Challenges and Opportunities to Drive Change in the Healthcare System Explored at America’s Health Insurance Plans Exchange Conference and Institute 2013
- by elaine blog
The program theme at the June America’s Health Insurance  Plans (AHIP) Exchange Conference and AHIP’s Institute 2013 was Transforming Our Health Care  System: Navigating and Succeeding in the New Marketplace.  Topics included care delivery transformation,  innovation for a new healthcare eco system, Health Insurance Exchanges, the  nexus of consumerism, retail and healthcare, driving value through improved  operations and leveraging technology, data and innovation to transform care. Oracle  participated as a sponsor of both conferences, signaling the significant  investment and activity Oracle continues to make in helping health plans,  providers and government agencies become more efficient and more relevant in  the healthcare market place. 
  AHIP is a national  trade association representing the health insurance industry. AHIP’s members provide  health and supplemental benefits to more than 200 million Americans through  employer-sponsored coverage, the individual insurance market and public  programs such as Medicare and Medicaid.    AHIP advocates for public policies that expand access to affordable  health care. 
  Health plans are focusing on the Health Insurance  Exchanges and the opportunities they offer to provide better access and higher  quality healthcare.  With the  opportunities come operational challenges to implementation and innovative  technology solutions to consider.    
    At the Exchange Conference, Oracle hosted a breakfast  symposium on “Strategies for  Success:  Driving Business Transformation  in the Growing Health Insurance Exchange Market”.  
  With Health Insurance Exchanges as catalysts for change,  attendees learned about how to achieve integration within an Exchange and  deploy new business strategies to support health reform initiatives. Discussion  covered steps and processes to successfully establish and implement enrollment  systems, quote to card activities, program pricing, claims billing, automated  claims processing and new customer service tools.   
  Piyush Pushkar, COO of Benefitalign, an Oracle partner  that provides solutions to adopt innovative business models for retail, HIX,  consumer-centric health plan and benefits administration, spoke on the state of  the Exchanges in the U.S. and the activities health plans are engaged in to  support individuals entering the healthcare system, including sales automation,  member enrollment automation/portals and integration strategies with the  Exchanges. 
    The Oracle and Benefitalign partnership allows seamless  integration between a health plan enrollment solution with the HIX individual  market and allows for the health plan to customize and characterize the  offerings available to the HIX that may or may not be available through other  channels.  This approach can benefit the  health plan through separation of interests, but also because some state-run  HIXs require such separation. 
    Janice W. Young,  Program Director, Payer IT Strategies, IDC Health Insights, reviewed a survey  of health plans on their investment priorities for this last year as well as  this year.  She also identified the  2013-2015 strategies of go/get to market with front end and compliance  investments; leveraging existing business processes and internal technologies;  and establishing best practices.  Of key  interest to the audience was a reform era payer solutions platform overview  mapping technologies to support the business operations. 
    David Bonham of the Oracle Health Insurance organization  moderated the panel and spoke on Oracle’s presence in healthcare and products  for payers to help them drive efficiencies and gain a competitive advantage in  an ever changing market. 
    Oracle serves healthcare stakeholders with applications such  as billing, rating and underwriting, analytics, CRM, enrollment, and products  for processing of health insurance claims including pricing and benefits  administration, as well as payment of providers through alternative, non-fee  for service reimbursement methods.   Oracle  in Healthcare….Did you know? 
   
    More  than 80 healthcare payers run Oracle applications. 
    More  than 300 leading healthcare providers run Oracle applications. 
    10  out of the top 12 fortune Global 500 healthcare organizations run Oracle  applications. 
   
  For more information on Oracle solutions for healthcare  payers, please visit oracle.com/insurance or these individual solution pages: 
   
    Oracle  Health Insurance Components 
    Oracle  Insurance Insbridge Rating and Underwriting 
    Oracle  Insurance Revenue Management and Billing 
    Oracle  Documaker 
    Oracle  Healthcare 
    Oracle CRM 
   
  Related Resources 
   
    Webcast On Demand: Strategies for Success: Driving  Business Transformation in the Growing Health Insurance Exchange Market 
    Strategy Brief: Executing on the Individual  Mandate: Opportunities and Challenges for Healthcare Payers 
    White Paper: White paper: Navigating Alternative Provider Reimbursement Models  of the Future 
    Strategy Brief: Enterprise Rating Agility  Improves Payer Response to Healthcare Reform 
    Podcast: Technology  Implications of Healthcare Reform 
   
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