OEFI Chooses HealthEdge's Next Generation HealthRules Technology Platform
HealthRules product suite will enable leading Taft-Hartley healthcare funds to save millions while delivering an array of new products to the market
HealthEdge, provider of the only modern, enterprise-class software platform for healthcare payors, recently announced that the Pasadena, Calif.-based Operating Engineers Funds Inc. (OEFI), has selected the patented HealthRules product suiteto tackle the non-profit health plan's unique and challenging service needs. An independent professional benefits administrator operating under the Taft-Hartley labor act, OEFI administers the employee benefit programs of the International Union of Operating Engineers (IUOE), Local 12, and its dependents and beneficiaries, including more than 35,000 heavy equipment operators, mechanics, concrete pumpers, soil testers, inspectors, and surveyors.
According to Fund Manager Mike Graydon, "After struggling for years with an outdated claims processing system, our Trustees were looking for a proven, next-generation healthcare technology platform that would serve us well both now and into the future. We did not want to face yet another major system overhaul in a few years when the next set of healthcare standards are adopted," Graydon continued, "and we were focused on finding a system that was designed to be implemented quickly and with less risk than other available offerings. After a rigorous evaluation and selection process, we found that HealthRules was the only product available that met both of these criteria."
"Our use of the HealthRules platform," Graydon continued, "will enable us to enter into more sophisticated agreements with our insurance carriers, which is something that will benefit both OEFI and our members. Based upon the results of our early testing with the HealthRules products, for example, we expect to realize as much as $4M in potential savings from one of our large insurers as a result of the significant reduction in turnaround time that we will be able to achieve."
With an in-house, legacy system that had been extensively modified, finding a platform that could quickly and easily address the complexity of the existing OEFI plans and contracts, while at the same time enabling the company to offer a wide variety of new products based on the rapidly evolving needs of their members, was a top priority. HealthEdge proved that it could meet these needs by quickly configuring many of OEFI's most complex benefit plans and contracts. "HealthEdge's performance during our evaluation was so impressive," added Graydon, "that OEFI staff made a unanimous recommendation to the Board of Trustees to purchase the HealthRules suite within a week of its completion."
HealthRules' language-based technology provides organizations like OEFI with real-time configurability and a level of flexibility that can accommodate even the most complex plan and contract designs. These capabilities were a decisive factor in OEFI's selection process, because they will enable OEFI to quickly and easily address the continuously evolving needs of their members using in-house resources. "HealthRules will enable us to handle a great deal of change with very little effort," said Graydon, "and it will allow us to instantly provide a wealth of information that will aid our Trustees and their advisors in terms of both planning and decision making."
"As organizations like OEFI search for technology that will allow them to more effectively compete in the new healthcare marketplace," said Rob Gillette, CEO of HealthEdge, "more and more of them are recognizing the unique capabilities that are part of the award-winning HealthRules product suite. We are thrilled to have OEFI as a customer, are we are looking forward to helping them achieve their goals using the HealthRules platform."
About Operating Engineers Funds, Inc.
Pasadena, Cal.-based Operating Engineers Funds Inc. is a non-profit corporation that administers the employee benefit programs for over 35,000 members of the International Union of Operating Engineers (I.U.O.E.), Local 12, and their dependents and beneficiaries.
The majority of Local 12's operating engineers work in public and private construction as heavy equipment operators, mechanics, concrete pumpers, soil testers, inspectors, and surveyors. For more than 45 years, the Board of Trustees of the Fund has worked to provide broader and better health benefits for every eligible participant. Currently, the fund provides health and welfare benefits for over 15,000 active participants and about 7,000 retirees. Including dependents, approximately 100,000 people are eligible to receive benefits from the Fund, and an average of 5,000 claims are processed every day. Since the first claims were paid in April 1955, the Fund has paid benefits in excess of $1.6B.
About HealthEdge
HealthEdge provides the only modern, enterprise-class software platform for healthcare payors. Using the patented, award-winning HealthRules software suite, health plans and other payors can respond to business opportunities and market changes within hours rather than the usual months or years, while drastically reducing both IT and operational costs. Leveraging an investment of more than $125M, HealthRules is the most modern, scalable, and cost-effective technology in the industry. HealthEdge provides the competitive advantage that enables payors to thrive in the dynamic healthcare environment. For more information, visit http://www.healthedge.com.
SOURCE: HealthEdge