Gold Coast Health Plan Selects Conduent for Medicaid Managed Care Administration
FLORHAM PARK, N.J., Jan. 31, 2019 /PRNewswire/ -- Conduent Incorporated (NYSE: CNDT), a digital interactions company, was awarded a $100 million, seven-year contract extension to provide third-party administration services for Gold Coast Health Plan (GCHP), a Ventura County, Calif.-based Medi-Cal plan.
Conduent will deploy an end-to-end plan administration platform, including member experience and automation tools, for GCHP, which manages the Medi-Cal benefit for nearly 200,000 members. The technology will include analytics for fraud, member and provider behavior, and will automate tasks, including enrollment, claims processing and financial management, to reduce transaction time and lower administration costs.
Using an integrated data exchange model, the solution will help GCHP in its quest to exceed member and provider service goals while also maintaining compliance with the California Department of Health Care Services (DHCS) and Centers for Medicare & Medicaid Services (CMS) regulations. The model fully supports the value-based care model of incentive-based provider payments.
"With the acquisition of Health Solutions Plus, Conduent has the technology we need to automate our back-end processing, which will help us ensure both members and providers continue to receive the exceptional service they expect from GCHP," said Dale Villani, CEO, GCHP. "The new digital solution will make our workflow more efficient, allowing us to save valuable dollars and invest them back into the plan."
Conduent's acquisition of Health Solutions Plus, the number one vendor for payer claims and administration platforms in both the 2018 and 2019 Best in KLAS: Software and Services reports, closed earlier this month. The 2019 Best in KLAS report was released earlier today.
"Successfully administering and growing health plans is much easier when the right technology is in place," said Pratap Sarker, Group Chief Executive, Conduent, Financial Services and Healthcare. "By automating and leveraging analytics for GCHP, we'll partner every step of the way, from enhancing the member experience to ensuring each claim is properly analyzed and efficiently paid."
Implementation of the new solution is underway and expected to be complete in 2020.
Conduent Health has more than 30 years of experience in healthcare, with an extensive presence in the payer, provider and pharmaceutical markets, including servicing 20 of the top 20 managed healthcare plans, working with 40 percent of U.S. hospitals and 14 out of 15 of the top global pharmaceutical companies.
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Conduent creates digital platforms and services for businesses and governments to manage millions of interactions every day for those they serve. We are leveraging the power of cloud, mobile and IoT, combined with technologies such as automation, cognitive and blockchain to elevate every constituent interaction, driving modern digital experiences that are more efficient, helpful and satisfying.
Conduent's differentiated offerings touch millions of lives every day, including two-thirds of all insured patients in the U.S. and nearly nine million people who travel through toll systems daily. Whether it's digital payments, claims processing, benefit administration, automated tolling, customer care or distributed learning – Conduent serves a majority of the Fortune 100 companies and more than 500 government entities. Learn more at www.conduent.com.
About Gold Coast Health Plan
Gold Coast Health Plan proudly serves nearly 200,000 Medi-Cal beneficiaries in Ventura County through its network of primary care physicians, specialists, behavioral health providers, hospitals, and pharmacies. Since it was founded in 2011, Gold Coast Health Plan has been committed to providing access to high-quality care and improving the health of its members, which include 1 in 5 county residents, 1 in 8 seniors, and 1 in 2 children up to the age of 5. To learn more, visit: www.goldcoasthealthplan.org.
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