business process solutions... Learn More Accelerating client's success using Health IT and ePrior Authorization’s
Real Benefits:
Reducing Frictional Costs and
Speeding Time to Therapy
A comprehensive 107 page report
on present-day ePA and the future
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Simplifying
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compliance...
regulatory
Creating value in today's
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healthcare ecosystem...


Payers & PBMs

We advise health plans, self-insured employers, and PBMs in their efforts to leverage health IT to traverse the complex post-health reform era.

Featured White Paper

Health Plans and Health Information: Six Areas of Opportunity Under the Affordable Care Act

Much has been written about the problems with the Affordable Care Act (ACA), particularly related to its costs and complexities. Instead, the healthcare industry, and specifically health plans, should regard the legislation as a positive catalyst to make the strategic health information technology (HIT) investments that have been postponed thus far.

The tumultuous forces roiling the industry were set in motion long before the ACA was enacted in March 2010, but while the ACA unquestionably has accelerated and influenced much of that upheaval, healthcare was already changing. Although many stakeholders put ACA implementation on hold pending election results, it is now time for industry players to think strategically about the ACA, decide how to respond to best advantage, and then execute on those strategies. | Read More

Focus Areas

HIT Strategy to Meet Quality and Cost Goals

We advise our clients on strategies to gain competitive advantage and improve the quality of their provider networks. First steps range from smart investment and deployment of health IT to improve coordination and continuity of care to increasing quality scores (e.g., Star Ratings) and optimizing the plans’ medical loss ratios. Efforts may range from smaller scope projects such as implementing the new electronic prior authorization standard to creating a roadmap of projects for HIE sustainability.

Payer and PBM clients use our in-depth vendor landscape analyses of electronic health records, health information exchange, tools for patient engagement, clinical decision support and population health analytics to inform their accountable care organization (ACO), quality improvement and medical expense management strategies.

Navigating the Consumer-Centric Market

We assist our clients in building and improving key capabilities to successfully compete in a more demanding, consumer-centric and transparent healthcare marketplace. Examples include: marketing, ACO operational capabilities and population and disease management programs.