentials Medicare Package includes a choice of TriZetto Medicare applications to automate CMS enrollment, eligibility reconciliation and revenue management.

Signal Hill, Calif.-based MD Care was looking for a solution that would enable the payer to design innovative benefit plans, improve operational efficiency and stability and more easily comply with Centers for Medicare & Medicaid Services (CMS) requirements and the 5010/ICD-10 mandates.

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 ManagementTM, 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.

Footnote
1. IDC Health Insights white paper sponsored by TriZetto, Small Healthcare Payers: Opportunities and Challenges in the Emerging Market, Doc #HI218869, June 2009

MEDIA CONTACTS:

Loren Finkelstein
The TriZetto Group
303-542-2460
loren.finkelstein@trizetto.com

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