Oracle and Benefit Management LLC Enable Healthcare Payors and Providers to Shift from Retrospective Payments to Prospective Bundled Payments

Redwood Shores, Calif.—May 13, 2016

Oracle today announced that Benefit Management LLC, a progressive health Third Party Administrator (TPA) and joint venture of NueHealth, has selected Oracle Health Insurance Value Based Payment Cloud Service to deliver a cloud-based prospective bundled payments system for healthcare payors and providers.

While the goal of healthcare reform has been to decrease costs and improve patient outcomes, it has healthcare payors and providers grappling with how to master the complexity of bundled payment models—specifically the shift from retrospective payments (paying for healthcare services after they are completed) to prospective payments (at the time the service is requested and agreement on a flat fee). 

Benefit Management LLC will harness the power of Oracle Health Insurance Value Based Payments Cloud Service to help payors seamlessly maneuver and scale complex bundled payments, and help ensure timely and accurate payment to providers as they move to a prospective bundled payments model.

“The transition to value-based payments is one of the biggest challenges facing payors and providers today,” said Chad Somers, CEO of Benefit Management. “It is imperative that all aspects of value-based payments be considered before making this change. Never before has combining the clinical outcomes with payment been so important. Oracle Health Insurance Value Based Payment Cloud Service will allow us to revolutionize bundled payments by processing payment at the time service is rendered instead of months later.”

The combination of Benefit Management’s services, backed by 20 years of success with a diverse client base of self-funded employers, and Oracle’s offering will allow Benefit Management customers to:

  • Easily navigate the transition to prospective bundled payments
  • Reduce the provider risk making it easier for providers to participate
  • Decrease the total cost of bundled procedures
  • Increase the quality of care for bundled procedures

“The Oracle insurance cloud solution can also be leveraged by Benefit Management’s self-funded employers,” Somers said. “Value-based programs, especially when you’re talking about bundles, are of tremendous benefit to self-funded employers, and the capability to manage and adjudicate claims based on those kinds of value-based contracts will be something employers can take advantage of to great effect.”

“Oracle Health Insurance Value Based Payment Cloud Service provides the technology platform to administer many different non fee-for-service arrangements in a single solution,” said Srini Venkatasanthanam, Vice President for Oracle Insurance. “Oracle’s health insurance solution enables organizations such as Benefit Management to reduce time-to-market and significantly lower overall cost of ownership. We look forward to enabling Benefit Management to deliver an innovative prospective bundling offering to the market.”

To learn more about Oracle’s Value Based Payment Component and the opportunities it will provide to provider, payors and employers, visit Benefit Management online at www.BenefitManagementLLC.com

 

From Oracle Press Release