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 the sales team — 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.
Medical Management	ikaMM’s integrated medical intelligence and management solutions proactively measure and act to improve quality, utilization, satisfaction and regulatory reporting.
Claims	ikaClaims delivers rapid, automated administration of claims for any line of business — group and individual as well as commercial, Medicare and Medicaid — in one highly streamlined, configurable system.
Customer Service	ikaCustomerService provides the exact level of support that any health plan needs to ensure its customer service function runs smoothly, efficiently and effectively.