Accelerate healthcare innovation: TriZetto's data-powered approach (HLS208)

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

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