PLEXIS Healthcare Systems an established innovator in digital core administration and claims management solutions, is included in Gartner’s Market Guide for U.S. Healthcare Payers’ Core Administrative Processing Solutions (25 June 2019) as a Representative Vendor.
“We believe Gartner’s Market Guide for U.S. Healthcare Payers’ Core Administrative Processing Solutions consistently illustrates the key drivers for healthcare payers’ success,” said Sean Garrett, PLEXIS’ Chief Operating Officer. “We know PLEXIS leverages over two decades of innovative development to include cloud-based delivery models, next-generation business process outsourcing (BPO), open APIs, modular solutions, highly configurable benefit administration, and greater visibility with ready access to real-time data. We believe these enhanced capabilities empower payers with highly-competitive assets such as member/provider engagement toolsets, value-based reimbursement models, and speed-to-market for new lines of business or products.”
One of Gartner’s key findings in the report is, “Payer CIOs are modernizing core systems and embracing the cloud to meet their CEOs’ digital transformation ambitions. Legacy CAPS lack critical digital enablement capabilities (such as cloud delivery models or support for APIs), which is driving payer CIOs’ increasing investment in next-generation CAPS.”
Gartner says, “Next-generation CAPS are more agile and intelligent than legacy solutions. They also enable faster new product launches (including new lines of business), real-time data sharing and transaction processing between payers and providers (as well as business partners), and personalized benefits management tools to help engage and serve members. Next-generation CAPS are defined by the following characteristics: ecosystem enablement, cloud delivery, modern architecture, configurability, componentization, and value-based payment enablement.”
“In relation to cloud delivery, we believe our PLEXIS Cloud hosting and delivery capability provides a full-service delivery model with the option to add our supporting managed IT services,” said Garrett. “The PLEXIS Cloud offering enables IT resources to be freed up to focus on more mission critical functions. Additionally, PLEXIS is well-known for providing an open architecture with the configurable interfaces payers need for critical, real-time data transfer and automated workflow support, which ultimately increase efficiency and accuracy in healthcare payer transaction processing.”
In relation to the transition to value-based payment models, the PLEXIS platform offers extensive modular pricing/reimbursement options to allow payers to implement innovative value-based payment models for important markets including both commercial and Medicare Advantage.
Gartner, Market Guide for U.S. Healthcare Payers’ Core Administrative Processing Solutions, Mandi Bishop, 25 July 2019
Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.
Sean R. Garrett