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HMS Cited by Gartner in Payment Integrity-focused Research Report and Market Guide for Healthcare Payer Care Management Workflow Applications

March 22, 2018 at 9:07 AM EDT

IRVING, Texas, March 22, 2018 (GLOBE NEWSWIRE) -- HMS (NASDAQ:HMSY), a leading provider of cost containment solutions to the U.S. healthcare market, was named a Representative Vendor in two recently published Gartner reports: U.S. Healthcare Payer CIOs Must Adopt Prospective Payment Integrity to Thwart Improper Claims Payment and Fraud and Market Guide for Healthcare Payer Care Management Workflow Applications.

In its report “U.S. Healthcare Payer CIOs Must Adopt Prospective Payment Integrity to Thwart Improper Claims Payment and Fraud1,”Gartner states that payer “CIOs can significantly improve the financial returns from payment integrity programs. By expanding solution capabilities to incorporate prospective – even pre-emptive – processes, CIOs can exponentially increase financial performance and improve provider relationships.”

“We believe Gartner is spot on to identify prospective payment integrity as a key opportunity for payers to increase savings and strengthen provider relationships,” said Bill Lucia, HMS’ chairman and CEO. “For more than three decades, we’ve been working with our government and commercial customers to ensure payment accuracy. Today, over half of our coordination of benefits work is performed on a prospective basis. We are well positioned to help payers navigate the more complex aspects of payment integrity involving interaction with their provider networks and integration with their payment systems.”

In its “Market Guide for Healthcare Payer Care Management Workflow Applications2,”Gartner lists HMS as a Representative Vendor for its Essette product offering.

The Essette care management platform helps risk-bearing healthcare organizations identify, engage and better manage patient populations. Together with Eliza, which uses behavioral science and multi-channel communications to help health plans engage their members, the two product offerings provide improved health outcomes, reduced costs and enhanced member satisfaction.

“As the healthcare industry intensifies its consumer focus, our clients want a comprehensive solution to help them better understand their members and engage them in changing behavior to improve their health,” said Lucia. “Our new care management and consumer engagement offerings, combined with our heritage payment accuracy solutions, position HMS to address virtually every aspect of the estimated $1 trillion in annual U.S. healthcare spend lost to fraud, waste and abuse.”

1Gartner, “U.S. Healthcare Payer CIOs Must Adopt Prospective Payment Integrity to Thwart Improper Claims Payment and Fraud,” by Bryan Cole and Mandi Bishop, February 13, 2018.

2Gartner, “Market Guide for Healthcare Payer Care Management Workflow Applications,” by Jeff Cribbs, March 7, 2018.

Gartner Disclaimer
Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner's research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

About HMS
HMS is a leading provider of cost containment solutions to the U.S. healthcare market. Our solutions improve financial and health outcomes for organizations at risk. Using innovative technology and powerful data analytics, we help clients reduce costs, increase quality and achieve regulatory compliance. As a result of our services, clients save billions of dollars annually. Visit us at www.hms.com or follow us on Twitter at @HMSHealthcare.

Contact:

Elizabeth Bonet, HMS
972 894 8405
elizabeth.bonet@hms.com

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Source: HMS Holdings Corp