“This is a complete solution for both our Medicaid and commercial lines, fully integrated on one technology platform that can be implemented in just months. It’s just an amazingly different approach to automating health plan business processes that will successfully support our strategic growth plans — I can fully understand why ikaSystems’ client base is so passionate about ikaEnterprise.”

Randy Narowitz, Chief Executive Officer Total Health Care, Detroit, MI

ikaEnterprise for
the Medicaid Market

One Integrated, Web-Based Solution
to Fuel Rapid Growth

Medicaid growth and product development are among payers’ and policymakers highest priorities. According to the Kaiser Family Foundation, the recession caused Medicaid spending growth to average 7.9% across all states in fiscal 2009, the highest rate of growth in six years, while enrollment growth averaged 5.4% — both figures well above projections.

With a growing membership to serve and an economy slowly on the mend, states will continue to be challenged to make the most of their Medicaid funds. Provider rate cuts, tightening eligibility restrictions and limiting benefits hold little appeal for any stakeholder in the process, while managed care techniques that help ensure the wise utilization of resources are gaining momentum.

Medicaid managed care plans that implement effective medical and drug utilization controls as well as proactively measure quality metrics and promote health through collaborative care management programs can deliver accessible, high-quality healthcare at an affordable cost. The answer is having systems that allow health plans to act with speed and agility to maximize the market opportunity while minimizing the risk of a demanding population and complex regulatory requirements.

 

Create a Highly Intelligent and Effective Organization

ikaEnterprise automates all key processes in the Medicaid business cycle, combining business intelligence and transactional systems for core claims adjudication, care management and proactive quality measurement and reporting with self-service portals for sales, administrative, member and provider use. Medicare functionality can also be seamlessly integrated. The result is an end-to-end, fully Web-deployed solution for process automation and intelligence management.

Using our agile, modular technology, payers can create a single intelligent ecosystem — comprising health plan staff, members, providers and brokers — that feeds on the same real-time information and fluidly responds in a way that benefits the ecosystem as a whole.

Build Your Own Solution

ikaEnterprise modules can be implemented one at a time or all at once, helping health plans better manage IT expenses and develop their confidence in ikaSystems as a technology partner while delivering increasing value. With ikaEnterprise, you can innovate at your own pace and create your ideal solution.

For Medicaid plans, ikaEnterprise offers solutions in the following areas:
 

Portals
 		 ikaPortals provide self-service capabilities for sales, members, providers and health plan administrative staff.
 
Claims
 		 The ikaClaims solution suite empowers health plans to turbo-charge all of their claims administration activities or to extend their existing IT investments by adding on high-performance functionality.
 
Medical Management
 		 ikaMM's integrated medical intelligence and management solutions proactively measure and act to improve quality, utilization, satisfaction and regulatory reporting.