December 09, 2008 UPMC Health Plan Expands Relationship with ikaSystems for Quality Improvement and Cost Containment  

Integrated Medical Management Solutions Join Strategic Portal Solutions for Commercial and Medicare Business Lines

A successful multi-year partnership with ikaSystems has led UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, to expand its partnership with the provider of enterprise-level Web-based technologies for healthcare payer organizations. UPMC will add Web-based integrated medical management solutions to its existing roster of ikaEnterprise modules underlying its portal strategy, allowing the plan to enhance healthcare quality for its members while fully supporting providers in their quest for easier access to more current, meaningful performance information.

“ikaSystems’ unique modular technology has been an excellent fit for UPMC’s needs, significantly lowering the risk of IT deployment by enabling us to address our most pressing business needs in order of priority,” said Ed McCallister, chief information officer at UPMC. “We began with ikaSystems’ Web-based business process automation solutions in 2006, rolling them out to support our goal of aggressively expanding our Medicare HMO and PPO product lines. Success in this area led us to add our commercial lines of business to the ikaEnterprise platform in August of this year.

“We’re excited about this latest project — using ikaEnterprise applications to proactively fuel a wide range of healthcare quality initiatives — because we’re convinced that ikaSystems will bring the same level of intelligence, flexibility and commitment to its partnership with UPMC. We expect to achieve nearly immediate time to value with these implementations, and ikaSystems has never disappointed.”

UPMC will implement the following components of ikaMM, ikaSystems’ suite of medical management solutions that blend insight and workflow collaboration into a single, comprehensive and highly intelligent system:

• ikaProHEDIS+, a patent-pending Web-based application that combines analytic and workflow tools to enable proactive quality management. Health plans can analyze their quality status at any time for HEDIS® or any other quality program, with easy-to-run standard and ad hoc reports that draw on real-time or near-real-time data. Providers, care managers and members, in turn, gain access to current — not retrospective — information, allowing them to take action to improve patient care.
  
• ikaP4P, an integrated, real-time pay-for-performance application that allows health plans to define their own P4P programs, set up all P4P parameters, monitor bonus programs in real-time, and allow providers on-demand access to the data that drives their bonus payments.
  

All ikaMM modules run off a single comprehensive database for claims, laboratory, pharmacy, encounter data, practice management and electronic medical records information that supports standard and ad hoc report generation, with drill-down and drill-up access to normalized and analyzed data in a Web-based environment.

According to Ravi Ika, president of ikaSystems, “UPMC has achieved outstanding results using our strategic portal solutions — for example, it was able to expand its Medicare membership from 33,000 to 80,000 in two years without adding staff. From the start of our relationship, UPMC has been a vital partner to ikaSystems, as committed to our success as we are to UPMC’s. This innovative organization understands the value of integration in staying ahead of the competition, and as it adds modules of ikaEnterprise, that value increases exponentially. We look forward to this new stage in our partnership and to helping UPMC achieve its quality management goals.”

About UPMC Health Plan
UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, is owned by the University of Pittsburgh Medical Center (UPMC), one of the nation's top-ranked health systems. The integrated partner companies of the UPMC Insurance Services Division — which includes UPMC Health Plan, UPMC Work Partners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health — offer a full range of group health insurance, Medicare, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to nearly 1.2 million members. Our local provider network includes UPMC as well as community providers, totaling more than 80 hospitals and more than 7,600 physicians in a 29-county region. For more information, visit www.upmchealthplan.com.

About ikaSystems Corp.
ikaSystems is healthcare payers’ premier provider of Web-based ERP technology for process automation and intelligence management. ikaEnterprise, the company’s flagship product, automates all key processes in the payer business cycle, supporting commercial, Medicare and Medicaid lines of business. The system consists of five stand-alone, self-service Web portals for sales/broker, administrative, employer, member and provider use, each of which are tightly integrated with business intelligence and transactional systems for core claims adjudication, care management and proactive quality measurement and reporting. Using our agile, modular technology, organizations can move quickly to lower administrative and medical care expenses through greater automation and highly intelligent decision-making. To learn more, please visit www.ikasystems.com.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).