Cognizant Earns NCQA Disease Management Systems Recertification

Cognizant TriZetto Software Group has been awarded the Disease Management (DM) Systems Certification from the National Committee for Quality Assurance (NCQA) for eight of its disease management programs. Supported by Cognizant’s TriZetto CareAdvance® Enterprise solution, the programs include asthma, coronary artery disease, chronic obstructive pulmonary disease, depression, diabetes, heart failure, low back pain, and new to this year’s certification, behavioral health.

“As the industry continues its shift toward population health management, the relationship between physical health and mental health plays a critical role in providing a holistic approach to patient care,” said Julie King, Director of Clinical Product Management, Cognizant. “According to The World Economic Forum, mental disorders are projected to cost $6 trillion by 2030. Since a majority of mental health patients don’t have relationships with primary care physicians, solutions like CareAdvance Enterprise can help organizations identify and provide care to these patients, ultimately delivering better outcomes overall.”              

Cognizant’s CareAdvance Enterprise application provides health plans with identification and classification tools for population health management. These tools, in conjunction with pre-configured clinical content, automate care management activities. The solution captures member information from several sources, including the member portal, which enables members to enter self-reported data to their personal health record, receive personalized health information and interact with care managers via bi-directional communications. The solution also provides payers and physicians with automated, two-way communications regarding utilization management authorization requests without the need for phone calls, faxes or other manual processes.

NCQA’s DM Certification standards are purposely set high to encourage organizations to continuously enhance quality. The standards are developed with input from a number of experts, including researchers in the field, the Disease Management Advisory Council (DMAC), standing committees, employers, purchasers and operators of disease management programs, and state and federal regulators.

“Today’s complex healthcare environment requires organizations to refocus their strategies to address population health management challenges and drive success,” said Brian McCallion, Vice President of Care Solutions, Cognizant. “Our priority is maintaining organizational and product alignment with NCQA’s highly respected industry standards, as well as leveraging solutions like CareAdvance Enterprise to help payer organizations improve cost, efficiency and collaboration with providers, to ultimately deliver quality patient care.”

*NCQA has reviewed and certified Cognizant TriZetto Software Group Inc.’s systems capability. For complete details on the scope of this review, please visit www.trizetto.com.

About NCQA

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers. NCQA’s Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.