Arkansas Blue Cross and Blue Shield Selects TriZetto’s Clinical CareAdvance^® System

NEWPORT BEACH, Calif.--(BUSINESS WIRE)--The TriZetto Group Inc. today announced that Arkansas Blue Cross and Blue Shield has signed a perpetual license for TriZetto’s Clinical CareAdvance^® application to help manage members’ acute and chronic illnesses and improve health status across its member population.

Arkansas Blue Cross, an independent licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in the state, serving approximately one-third of the fully insured market. TriZetto’s software and IT services are used by more than 60 percent of Blue Cross and Blue Shield plans nationwide.

TriZetto’s Clinical CareAdvance system will consolidate data from three legacy systems and integrate several manual processes currently used by Arkansas Blue Cross to streamline processes and gain efficiencies. The care management product will go live at the Little Rock-based payer in approximately one year.

“At Arkansas Blue Cross, our goal is to help guide our members to better health through information and support,” said Steve Abell, vice president of enterprise networks for Arkansas Blue Cross. “That guidance is through both programs and people to help members better understand the healthcare system, improve their relationship with their doctors or other healthcare providers, and educate and empower them to make better healthcare decisions overall. We believe TriZetto’s Clinical CareAdvance application will help us reach more members more effectively, and ensure they are getting the right healthcare service at the right time. Long term, we believe that as our members get more personalized attention and information, it will improve their health and the healthcare system. Clinical CareAdvance will help improve the efficiency of our care management programs, support a significantly increased case load for our nurses, improve reporting and service for our customers, and enhance care for our members.”

“Arkansas Blue Cross’ current care management programs already have reduced hospitalizations, decreased lengths of stay and lowered emergency room utilization,” said Joe Manheim, senior vice president of CareAdvance and benefits administration at TriZetto. “With TriZetto’s Clinical CareAdvance system, the organization can take its impressive results to the next level with a single data source for real-time risk stratification that identifies members who change health status, for better analytics and for more robust reporting to employers and states.”

TriZetto’s care management application applies clinical algorithms that create targeted interventions to help improve members’ health. The Clinical CareAdvance system 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 product 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 Arkansas Blue Cross’ high-touch case and disease management programs.

About Arkansas Blue Cross and Blue Shield

Founded in 1948, Arkansas Blue Cross and Blue Shield, an independent licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in Arkansas, serving approximately one-third of the fully insured market. Arkansas Blue Cross and its affiliates have more than 2,550 employees. If combined, the 39 independent, locally operated Blue Cross and Blue Shield plans collectively provide healthcare coverage for 98 million -- nearly one in three -- Americans.

About TriZetto

TriZetto is Powering Integrated Healthcare Management™. With its technology touching more than half of the U.S. insured population, TriZetto is uniquely positioned to drive the convergence of health benefit administration, care management and constituent engagement. The company provides premier information technology solutions that enable payers and other constituents in the healthcare supply chain to improve the coordination of benefits and care for healthcare consumers. Healthcare payers include national and regional health insurance plans, and benefits administrators that provide transaction services to self-insured employer groups. The company’s payer-focused information technology offerings include enterprise and component software, hosting and business process outsourcing services, and consulting. Headquartered in Newport Beach, Calif., TriZetto can be reached at 949-719-2200 or at www.trizetto.com.