New TriZetto Cross-Constituent Survey Finds Surprising Agreements and Disagreements...

New TriZetto Cross-Constituent Survey Finds Surprising Agreements and Disagreements About Healthcare IT Solutions

Employers, Brokers, Health Plans, Physicians and Consumers
Identify Information Gaps, Misaligned Incentives and Lack of Awareness
NEWPORT BEACH, Calif.--(Business Wire)--
Results of a survey released today by The TriZetto Group Inc.
(NASDAQ: TZIX) show that patients, doctors and other healthcare
constituents agree that more shared information and aligned incentive
programs are key to helping solve the healthcare affordability crisis
and that health plans are best positioned to coordinate these
improvements.

The findings of TriZetto's 2008 Integrated Healthcare Management
(IHM) Survey highlight a disaggregated healthcare system in which
employers, doctors and consumers too often don't have or don't use the
information they need to optimize and coordinate individual health and
treatment decisions, consumer and provider incentives are misaligned,
and in some cases constituents lack agreement about the kind of
technology and tools needed to improve healthcare delivery.

"To borrow a line from the movie Cool Hand Luke, what we have here
is a failure to communicate," said Dan Spirek, executive vice
president, integrated health solutions, and chief solutions officer at
TriZetto. "Consumers, providers, employers, brokers and payer
organizations are disconnected from one another and therefore have
difficulty coordinating healthcare decisions to drive better outcomes.
The good news is that the requisite data on health status, medical
procedures and much more resides largely in the administrative and
care management systems of health plans, so these organizations are
ideally positioned to share this information with all healthcare
constituents, improve the alignment of incentives and thereby optimize
the coordination of health benefits and care for the consumer. We call
this systemic approach Integrated Healthcare Management," Spirek said,
"and we believe IHM can help fix what ails the U.S. healthcare
system."

Commissioned by TriZetto and conducted by TNS Custom Research, a
global market information firm based in London, the IHM Survey is a
cross-constituent study - of senior-level health plan employees,
employers, brokers, general practitioners and specialists, and
consumers - and will be conducted annually, according to TriZetto. For
the inaugural study in late 2007, more than 1,700 individuals were
queried online regarding healthcare costs, cost management, incentive
programs and the availability of information and tools to make
healthcare decisions.

AFFORDABILITY IS A CRITICAL CHALLENGE

High costs in the U.S. healthcare system impact all constituents
as well as the system itself. Survey results show that consumers, in
particular, have been touched by the challenge of healthcare costs.
Eighty-one percent of consumers surveyed by the TriZetto IHM study
expressed concern about their future healthcare costs, and only 8
percent voiced a lack of concern. Similarly, 73 percent said they were
concerned about their current healthcare expenses, while 62 percent
expressed worry that their current health insurance plans would not
adequately control these costs.

While the industry as a whole seeks better cost management, "the
first step in improving cost management must be higher levels of basic
awareness," according to the report, and awareness requires shared
information.

CONSTITUENTS HAVE HIGH INTEREST IN SHARED INFORMATION

Eighty-eight to 91 percent of all constituents saw some value in a
range of online information tools that help anticipate healthcare
costs, select benefit packages and receive customer service. Examples
of such tools are estimators that consumers can use to determine how
much they will pay for treatments or online comparisons of physician
and hospital costs and quality. Three in four constituents (78
percent) said they would like employers to offer online reward
programs that encourage healthy choices about diet, exercise and
tobacco use.

Doctors, too, believed that additional online information would
benefit the healthcare system. Roughly 60 percent of providers said
that posting quality ratings would have a positive effect on patient
satisfaction and on their practices, and between 80 and 90 percent
rated as very or extremely important that they have access to
patients' health information prior to appointments and access to
patient records of treatments and medications across all physicians
and hospitals.

Four out of five providers, according to TriZetto's IHM Survey,
believed pay-for-performance programs, a healthcare industry trend,
would be bolstered if payers "proactively shared patient information
to facilitate stronger care-giver interaction and better care."
Significantly, two-thirds of providers surveyed rated as very or
extremely important the integration of health insurance company
information systems with those of physicians and hospitals.

CONSUMER, EMPLOYER AND PROVIDER INCENTIVES REQUIRE ALIGNMENT

More than 90 percent of both employers and payers in the TriZetto
IHM study considered wellness incentives at least somewhat effective
as a way to lower the healthcare costs of employees and their
families. And consumers appeared up for the challenge: Between 50 and
60 percent said they would be interested in using a range of
incentives, if they were available, to take health risk assessments
and participate in wellness programs such as exercise. Further, there
was agreement among consumers, employers and payers in the TriZetto
study that participation in workplace health and productivity
management programs could be encouraged most by cash incentives,
co-pay or premium reductions, and lower co-insurance levels.

However, in an example of where incentive alignment could be
improved, consumers found few opportunities to sign up for wellness
programs, with only 6 to 18 percent reporting participation in a range
of such incented programs. Further, according to TriZetto's IHM
Survey, most employers - 60 percent - reported that they had no
information systems with which to mange incentive-based programs. And
only 28 percent of employer, broker and payer respondents said they
were very or extremely likely to build incentives into health benefit
plan contracts, with 44 percent unlikely to include such contractual
commitments in the near term.

Among providers, some 60 percent of general practitioners and
specialists surveyed by TriZetto thought that incentives to coordinate
care across facilities would improve outcomes and reduce costs. Half
believed that pay-for-performance programs could be an effective way
to reduce cost and improve quality. But, in another example of an
opportunity for better incentive alignment, only about a fourth of
surveyed providers reported participation in payer-sponsored
pay-for-performance programs.

PAYERS ARE BEST POSITIONED TO LEAD THE WAY, BUT MUST CHANGE ROLE

When asked who might best lead the coordination of health benefits
and care for the healthcare consumer, payers were most frequently
named by all constituent groups. Health plans were preferred by 26
percent of respondents overall, according to TriZetto's IHM Survey,
versus 18 percent for consumers, 17 percent for government and 14
percent for physicians and hospitals.

"However, to lead the coordination of health benefits and care,
payers must evolve from their historically transactional orientation
to a broader role as health and wellness advisor," according to
Spirek. "Laudable are the initial efforts of national players, which
are driving awareness. But regional players may be best positioned to
deliver real results that enhance information exchange and close
information gaps between healthcare constituents."

INFORMATION AND AWARENESS GAPS ACROSS CONSTITUENCIES

Exemplifying these information gaps was the finding by the
TriZetto IHM Survey that consumers were unaware of how much employers
paid toward their insurance premiums. Only one in 10 consumers knew
that the employer share was greater than $1,000 per year per
individual and more than $5,000 per year per family. Four in 10
consumers had no idea what employers paid, and in fact, five in 10
believed employers paid considerably less than what they paid toward
employee premiums. In 2007, employers' monthly premium payments were
more than $3,600 per individual and $7,400 to $9,400 per family.(a)

Regarding their own outlays, nearly two-thirds of consumers
admitted in the TriZetto IHM study that, at best, they were only
somewhat aware of their healthcare expenditures. Yet, in contrast,
most consumers expressed concern about their future healthcare costs.

While cost awareness was an issue for individuals, cost management
revealed an information gap among providers. Nearly half of the
surveyed providers reported increases in accounts receivable and bad
debt. However, only some providers were actively assessing patient
liability, with 68 percent saying that they infrequently or never
estimated the amounts patients owed prior to providing care. But the
TriZetto survey also showed that the number of providers who estimate
patient liability would grow by 70 percent if online tools were
available for them to do so.

Other online tools can help consumers track their medical
expenses, get estimates for procedures, compare provider costs and
quality, and manage personal health information. Eighty-seven to 92
percent of surveyed consumers claimed that they had an interest in
using a range of such tools. But there was evidence of an information
gap because 43 percent of consumers simply did not know if online
tools were available to them.

LACK OF AGREEMENT CONCERNING THE INFORMATION CONSTITUENTS SEEK

To some degree, payers and providers were not in agreement about
the information that would be required to improve the coordination of
benefits and care for consumers.

For example, the TriZetto IHM Survey revealed that providers would
like to have access to patient records across all providers. However,
only a minority of payers (29 percent), according to the survey,
reported that providers requested this kind of access. And while
two-thirds (67 percent) of providers said that integration of
insurance with provider and hospital management systems would be
important, only a third (33 percent) of payers acknowledged that
providers sought this integration.

The TriZetto IHM Survey revealed a similar disconnect between
employers, brokers and payers. While more than half of surveyed
employers and almost 75 percent of brokers favored information tools
that would help determine the plan options that best fit an employee's
benefit management goals, only about 40 percent of payers perceived
this need. Sixty-five percent of brokers and 48 percent of employers
favored applications that would ease the management of employee
incentives, but only 42 percent of payers acknowledged this sentiment.

"Again, payers have all the benefit plan, cost and treatment
information on Americans with health insurance," Spirek said. "Payers
can close these information gaps, bridge these disconnects and drive
IHM by leveraging the wealth of health benefits and care information
in their systems to engage constituents and align incentives, helping
to solve the affordability crisis."

A full report on the findings of TriZetto's 2008 IHM Survey is
available on the home page of www.trizetto.com or from the contacts
listed below.

About TriZetto

TriZetto is Powering Integrated Healthcare Management(TM). With
its technology touching nearly half of the U.S. insured population,
TriZetto is uniquely positioned to drive the convergence of health
benefit administration, care management and constituent engagement.
The company provides premier information technology solutions that
enable payers and other constituents in the healthcare supply chain to
improve the coordination of benefits and care for healthcare
consumers. Healthcare payers include national and regional health
insurance plans, and benefits administrators that provide transaction
services to self-insured employer groups. The company's payer-focused
information technology offerings include enterprise and component
software, hosting and business process outsourcing services, and
consulting. Headquartered in Newport Beach, Calif., TriZetto can be
reached at 949-719-2200 or at www.trizetto.com.

(a) Kaiser Family Foundation and Health Research and Educational
Trust, "Employer Health Benefits, 2007 Annual Report"

Investor Contact:
TriZetto
Brad Samson, 949-719-2220
brad.samson@trizetto.com
or
Media Contact:
Melissa Bruno, 781-684-0770
trizetto@schwartz-pr.com

Copyright Business Wire 2008