TriZetto’s Value-Based Solution Enables BlueCross BlueShield of Tennessee to Incent and Reward Members for Healthy Behaviors

DENVER--(BUSINESS WIRE)--TriZetto Corporation today announced that BlueCross BlueShield of Tennessee, Inc., which serves 3 million members, is using TriZetto’s integrated solution set to provide highly innovative value-based insurance designs to members. Value-based designs, also referred to as value-based benefits, enable health plans to deliver benefits and incentives to members based on their individual health status and on activities they might engage in to promote their health and wellness.

“Employer groups increasingly are asking that payer organizations provide value-based products”

BlueCross tested a complex, member-level value-based benefits offering in 2011, conducting two successful pilot programs. Administration of the program was supported by a software application called the TriZetto Value-Based Benefits Solution. The solution pre-integrates with TriZetto’s core administrative system, which is used by the health insurer to process claims and conduct other administrative operations.

“The most compelling advantage we saw in TriZetto’s Value-Based Benefits Solution was that we could easily offer the solution to our employer customers without customizing the IT configuration of each group,” said Helen Cansler, IT manager, sales and marketing systems at BlueCross.

The system enables BlueCross to automate and streamline tasks that otherwise would require extensive manual effort, which can increase costs and lead to errors and delays. The Value-Based Benefits Solution also enables the health plan to deliver gift cards as incentives to qualifying members.

TriZetto consultants provided support throughout the implementation project. “The consultants helped us understand the solution and then configure the system to facilitate the design of new benefit plans and future value-based programs,” said Tracy Thomas, product manager at BlueCross.

TriZetto’s consulting team was “critical to the system implementation, as we were early adopters of the solution,” Thomas said. “TriZetto consultants worked with us to use the system not only for our initial programs, but showed us how we can use the solution moving forward. We created different scenarios and considered incentive designs that our customers desired. Then, together, we walked through how to configure the system. Ultimately, this process enabled us to help each other improve the overall solution.”

A health insurance broker noted that “BlueCross and TriZetto did a good job implementing the value-based benefits program. I think the implementation went well, and BlueCross was very responsive and provided timely answers and feedback during this pilot program.” The pilot programs were so successful that, in mid-2012, BlueCross began to dramatically expand the programs into the market, deploying the value-based offering to as many as 14,000 employer groups.

“Employer groups increasingly are asking that payer organizations provide value-based products,” said Sal Gentile, president of TriZetto’s Blue Cross and Blue Shield market organization. “TriZetto’s Value-Based Benefits Solution has provided BlueCross with a competitive edge. While many of its competitors administer incentives, BlueCross goes a step further, thanks to TriZetto’s solution, adjusting members’ cost-share at the individual level. That’s a competitive differentiator for the health plan.”

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About BlueCross^®

BlueCross BlueShield of Tennessee’s mission is to provide its customers and communities with peace of mind through affordable solutions for health and healing, life and living. Founded in 1945, the Chattanooga-based company is focused on reinventing the health plan for its 3 million members in Tennessee and across the country. Through its integrated health management approach, BlueCross provides patient-centric products and services that drive health improvement and positively impact health care quality and value. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company's website at bcbst.com.

About TriZetto

TriZetto delivers world-class information solutions that enable healthcare organizations to work more efficiently and collaboratively to deliver better health. Its solutions reach 200,000 care providers, streamline processes for more than 360 payers and touch over half the U.S. insured population. TriZetto solutions help health plans and TPAs increase administrative efficiency, improve the cost and quality of care, and succeed in the retail healthcare market. Its solutions help physicians and health systems simplify business processes and execute strategies for population health management and accountable care. TriZetto’s healthcare experience, innovative solutions and comprehensive services help simplify healthcare for everyone. For more information, visit www.trizetto.com.