Consumers think of consumer-driven plans as a single product so it is important from a service perspective that health plans have the means to administer these types of plans in the same way.
Lorton, Va. (PRWEB) May 02, 2012
Medical and pharmacy claims for all of UPMC Health Plan’s HealthyU products are being effectively and efficiently processed by Acero Health Technologies’s XpandCDH™ enterprise application.
UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, is using XpandCDH to set up and administer a wide variety of consumer-driven spending accounts that are available with HealthyU. Since introducing HealthyU in late 2011, UPMC Health Plan has been relying on XpandCDH to provide its consumer-driven accounts with the same exceptional level of service and support available to members in all of its other products.
“Implementing XpandCDH offered UPMC Health Plan both a comprehensive business solution as well as a scalable technical platform for our HealthyU products,” said Ed McCallister, Chief Information Officer for the UPMC Insurance Services Division. “UPMC and Acero partnered to create an integrated approach that allows us to quickly implement and manage new employer groups and members on HealthyU. This approach allows us to leverage our business knowledge, core systems and people while adding advanced, real-time CDH functionality.”
HealthyU offers employers several plan options, each designed to reward members who exhibit healthy behaviors and become more involved in their health care decisions. HealthyU members may receive financial incentives by completing specific activities, such as a preventive care visit, a flu shot, or a health coaching program. Members can choose from more than 100 activities, developed from UPMC Health Plan’s award-winning wellness and care management programs.
XpandCDH is an integrated technology solution that facilitates enrollment, sophisticated contribution designs and claims processing for consumer-driven health plans. It ensures that members receive and use the correct amounts based on their particular plan design. The solution provides members and customer service with a consolidated, consistent and accurate view of benefits and claim information, including details related to the spending accounts.
“The close integration between XpandCDH and UPMC Health Plan’s other core systems permits UPMC Health Plan to focus on its core administrative functions, while eliminating many of the synchronization issues that are sometimes associated with consumer-driven health solutions,” says Alan Merchant, Chief Executive Officer of Acero. “Consumers think of consumer-driven plans as a single product so it is important from a service perspective that health plans have the means to administer these types of plans in the same way.”
“By using XpandCDH we can enroll a new group or new individual members into HealthyU as easily as we can enroll a member into a PPO plan,” said McCallister. “We especially liked the real-time pharmacy integration which allows medical and pharmacy claims to be processed in coordination with the spending accounts. Using a real-time approach avoids many of the synchronization issues that might otherwise occur with PBM integration.”
As a services-based application, XpandCDH offers health plans a robust, easy-to-manage technical solution that will scale as membership grows while also providing the sophisticated business functionality needed to implement many market-leading consumer-driven features such as stacked accounts, integrated pharmacy, embedded deductibles, and many others.
For more information about HealthyU, go to http://www.upmchealthyu.com.
About Acero Health Technologies
Acero Health Technologies, an innovative information technology company serving today's healthcare visionaries, allows health plans to incrementally add software solutions to address new business challenges without requiring wholesale changes to existing investments. The Acero team has significant health plan and technical experience developing sophisticated enterprise software solutions for health plans and third-party benefits administrators. Acero’s PlanXpandTM engine powers several technology solutions including XpandCDH, a powerful tool for administering consumer-driven health plans and XpandPBMTM an application that facilitates real-time integration of pharmacy and medical benefits. For more information, visit http://www.acerohealth.com.
About UPMC Health Plan
UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, one of the nation's top-ranked health systems. The integrated partner companies of the UPMC Insurance Services Division – which includes UPMC Health Plan, UPMC WorkPartners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health – offer a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to nearly 1.8 million members. Our local provider network includes UPMC as well as community providers, totaling more than 125 hospitals and more than 11,500 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland. For more information, visit http://www.upmchealthplan.com.
Acero Health Technologies