HMS Cited by Gartner in Payment Integrity-focused Research Report and Market Guide for Healthcare Payer Care Management Workf...
March 22 2018 - 8:07AM
HMS (NASDAQ:HMSY), a leading provider of cost containment solutions
to the U.S. healthcare market, was named a Representative Vendor in
two recently published Gartner reports: U.S. Healthcare Payer CIOs
Must Adopt Prospective Payment Integrity to Thwart Improper Claims
Payment and Fraud and Market Guide for Healthcare Payer Care
Management Workflow Applications.
In its report “U.S. Healthcare Payer CIOs Must Adopt Prospective
Payment Integrity to Thwart Improper Claims Payment and Fraud1,”
Gartner states that payer “CIOs can significantly improve the
financial returns from payment integrity programs. By expanding
solution capabilities to incorporate prospective – even pre-emptive
– processes, CIOs can exponentially increase financial performance
and improve provider relationships.”
“We believe Gartner is spot on to identify prospective payment
integrity as a key opportunity for payers to increase savings and
strengthen provider relationships,” said Bill Lucia, HMS’ chairman
and CEO. “For more than three decades, we’ve been working with our
government and commercial customers to ensure payment accuracy.
Today, over half of our coordination of benefits work is performed
on a prospective basis. We are well positioned to help payers
navigate the more complex aspects of payment integrity involving
interaction with their provider networks and integration with their
payment systems.”
In its “Market Guide for Healthcare Payer Care Management
Workflow Applications2,” Gartner lists HMS as a Representative
Vendor for its Essette product offering.
The Essette care management platform helps risk-bearing
healthcare organizations identify, engage and better manage patient
populations. Together with Eliza, which uses behavioral science and
multi-channel communications to help health plans engage their
members, the two product offerings provide improved health
outcomes, reduced costs and enhanced member satisfaction.
“As the healthcare industry intensifies its consumer focus, our
clients want a comprehensive solution to help them better
understand their members and engage them in changing behavior to
improve their health,” said Lucia. “Our new care management and
consumer engagement offerings, combined with our heritage payment
accuracy solutions, position HMS to address virtually every aspect
of the estimated $1 trillion in annual U.S. healthcare spend lost
to fraud, waste and abuse.”
1Gartner, “U.S. Healthcare Payer CIOs Must Adopt Prospective
Payment Integrity to Thwart Improper Claims Payment and Fraud,” by
Bryan Cole and Mandi Bishop, February 13, 2018.
2Gartner, “Market Guide for Healthcare Payer Care Management
Workflow Applications,” by Jeff Cribbs, March 7, 2018.
Gartner Disclaimer Gartner does not endorse any
vendor, product or service depicted in its research publications,
and does not advise technology users to select only those vendors
with the highest ratings or other designation. Gartner research
publications consist of the opinions of Gartner's research
organization and should not be construed as statements of fact.
Gartner disclaims all warranties, expressed or implied, with
respect to this research, including any warranties of
merchantability or fitness for a particular purpose.
About HMSHMS is a leading provider of cost
containment solutions to the U.S. healthcare market. Our solutions
improve financial and health outcomes for organizations at risk.
Using innovative technology and powerful data analytics, we help
clients reduce costs, increase quality and achieve regulatory
compliance. As a result of our services, clients save billions of
dollars annually. Visit us at www.hms.com or follow us on Twitter
at @HMSHealthcare.
Contact:
Elizabeth Bonet, HMS972 894 8405elizabeth.bonet@hms.com
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