Simplify Healthcare’s Benefits1™.Medicare continues its market-leading position of managing 30% of the total nationwide PBP market share compliant with CMS modernization initiatives

AURORA, Ill.--(BUSINESS WIRE)--Simplify Healthcare, a leading healthcare Payer technology company, announced that its customers leveraged its Medicare Advantage benefit plan management solution — Benefits1™.Medicare — to complete another successful PBP bid management season post-CMS PBP modernization.

Benefits1™.Medicare is the only solution in the marketplace to have successfully integrated with HPMS APIs for large-scale bid submissions, as well as importing data from the modernized HPMS portal.

Benefits1™.Medicare led the way to comply with the CMS modernization initiative by incorporating over 27,000 schema changes and deploying them in a 2–3 months’ timeframe in compliance with CMS API schema releases, enabling the management of 30% of the total PBPs to HPMS.

“While Payers nationwide faced challenges with the modernized PBP filing process, Benefits1™.Medicare continued its market-leading position by complying with the CMS modernization initiative to account for over 30% of the total Medicare bids nationwide. Benefits1™.Medicare is the only solution to successfully integrate with HPMS APIs in the marketplace. Benefits1™.Medicare also enabled HPMS data import to incorporate plan characteristics for collateral generation and managed 2023 and 2024 data structures to comply with Payer mandated material needs for ANOCs, EOCs, and SBs. Our platform approach is committed to enabling a connected benefits journey within the Payer ecosystem while continuing to remain hyper compliant with CMS initiatives.” — Nirnay Patel, EVP and GM, Benefits1™, Simplify Healthcare.

About Simplify Healthcare

Simplify Healthcare powers connected benefits and provider journeys for Payers through a scalable, enterprise-grade, secure, compliant, and configurable cloud based software platform — Simplify Health Cloud™. Packaged on the Simplify Health Cloud™ — Benefits1™, Provider1™, Service1™, Claims1™, and Experience1™ provide Payers with discrete and precise solutions to complex problems and opportunities in delivering a rich set of products, benefits, and provider data.

For more information, please visit simplifyhealthcare.com

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