“Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent.”~ Calvin Coolidge
The quote from John Calvin Coolidge very aptly summarizes the sentiments of our star team behind the success of CentricityTM Financial Risk Manager. September 9th 2014 was a significant day for us- Frost & Sullivanpresented the 2014 North American Healthcare Financial Management New Product Innovation Leadership Award to GE Healthcarein recognition of the company’s ability to provide integrated care solutions for the healthcare enterprise. The press release articulates the details of the award.
We began our journey with Centricity Financial Risk Manager during the HMO days of the 1990’s in the US. The product was initially built to help provider and health plans taking on capitated contracts to manage claims adjudication, member enrollment, benefits administration and case management. Since then the solution has evolved into a robust offering comprising of range of features and services that help healthcare systems to reduce the cost of risk-based contracts by streamlining associated business processes, thus improving profitability and maximizing efficient workflows. Today, we have over 30 industry leading health institutions using the solution to manage over 7 million lives across the country.
Numerous highly disruptive forces are impacting U.S. healthcare providers, none more so than the rapid move to value-based reimbursement. Healthcare market transformation is leading to new financial realities for providers who must now learn to manage increased risk. According to Porter Research, in the next five years, over 65 percent of all lives will be covered under value-based or risk-based contracts. This represents a major challenge for healthcare providers who have lived for so long in the fee-for-service world. GE Healthcare’s mission is to create the next-generation of IT performance breakthroughs. The company helps enable healthcare organizations bring on new capabilities that ensure success in an era of dramatic transformation. GE Healthcare offers a suite of clinical and financial IT solutions that are specifically designed to improve operational efficiency in the face of increasing financial constraints and changing reimbursement models.Centricity Financial Risk Manager is an innovative technology solution that helps providers and health plans administer risk-based claims and monitor utilization and reimbursements while handling increasingly complex contract terms.
Centricity Financial Risk Manager was initially built for providers with their own health plans, offering tremendous value as a full service solution to help organizations adjudicate and pay claims. Centricity Financial Risk Manager is based on proven technology and comes equipped with a number of unique features relative to its competitors in the marketplace as described below:
- First, the application platform includes a full product suite that automates essential functions such as claims adjudication, eligibility processing, claims systems configuration, health plan benefit administration, utilization management, EDI transactions, coding and compliance, document imaging, provider credentialing, and analytics and reporting.
- Second, Centricity Financial Risk Manager is offered as stand-alone, system agnostic solution so that is has the ability to interface with clinical and financial solutions from other vendors.
- Third, the solution is highly customizable and scalable so that it can grow with customers’ changing needs.
- Fourth, the offer incorporates value added services including business process outsourcing to enhance customers’ business performance. GE Healthcare has plans to further augment its BPO services with a strategic consulting offering in the near future.
The Frost & Sullivan award has further solidified our belief that we are solving the right problems. The team is determined to further strengthen the offering for the customers. Ultimately, our belief in helping healthcare institutions navigate the value based reimbursement world will drive us to make a positive difference in the healthcare delivery system in the United States.