Dell IKA Strategic Alliance webinar


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Learn How the Dell ikaSystems Alliance Can Benefit You

The healthcare payer market is facing the perfect storm – healthcare reform, changing regulation and an aging population.

• The healthcare market is undergoing significant change as it begins to implement key provisions within the Patient Protection and Affordable Care Act of 2010 (PPACA). PPACA mandates that payers increase focus on reducing their Administrative Loss Ratio (ALR) and better manage their Medical Loss Ratios (MLR).

• Regulatory changes like ICD-10 implementation and a dramatic increase in membership anticipated with the introduction of Health Insurance Exchanges (HIXs) are driving new demands for IT system replacement, modernization efforts and applications remediation.

• The aging population will drive higher demand and capabilities in the Medicare arena.
To succeed, health plans will need to evaluate their current IT systems capabilities to optimize daily operations and reduce administrative costs while meeting changing regulatory demands.
With this in mind, Dell and ikaSystems formed a strategic alliance that we believe provides a long over-due solution to a complex and competitive healthcare payer core administrative application market.

To give you a better understanding of how this alliance can positively affect your health plan, Dell and ikaSystems hosted a webinar for participants to:

• Gain a clear understanding of our combined value proposition for core administrative applications, business processes and IT support that can help health plans thrive in today’s market

• Learn how we can help you enhance agility and efficiencies in your business practices

• Learn how to better manage daily operations and reduce administrative costs with a flexible, scalable platform

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Dell IKA Strategic Alliance webinar

  1. 1. Learn How the DellikaSystems Alliance CanBenefit YouSeptember 28, 2011Download this presentation at
  2. 2. Introductions Ravi Ika Tim Quigley Jeff Broocks Executive Chairman & Vice President, Executive Director, Founder, National Healthcare Group, Payer Solutions, ikaSystems Dell HCLS Services Dell HCLS Services2
  3. 3. Topics of Discussion• Introductions• State of Dell• State of Healthcare Market• State of ikaSystems• Dell / ikaSystems Strategic Alliance• Q&A3
  4. 4. Dell Healthcare Strength• Leading global healthcare IT and BPO services provider• 11,000+ healthcare and life sciences professionals• Support more than 10,000 healthcare providers, health plans, pharmaceutical, biotech, medical devices, diagnostic and scientific instrumentation customers worldwide• More than 500 technology partnersDell Healthcare Payer Strength• Support more than 100 insurers, which include commercial, Medicare and Medicaid lines of business• Operate the only Health Insurance Exchange of its kind• Enable the creation of a sustainable insurance marketplace for individuals, employers and employees• Help payers navigate uncertainty by identifying improvement opportunities and risks• Support alignment of core business functions with the Exchange environment• Help health plan customers transition to a consumer-centric model4
  5. 5. Current State of the Healthcare MarketWe are facing the greatest changes to healthcare in more than a generation Healthcare Regulatory Market Reform Changes Dynamics • Accountable Care • HIPAA 5010 • Cost Pressures Organizations • Product Evolution (ACOs) • ICD-10 • Increased • State Health • CMS Program Exchanges (HIXs) Consumerism Changes • Aging Population • Consumer Operated and and Increased Oriented Program Membership (CO-OP) • ALR/MLR5
  6. 6. Market Perspective • Looking for a platform that is highly agile, requires minimal time to implement and has limited or no up-front capital investments • Interested in seasoned and capable services vendors operating on open Health plans architectures and flexible and configurable applications • Seeking partnership models that include business process and technology are… outsourcing services • Expressing increasing interest in rapidly deployable SaaS/BPO models • Looking for an integrated solution that does not require multiple vendor contracts to achieve their objectives • Payers require a highly flexible and configurable application that is better suited to meet the needs of the rapidly evolving post-reform healthcare Analysts market suggest… • Payers evaluate their current IT systems’ capabilities to optimize daily operations and reduce administrative costs while meeting changing regulatory demands6
  7. 7. Why ikaSystems?• Strategic alliance combines Dell’s extensive payer business process experience and healthcare cloud expertise with ikaSystems’ flexible, scalable, rapidly deployable cloud-based suite of integrated administrative and care management solutions• Ability to help payers optimize daily operations, reduce administrative costs and increase operational efficiencies while meeting changing regulatory demands7
  8. 8. ikaSystems8
  9. 9. ikaSystems Overview• Enterprise-level cloud Revenue Growth computing solutions for payers• Single, modular system for all business lines• Backed by Providence Equity Partners, 7th largest private equity firm• 350+ employees focused exclusively on payers 2008 2009 2010 2011P ikaSystems is delivering today on a fundamentally different model focused on helping health plans radically reduce administrative, technology and medical costs9
  10. 10. ikaEnterprise• Comprehensive suite• Modular but integrated IKAPORTALS• Implement at client’s pace IKASALES• Fully user-configurable• Efficient work flow for IKACLAIMS today’s plans• Intuitive for minimal training• Scalable for largest plans• Highly secure• Centralized data for powerful reporting available across business IKAMM• Leveraged investment: IKAMEDICARE Compliance, innovation managed by ikaSystems10
  11. 11. ikaEnterprise: Modular Solutions for All Business LinesikaSales ikaPortals ikaClaims ikaMedicare ikaMedicalManagement ikaCRM, designed  Sales Portals  ikaClaims  ikaMedicareGateway  ikaDWH, a consolidated specifically for  sales  ikaEnterprise  automate the database of administrative, health plans Service (customer complexity of CMS financial and clinical  underwriting information Sales Portals service application) data exchanges for  enrollment enrollment ikaUA, utilization analytics for  Individual  ikaNetwork   Group  fulfillment Manager  payment executive, actuarial, marketing reconciliation underwriting, finance, quality  Medicare   provider network effectiveness and med management ikaBilling management  membership decisions analysis reconciliation ikaCommissions  contracting ikaProfyle (physician  Employer Portal  ikaD4C (Diagnosis   fee-schedule profiling)  Member Portal negotiation for Care)  ikaDM (disease management)  Provider Portal  payment  enhance diagnosis accuracy and  ikaCM (case management) reconciliation and 1099 coding  ikaAM, supporting production  optimize care authorization management, pre-certification and  accurate concurrent review reimbursement  ikaHEDIS/ikaProHEDIS+  Medicare Sales (proactive HEDIS program Portal management)  ikaP4P (pay-for- performance) 11
  12. 12. Today’s ChoiceHealth plan business solutions “in the cloud,”with zero technology footprint• Rapid implementation• Lower costs• Seamless upgrades• Consistent data• Predictable availability, full redundancy• Industry-leading Microsoft, Dell and Oracle platforms• Extends existing technology investments12
  13. 13. Why ikaSystems Selected Dell• Superior healthcare BPO expertise, sophisticated service level tools• Exceptional brand and market reputation• Provides large bench strength of implementation expertise• Power to leverage other Dell resources including infrastructure• Commitment to.. – Healthcare – Customers – Service excellence• Philosophical alignment with ikaSystems13
  14. 14. Dell / ikaSystems Value to Health Plans14
  15. 15. Dell/ikaSystems Partnership… Value …empowers healthcare transformation • Two world class solution Dell/ikaSystems delivers integrated solutions that providers combining forces in a enable healthcare organizations to solve critical long-term partnership problems while improving quality of delivery. • Combination of services and end-to-end software solutions • Solutions help customers reduce administrative costs, manage medical expenses and Increased Process meet regulatory requirements Efficiencies Improvements “Health plans should include Dell/ikaSystems on any short list for business outsourcing and technology outsourcing assessments.” Janice W. Young, Program Director, IDC-Health Insights Customer Responsive Commitment Delivery15
  16. 16. Q&A16
  17. 17. Thank YouDownload this presentation at