Industry Watch

June 24, 2011
Rx Gets High Marks Pittsburgh-based Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association has renewed its pharmacy

Rx Gets High Marks

Pittsburgh-based Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association has renewed its pharmacy benefit contract with Franklin Lakes, N.J.-based Medco. The three-year agreement covers more than 2.3 million beneficiaries.

“As part of our review process, we evaluated several alternatives, including in-house management of our pharmacy benefit program, as well as the outsourcing of component services,” says Kenneth Melani, M.D., Highmark president and CEO. “However, we made the decision to continue our relationship with Medco based on overall cost, efficiency and quality, as well as the opportunity to create the next advancement in a fully integrated healthcare delivery model.”

David Snow Jr., chairman and CEO of Medco adds, “Medco appreciates the opportunity to remain Highmark's partner in providing high-quality pharmacy care, and we look forward to our continued collaboration, leveraging leading-edge technology to provide solutions for tomorrow's healthcare challenges.”

The award is subject to final contract execution.

Annual prescription drug claims costs for the members served by Highmark were approximately $2 billion in 2005, the company says.

Supporting — and Linking — Data

EBSCO Publishing of Ipswich, Mass. and evidence-based clinical decision support provider, Zynx Health of Los Angeles, have formed a new partnership. Mutual customers will be able to link from Zynx Resources to EBSCO's CINAHL database.

“The partnership between Zynx Health and EBSCO Publishing enables clients of Zynx evidence-based tools who have a subscription to CINAHL to have direct access from Zynx products to articles from the CINAHL database,” says Dave Rhew, M.D., vice president of content development for Zynx Health. “This access significantly expands the amount of information that may be provided at the point of care for nurses and other members of the interdisciplinary team.”

The Demand for On-Demand Management

Cary, N.C.-based provider of on-demand supplier management and procurement automation solutions, SciQuest Inc., and Redwood Shores, Calif.-based Oracle have formed a partnership. The idea is to integrate SciQuest's on-demand catalog management tools with the Oracle E-Business Suite and Oracle's Peoplesoft Enterprise for a robust e-procurement solution tailored for the higher education and life sciences markets.

SciQuest's applications are on-demand, multi-commodity supplier enablement, management and integration solutions designed to enhance existing procurement systems to increase on-contract spending and improve enterprise productivity and spend management. Through the SciQuest Supplier Network (SQSN), organizations can enable a critical mass of supplier catalog content which, it says. is crucial to maximizing purchasing efficiency, user adoption and spend visibility.

Seamless business document exchange is provided between SciQuest's Order Manager and Settlement Manager and Oracle procurement applications using Fusion Middleware. The use of this architecture is designed to allow Oracle customers to more easily tailor and transition their business processes and help to assure a smooth transition to newer versions and upgrades of Oracle applications.

“Effective supplier enablement is crucial to successful deployment of an enterprise procurement platform,” says SciQuest Inc., president and CEO Stephen Wiehe. “Organizations investing in Oracle ERP solutions can now fill the supplier enablement gap, solving customer content issues, streamlining operations and further increasing ROI on their Oracle applications.”

Licenses, Schedules and Patents, Oh My!

Resource Scheduling Corporation, a wholly owned subsidiary part of the Newport Beach, Calif.-based Acacia Technologies group, has entered into a license with Kansas City, Mo.'s Cerner Corporation covering a patent that applies to systems for scheduling and managing resources. The agreement with Cerner resolves a patent infringement lawsuit that was pending in the District Court for the Eastern District of Texas.

The Resource Scheduling technology generally relates to methods and software application tools for scheduling and managing resources used in hospital facilities and other resource-dependent markets. These resource scheduling tools are often integrated as part of an Enterprise Resource Planning (ERP) solution used to manage a company's complete operations.

“… and the URAC Goes To… ”

Birmingham, Ala.-based DST Health Solutions Inc.'s Medical Services Department has been awarded the Health Utilization Management Accreditation from Washington, D.C.-based healthcare accrediting organization, URAC. URAC, an independent, nonprofit organization, is committed to establishing quality standards for the healthcare industry and ensures that organizations follow review processes that are clinically sound and respect patients' and providers' rights while giving payers reasonable guidelines.

“It is critically important for healthcare organizations to make a commitment to quality and accountability. URAC accreditation is a demonstration of that commitment.”

“DST Health Solutions should be commended for meeting strict quality standards,” says Charles Stellar, URAC board chair. “It is critically important for healthcare organizations to make a commitment to quality and accountability. URAC accreditation is a demonstration of that commitment.”

“The successful completion of this accreditation process assures our clients, members and providers that DST Health Solutions is compliant with the quality standards established by URAC related to medical management processes,” says Steve Sabino, president of DST Health Solutions.

The Medical Services Department of DST Health Solutions provides health plans throughout the United States with medical management services, such as pre-certification, case management, prospective care management and inpatient concurrent review.

Brand Name

Eldorado Computing, Inc. (ECI), the Phoenix-based health insurance application development, business process outsourcing services, IT engineering and operational consulting company, has changed its brand name to MphasiS Healthcare Solutions (though the legal entity remains unchanged as Eldorado Computing Inc.) in an effort to align itself to its core brand and better reflect its full scope of automated and outsourced offerings for health benefits management.

MphasiS Healthcare Solutions specializes in health insurance application development, business process outsourcing services, IT engineering and operational consulting.

The company provides integrated software and ASP solutions for health benefits management.

“With over 20 years experience serving the healthcare payer marketplace we have continually enhanced our service offerings to keep pace with industry trends,” says Zane Bell, CEO of MphasiS Healthcare Solutions. “Most recently, we have leveraged our deep healthcare domain expertise with MphasiS' proven track record with top-tier financial institutions to offer healthcare payers the most advanced outsourcing services to reduce costs, enhance operational efficiencies and maximize their return on investment (ROI). As we move into the future, MphasiS Healthcare Solutions looks forward to creating unlimited opportunities for healthcare payer organizations to maximize business performance.”

“… we have leveraged our deep healthcare domain expertise with MphasiS' proven track record with top-tier financial institutions to offer healthcare payers the most advanced outsourcing services … “

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