Accelerating Healthcare Innovation with Trio's Data-Powered Approach

Complexities in the Healthcare Industry

• Increasing complexity of claims and data (structured and unstructured)
• Rising administrative costs due to legacy systems
• Complex regulatory and compliance requirements
• Challenges in the enrollment process
• Data accuracy, reconciliation, and integration issues

Goals for Claims Management and Enrollment Process Transformation

• Automatic claims processing (zero-touch)
• Seamless data exchange between providers
• Accurate data and integration to meet interoperability goals
• Compliance with regulatory requirements
• Improved enrollment experience for members

Trio's Partnership with AWS

• Trio has been working with AWS for several years
• Cognizant, Trio's parent company, had an existing relationship with AWS
• Trio has focused on modernizing and optimizing its applications to be more real-time and better integrated with provider systems
• The partnership with AWS will enable Trio to better aggregate and leverage data to drive more outcomes for its clients

Trio's Application Management Services on AWS

• Trio is leveraging AWS managed services and combining it with Trio's application management services
• This approach aims to enhance automation, efficiency, and cost optimization
• Key focus areas include:
  • Improved claims processing
  • Real-time integration with provider systems
  • Higher auto-adjudication and first-pass rates
  • Ensuring seamless member experiences during enrollment periods

Customer Transformations

Large Midwestern Blue Cross Blue Shield Plan

• Faced a hard deadline to migrate off their core administrative system
• Trio implemented Facets G6 on AWS EKS, leveraging various AWS services
• Achieved rapid deployment through automation and standardization
• Impressive performance metrics, including 2.4 million claims processed per hour

Geisinger Health Plan

• Trio migrated Geisinger's Facets and other solutions to AWS
• Achieved scalability, performance, and cost benefits
• Enabling better connectivity between payer and provider systems through Trio's "Unify" initiative

Future State

• Leveraging AWS services like Bedrock and SageMaker to enable advanced AI and machine learning capabilities
• Reducing operational costs and focusing on the needs of key constituents (members, providers, brokers, and group administrators)
• Improving transparency and communication across the healthcare ecosystem
• Collaborating with AWS and other industry players to drive innovative solutions and better outcomes