NEWPORT BEACH, Calif. - May 7, 2009 - "Our nation spends more than any other on healthcare, yet our infant mortality rate and other clinical measures lag many countries. Why is this? And more importantly, how can we make our healthcare system better?"

These questions were posed by David A. Shore, PhD, director of the Harvard School of Public Health's executive education program, to a select gathering of healthcare industry leaders and notable academia at the 5th annual "Forces of Change" program, "New Strategies for the Evolving Health Care Marketplace."

Attendees at the program in late April broke out into working groups and crafted intriguing responses to what Dr. Shore later admitted was a purposely loaded question.

"The answers varied greatly based on the varying ways in which our distinguished participants defined ‘better'," said Dr. Shore. "We deliberately framed the conversation this way in order to show that we first must agree on what a better healthcare system would look like."

"One thing we can agree on is that a better healthcare system would not be one in which we spend more money for the current level of value," said Jeff Margolis, chairman and chief executive officer of The TriZetto Group, Inc., and one of the program's participants. "We spend enough money today to meet the healthcare needs of every U.S. citizen. The reason we're unable to do so is that healthcare information is siloed, the system is disaggregated and incentives are either nonexistent or misaligned."

The fix, suggested Margolis, is Integrated Healthcare Management (IHM), a systems-science approach that uses information technology and re-aligned processes to converge benefits administration, care management and constituent engagement information and incentives.

"And with convergence comes the opportunity to improve the cost and quality of healthcare for consumers and meet the goal of sustainable affordability, not simply affordability in the short run," he added. "Convergence increases as IHM improves information sharing between healthcare payers, providers, consumers and other constituents and aligns incentives through such initiatives as systematic evidence-based care management, value-based benefits and value-based provider reimbursement."

Public policy, said Margolis, can play an important role in advancing IHM and, hence, improvements to U.S. healthcare. He applauds the Obama administration and the legislature for their focus on and funding of healthcare information technology. However, he is concerned by what he perceives is an overemphasis on just the provider portion of the healthcare supply chain inside the Beltway.

"For example, the government has legislated a net $19 billion in funding to spur the adoption of computerized patient records, but the funding is primarily for hospital and private-practice health records," Margolis explained. "I'm highly supportive of provider electronic records, although at present just 9 percent of hospitals have such technology and medical practices that treat Medicare and Medicaid patients will be hard-pressed to become paperless before penalties kick in, as stipulated by the new law.* Washington should simultaneously encourage the adoption of payer-based personal health records (PHRs). Health plan information systems are a very rich repository of patient healthcare information. And unlike hospital and physician records, the data to populate PHRs are already 100 percent digitized; are designed to facilitate the creation of ‘health resumes' controlled by the patient; and include the patient's demographic, diagnosis, treatment and pharmaceutical history across multiple care settings over a discrete period of time. Why overspend taxpayer money to recreate the wheel in its entirety, when significant components to develop a platform for digital patient records already exist?"

Developed by Dr. Shore, the Harvard School of Public Health's Forces of Change model and supporting curriculum examine current healthcare market dynamics to reveal successful strategies for innovative leaders. The program employs real-world examples of the steps that healthcare organizations must take to create a sustainable competitive advantage in the complex healthcare marketplace. At Harvard University, the Forces of Change model and curriculum are taught annually to graduate students and to professionals in Harvard's Executive Education Programs.

The author of a forthcoming book, "The Information Cure," Margolis is available for interviews by contacting Schwartz Communications at 781-684-0770 or trizetto@schwartz-pr.com. Interviews with Dr. Shore may be scheduled by contacting Christina Thompson at 617-998-1087 or chthomps@hsph.harvard.edu.

About Harvard School of Public Health

The overarching mission of the Harvard School of Public Health is to advance the public's health through learning, discovery and communication. From advancing scientific discovery to training national and international leaders, the Harvard School of Public Health has been at the forefront of efforts to benefit the health of populations worldwide.

About TriZetto

Founded in 1997, TriZetto is a privately held healthcare information technology company in the U.S. With its technology touching half of the U.S. insured population, TriZetto is Powering Integrated Healthcare ManagementTM. TriZetto provides information technology solutions that enable health insurance payers and other constituents in the healthcare supply chain to improve the coordination of benefits and care for healthcare consumers. The company's offerings include enterprise and component software, hosting and business process outsourcing services, and consulting.

* Lohr, Steve, "Doctors Raise Doubts on Digital Health Data," The New York Times, March 26, 2009, and Huslin, Anita, "Online Health Data in Remission: Nascent Industry Ready With Systems If Money and Standards Are Resolved," The Washington Post, Feb. 16, 2009.

CONTACTS:

Government Relations Contact:
Brad Samson
The TriZetto Group
949-719-2220
brad.samson@trizetto.com

Media Contact:
Melissa Bruno
Schwartz Communications
781-684-0770
trizetto@schwartz-pr.com