Health Plans

Health plans are feeling the squeeze from every direction. Increased pressures on cost, quality and regulatory compliance are shifting the strategies and needs to operate a plan.

Smart Series provides many capabilities to extend the reach and results of Commercial, Medicare and Medicaid plans.  From claims administration through interconnecting your members, provider networks, brokers, and employers, health plans are supported in reducing medical loss and administrative costs. 

 

Emerging Plans

The growth and evolution of care delivery systems assuming full risk continues to rise rapidly. The formations are many – ACO, DSRIP PPS, MSOs and even more traditional IPAs. Faced with new administrative challenges, population health and care coordination initiatives, the prospect of using EMRs and HIEs to resolve these issues falls flat.

Smart Series offers the full complement of solutions required to operate a full risk system.

 

Administrators

Self-insured employers and trust constituents have evolved their expectations of plan administration. The enlightened administrator is competing beyond cost to include employee engagement, health and wellness, consumer-driven plans and medical spend reduction.

Smart Series offers comprehensive administration and communication capabilities.