The TriZetto Group, Inc., is a world-class healthcare IT company that provides solutions and services for payers and providers that drive administrative efficiency, improve the cost and quality of care, and increase collaboration and connectivity between payers, physicians and health systems.  TriZetto’s solutions touch more than half of the U.S. insured population, and reach over 350 health insurance payers and more than 21,000 physician offices representing more than 90,000 providers.

TriZetto is focused on helping healthcare organizations succeed in today’s evolving market and achieve their long-term business vision. TriZetto’s key strategic initiatives include:

• Voice of the Customer, TriZetto’s systematic approach to engaging clients in a strategic dialogue to take customer service and satisfaction to a new level.
• Enterprise Software Solutions, a broad portfolio of flexible and scalable systems to help healthcare organizations improve efficiency and respond quickly in an evolving market.
• TriZetto Advantage Services™, comprehensive application hosting, business process outsourcing and professional services to help customers meet key business objectives more quickly and with less risk.
• Systematic Health Management™, TriZetto’s unique approach to population health management that helps customers improve the cost and quality of care.
• Provider Connectivity, to drive improved efficiency, productivity and collaboration between physicians, health systems, members and payers. 

TriZetto Solutions

Healthcare Payers
TriZetto offers a full suite of proven solutions to help healthcare payers drive efficiency, improve the cost and quality of care and improve connectivity and collaboration with providers and members.  TriZetto’s 350+ payer customers include large national plans, BCBS organizations, regional and local plans, Medicaid/Medicare organizations, specialty groups and more than 100 benefits administration firms. TriZetto solutions include highly automated benefits administration, advanced care and network management, and flexible constituent engagement solutions, which deliver power capabilities individually – or as an integrated enterprise-wide platform for maximum efficiency and productivity.

TriZetto’s enterprise solutions support the transition to a value-driven healthcare system and new value-based care delivery and payment models, such as value based insurance design, bundled payments, episode of care payments, price transparency, tiered networks, Accountable Care Organizations, etc. - enabling advanced population health management, and flexible deployment and risk sharing across a number of different network designs.

Hospitals and Health Systems
In this era of accountable care, hospitals and health systems are assuming risk they have never managed before.  TriZetto offers a full suite of proven solutions for enhancing efficiency, lowering the cost and improving the quality of care.  TriZetto’s solutions are the industry standard for creating and managing physician and hospital networks, managing care for defined populations and administering health benefits.  Whether launching a health plan, creating and Accountable Care Organization, or assuming new forms of risk-based payment, TriZetto offers proven solutions to help.

Medical Groups, IPAs and Physician Practices
TriZetto offers industry leading revenue cycle management (RCM) services to over 90,000 physicians across the United States and is a pioneer in real-time claims adjudication.  TriZetto’s solutions are integrated with over 300 practice management systems and will soon enable medical practices to accurately calculate patient financial liability at the point-of-care and adjudicate claims in real-time.  In addition, TriZetto’s RCM solutions monitor, catch and fix claim issues before they reach the payer to ensure accurate and prompt payment.

Technology
TriZetto software is based on an architectural approach that provides superior flexibility, scalability and ease of configuration.  This approach enables customers to grow and transform the business while meeting changing regulatory requirements as well as shifting market demands.  Each year, TriZetto commits to invest more than $70 million in technology advancement, including product management and services, to help ensure that our customers’ technology investments continue to deliver value over the long term.

TriZetto Advantage Services
TriZetto services are delivered by a global team of 1,500 experienced professionals with deep knowledge of the healthcare industry and TriZetto solutions.  Services include application hosting and management, business process outsourcing, and consulting. TriZetto application hosting and management services currently support more than 30 million members and are delivered via cloud technologies to give customers flexible and scalable business services.  Its outsourcing services support the full spectrum of capabilities from enrollment, claims processing and customer support.  TriZetto’s 500-plus consulting professionals specialize in the implementation, configuration and ongoing optimization of TriZetto software.

Integrated Healthcare Management
When used together, TriZetto software and service solutions provide an integrated platform that enables shared information and aligned incentives that can encourage behavioral change across constituents and help transform the healthcare system from a volume- and transaction-based system to one that is value- and quality-based. A value-based system informed by clinical analytics is enabled by Systematic Health Management (SHM), SHM is TriZetto’s unique approach to population health management that helps manage unwarranted variations in care and improve both the cost and quality of care.  SHM is a foundational element of Integrated Healthcare Management®, the coordination of benefits and care delivery to drive more value from every healthcare dollar spent.  TriZetto’s integrated payer-provider platform will enable the deployment of promising new models that can drive collaboration, increase administrative efficiencies and meet consumer needs.

• Reduced administrative costs by up to 17 percent.
• Dramatic improvements in claims-payment accuracy, processing throughput and auto-adjudication rate.
• Accelerate launch of new benefit products and lines of business to win additional customers.
• Five-fold reduction in time to implement a new employer group.
• Savings of $4 million annually by increasing auto-adjudication rates.
• Reduce contract configuration time by 50 percent.
• Increased claims processor productivity by 70 percent.

Davida Dinerman
Schwartz MSL
Office: (781) 684-0770
Email: trizetto@schwartzmsl.com