Once again, the two hottest trends in healthcare are whistleblowers and algorithms, as they both generate huge sums of money for someone. A few months ago I posted about the announcement so not the wheels are in motion. Bottom line here again is to analyze cost and offer payer support by administering guidelines and tracking abilities for health insurance. Participating physicians can perhaps count on a bit more utilization intervention now as there will be more information available on each patient and more areas to question, combining cost and clinical evaluation. BD
The TriZetto Group, Inc. announced that CareMore Health Plan, Inc. has gone live with TriZetto's Clinical CareAdvance® application to help manage members' acute and chronic illnesses and improve health status across its member population. This brings to more than 30 million the number of covered lives on TriZetto's care management system.
TriZetto's care management application applies clinical algorithms that create targeted interventions to help improve members' health. The Clinical CareAdvance platform is based on flexible business rules that incorporate claims data, utilization measures, diagnostic triggers and optional data sources such as laboratory, biometrics and pharmacy. The system provides automatic guideline-based care planning, compliance monitoring, hierarchical team management, task lists, task routing and customizable care progress notes, letters and member communications. TriZetto's Clinical CareAdvance application will track each activity and provide an audit trail that helps extend the reach and benefit of CareMore Health Plan's high-touch case and disease management programs.