GREENWOOD VILLAGE, Colo. - January 10, 2011 - The TriZetto Group, Inc. today announced the general availability of its CareAdvance Enterprise^® 4.71 suite of solutions, the newest version of its care management platform focused on helping health insurance payers improve care coordination efficiency, engage physicians at the point of care and prepare for ICD-10 mandates. In addition, the new version has been updated to enhance usability and scalability across the enterprise.

“This newest version of the CareAdvance Enterprise suite of solutions is designed to help our customers be successful in the rapidly changing healthcare environment,” said Jeff Rideout, M.D., TriZetto’s chief medical officer. “By improving communication and connectivity with providers, health plans can engage physicians and enable them to automate requests for medical services, improving consistency of treatment and reducing unwarranted variations in care.”

Not only does version 4.71 improve payer-provider connectivity, it also readies payers for ICD-10 mandates and upcoming healthcare reform requirements. With clinical workflow capabilities, a 360-degree member view and the ability to identify opportunities for high-value clinical support, CareAdvance 4.71 is designed to help TriZetto’s health plan customers manage costs, while improving quality of care.

With ICD-10 deadlines looming, health plans must update their administrative and care management systems to accept ICD-10 codes and leverage the wealth of diagnostic information available by using the new codes. By integrating the CareAdvance Enterprise 4.71 application, payers will be ready to accept utilization management requests with ICD-10 codes and deliver care management interventions with greater diagnostic specificity.

“We are focused on providing the tools necessary for our payer customers to thrive in a changing care delivery process,” continued Rideout. “The solution is highly scalable, enhancing care management processes for health plans of varying sizes and complexity.”

The CareAdvance Enterprise platform combines utilization, case, disease and population management in one system to help increase administrative efficiency and promote quality care to members. The application helps care managers focus on members who need day-to-day management by skilled providers and clinicians, steering members to appropriate procedures or services based on their health profiles, and identifying members for health and wellness engagement.

The CareAdvance Enterprise suite includes the Clinical CareAdvance^® application for clinicians, providing support for utilization, case and disease management; the Personal CareAdvance^® application for members, providing population management; and the CareAdvance Provider^™ application, offering a self-service extension of utilization management for physicians and their staff. CareAdvance Provider is also equipped with a Member Clinical Profile (MCP). The MCP conforms to the HL7 Continuity of Care Document (CCD) industry format and provides a real-time view into the clinical information available in the CareAdvance Enterprise system. The CareAdvance Provider module will be offered as an add-on application to the Clinical CareAdvance solution.

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’s vision for the industry, Integrated Healthcare Management, is the optimized coordination of benefits and care for healthcare consumers to improve the value of every healthcare dollar spent. The company’s offerings include enterprise and component software, I.T. outsourcing services, business process outsourcing services and consulting that help payers transform and optimize their operations to enhance revenue growth, to drive administrative efficiency and to improve the cost and quality of care.

Media Contacts:

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

Schwartz Communications
Davida Dinerman/Pauline Louie
781-684-0770
trizetto@schwartzcomm.com