HEALTHCARE PAYER TECHNOLOGY

MSA empowers Health Plans to achieve tangible business outcomes by leveraging advanced technology, proven methodologies, and deep industry experience to deliver projects and services at light speed. Our healthcare payer technology experts have decades of experience successfully enabling health plans to remove hidden costs from day-to-day operations, automate complex processes, engage members and partners through digital services, and adapt plans and operations to the rapid changes in the industry. Of equal importance, we protect and defend critical assets and patient data to achieve compliance and innovate legacy and siloed systems to compete in the transformed healthcare environment. We do this through our portfolio of end-to-end solutions, designed to reduce the complexities of digital transformation for faster implementations, reduced risk, and lower cost.

Explore our Healthcare Payer Technology Solutions.

• check_circleIntelligent Automation for Health Payers
• check_circleIntegration Services for Health Payers
• check_circleDigital User Experience for Health Payers
• check_circleData and Analytics for Health Payers
• check_circleSecurity Services for Health Payers

Intelligent automation (iA) for health plans leverages robotic process automation (RPA), artificial intelligence (AI), machine learning (ML), hyperautomation and intelligent document processing (IDP) to increase efficiency, decrease costs and elevate member engagement and outcomes, so your organization can stay competitive.

• check_circleReduce repetitive administrative tasks to streamline processes, enhance efficiency and lower costs with RPA
• check_circleStandardize and integrate data and workflows across multiple, disconnected and disparate systems
• check_circleAutomate payer-provider collaboration through claims and appeals process automation that speeds payments and reduces redundancy
• check_circleEnhance the member experience and improve outcomes using automated chatbot technology and AI-powered automation
• check_circleAutomate back-office revenue cycle management with RPA and intelligent document processing (IDP)

Digital user experience enables payers to design member-centric experiences empowered by digital strategy, user experience design, artificial intelligence (AI) and data analytics, along with platform implementation for an omnichannel member experience. All of this enhances self-service care for increased member engagement, improved outcomes and increased member loyalty.

• check_circleProvide a seamless, omnichannel experience to help members easily access information, understand care options, update information, access or submit claims and research costs for improved care coordination
• check_circleDeliver personalized and contextualized communications with access to relevant education resources and services to support member wellness initiatives
• check_circleAutomate customer engagement with analytics and models that help predict the next best actions for automating low-value or low-risk tasks, reducing time spent on manual processes and freeing up resources for more complex tasks
• check_circleUnlock valuable care insights and member journey information using AI and data analytics to drive intelligent member engagement, improve care effectiveness and identify and manage high-risk members
• check_circleCreate an end-to-end member experience with the transparency and functionality members want and the integration and insights needed to enhance the member experience and deliver value-based care

Integration services and solutions enable payers to modernize their platforms by assessing, architecting, transforming, executing and managing the transition from legacy applications and data environments, which are costly and complex, to cloud-based, agile and efficient environments, which are future-proof, cost-effective and align with modern healthcare.

MSA’ integration services use innovative and effective middleware platforms to connect services, data and applications. By doing so, this creates a seamless environment supporting business users, such as providers, brokers, government entities, regulators, suppliers and PBMs and customer needs.

• check_circleTransition from costly and complex legacy applications and data environments to cloud-based, agile and efficient environments, which are future-proof, cost-effective and align with modern healthcare
• check_circleUse innovative and effective middleware platforms to connect services, data and applications
• check_circleDrive greater payer-provider collaboration for better care coordination with simplified workflows
• check_circleComply with CMS interoperability and FHIR mandates by increasing automation and streamlining decision-making and communications between payers, providers and members, supporting efficient care coordination
• check_circleConsolidate member experience data from internal and external sources and across the member journey to build data-driven member engagement strategies, maximize engagement with personalized communications, improve outcomes and boost member satisfaction
• check_circleEliminate data silos by consolidating disparate sources to enable a single source of truth for improving collaboration and increasing operational efficiency

Improve cyber resiliency, safeguard member data and protect your organization’s brand and reputation by implementing a multi-layered protection strategy against cyber-attacks for your networks, applications, devices and programs.

MSA helps your organization through our assessment and compliance, threat hunting, monitoring, identity access management and endpoint protection services.

• check_circleVulnerability Assessment and Penetration (PEN) testing to identify and remediate vulnerabilities and configuration issues with real-world attack simulations
• check_circleApplication and Infrastructure Security Assessments to test critical applications security and assess high-risk transaction platforms
• check_circleRisk Assessments to identify threats, vulnerabilities, level of exposure and possible impact
• check_circleControls Review to evaluate safeguards for confidentiality, integrity and availability of information systems

MAINTAIN COMPLIANCE WITH HEALTHCARE COMPLIANCE SERVICES TO INCLUDE:

• check_circleMinimum Acceptable Risk Standards for Exchanges (MARS-E)
• check_circleHealth Insurance Portability and Accountability Act (HIPAA)
• check_circleHealth Information Trust Alliance (HITRUST)

Turn data into insights by aggregating clinical, lab and pharmacy data across EMR systems and other sources. This better informs you of plan design and pricing, quality of care assessments and actuarial modeling, so you can best manage population risk, medical costs and member engagement metrics to enhance member engagement, increase quality of care and reduce costs.

• check_circleAutomate a generation of data insights for more actionable decision-making with artificial intelligence (AI), machine learning (ML) and other advanced technologies
• check_circleUse member journey analytics to analyze engagement and deliver more personalized interactions with proactive care management recommendations
• check_circleCapture and analyze risk and outcome data to define member benefits packages, enable new services and products to improve member wellness and support value-based care initiatives