Insights

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Knowledge Brief

Benchmarking Health Plans for Strategy, Operations, and Reform

HTMS recently completed benchmarking research in partnership with the Managed Care Executive Group (MCEG). This research reveals the priorities of regional health plans with regards to strategy, operations, and health reform.

White Papers

Patient Centered Medical Home

Health plans have a choice when it comes to improving member outcomes. Most models typically focus on the provider‐patient relationship. While creating that relationship is extremely important, the model proposed in this white paper encompasses the member‐provider-payer relationship and puts the health plan at the forefront of driving Patient Centered Medical Home.

Regional Health Plans & Reform: The 2010 Agenda

HTMS recently completed benchmarking research in partnership with the Managed Care Executive Group (MCEG). The research revealed the priorities of regional health plans with regards to strategy, operations, and health reform. The results of this research have been released in a white paper that examines regional health plan priorities for 2010 and is based on information gathered from approximately 50 regional health plans.

Enabling the Future: Modernizing Core Administration Systems

With increasing cost pressures, consumer empowerment, and technical innovations, the role
of health plans is evolving quickly. Consultants, foundations, and think tanks alike are quick to offer
a vision for new health market solutions. In this new order, transactional efficiencies and product
flexibility are no longer points of differentiation, but rather, foundational requirements. Market success is defined by agility, information management, and transparency.

Optimizing Health Plan Performance

In a competitive marketplace with growing cost pressures, health plans are challenged to continually
improve performance while minimizing costs. Efficiency goals are even harder to achieve in an
increasingly complex environment of custom plan designs, consumer‐driven products, self‐service, and
advanced care management. Plans that are able to optimize process and system performance can raise
service levels, reduce costs, and improve speed‐to-market.

Core Administration System Optimization: Business and Technical Configuration Assessment for Health Plans

Health plans face growing pressures in a shifting and increasingly competitive marketplace. Organizations must continually optimize performance, demonstrate flexibility, and respond to changing
regulatory and other requirements. Many plans survive in this fluid landscape by making incremental
adjustments to systems and processes in order to meet the next deadline. Fewer organizations take a
step back to assess the configuration of their software and business processes to ensure continuing optimal performance.