MEDecision and Avidyn Health to bring Integrated Medical Management to self-funded health care market

Wayne 15 November 2004MEDecision Inc., a software and services expert in care management, and Avidyn Health, a fully integrated care management company and member of Fiserv Health, together will bring Integrated Medical Management (IMM), to the self-funded health care market. The move will bring the competitive advantages of the industry's leading care management solution to Avidyn Health's customer base of third-party administrators (TPAs), employers, and other self-funded organisations seeking to control health care costs while improving patient outcomes.


Integrated into Avidyn Healths claims management process, the delivery of IMM will mean a complete and comprehensive set of system capabilities delivered to Avidyn Healths customer base. "Avidyn Health was launched earlier this year specifically to serve the self-funded health care market", stated John Weymer, chief operating officer for Avidyn Health. "The self-funded market is demanding a one-stop-shop solution for their managed care programmes. With IMM, we can provide an integrated care management system for utilization management, case management, disease management, and health and wellness programmes. This integrated capability will provide superior care management for self-funded organisations at a competitive price."

Running as ASP-style application hosted by MEDecision, IMM gives Avidyn Health the ability to provide centralized reporting and create a central source of clinical information. The latter is a source of data used to monitor patient outcomes, assess financial ramifications and help identify plan members who would benefit from disease management or wellness programmes. IMM also provides analytic and predictive modelling tools that, combined with the proven business model and professional expertise of Avidyn Health, offer a complete approach to managing health care.

"Avidyn Health's emphasis on clinical excellence played a decisive role in their selection of IMM", stated John H. Capobianco, president and chief marketing officer for MEDecision. "As a result, TPAs and others in the self-funded health care market will enjoy the benefits of a care management solution usually reserved for large managed care organisations."

Integrated Medical Management (IMM) is both a vision and product solution born out of the health care industry's need to unite disparate, best-of-breed care management systems into a single, holistic solution. The goal is to handle information more efficiently, and apply rules more consistently throughout the medical management decision-making process, and to recognize and leverage the interdependencies of care management, analytics, and transaction/authorization systems. The result is a higher quality of health care at lower costs.

MEDecisions IMM software platform fuses best-of-breed applications in Analytics and Disease Management, Advanced Medical Management, and Transactioning and Automated Authorizations. MCOs use the resulting solution to identify high-risk, high-cost members, diseases and conditions, which then automatically feed the programmes needed to improve patient care and optimize costs. Further, MEDecision's IMM automates health care transactions between MCOs and providers, thereby allowing the automated systems to focus on costs and allowing the professionals to focus on outcomes, while driving a consistent clinical philosophy throughout the care management process.

Avidyn Health, a Fiserv Health company, was launched in January 2004 to provide fully integrated, evidence-based solutions for controlling care costs. The company works with Fiserv Health third-party administrators (TPAs), outside TPAs and is available as a stand-alone service offering for self-funded employer medical plans. From three regional centres in Dallas, San Antonio and Wausau, Wisconsin, Avidyn Health offers utilization, case, maternity and disease management, health information services, health and wellness and independent medical review.

Fiserv Health provides a full array of independent health plan management, claims processing and administration services for self-funded medical, dental, vision and disability plans serving more than 1000 employer organisations, involving more than five million members. Operating through Avidyn Health, Fiserv Health offers an integrated suite of medical management programmes ranging from traditional solutions to newer, leading-edge approaches to containing health care costs.

Fiserv Inc. provides industry leading information management systems and services to the financial industry, including transaction processing, outsourcing, business process outsourcing and software and systems solutions. The company serves more than 15.000 clients worldwide, including banks, broker-dealers, credit unions, financial planners/investment advisors, insurance companies and agents, self-funded employers, lenders and savings institutions. Headquartered in Brookfield, Wisconsin, Fiserv reported $2,7 billion in processing and services revenues for 2003.

MEDecision is a software and services provider of integrated care management solutions. Founded in 1988, the company specializes in linking patients, providers and payers in an information network that relies upon electronic health records to improve overall health outcomes and reduce costs. MEDecision's software products are being used by more than 60 managed care organisations including more than half of all Blue Cross Blue Shield plans, to improve the quality of health care and reduce both administrative and unnecessary clinical costs for approximately one in every seven Americans with health insurance. More company news is available in the VMW October 2004 article MEDecision taps premier supplier of clinical best practices and data.

Leslie Versweyveld

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