RAM Technologies, Inc., the perennial leader in the development of enterprise software for healthcare payers administering Medicare Advantage and Special Needs plans, is proud to announce the value based benefit capabilities available with HEALTHsuite Advantage™ and Medicare Advantage-in-a-Box. The advanced functionality provides health plans with the tools they need to participate in the Centers for Medicare and Medicaid Services’ (CMS) Value-Based Insurance Design (VBID) model.
The advanced value based benefits processing capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box enable health plans to identify patients who are eligible for the program and then adjust their patient responsibility accordingly. The system provides functionality to identify specific co-payments, coinsurance and / or deductibles that can be waived for patients participating in pre-defined initiatives. VBID functionality includes the ability to reduce cost shares and add supplemental benefits for enrollees with chronic conditions.
In 2020, CMS has expanded the scope of the VBID model, allowing for more health plans to participate including special needs plans (D-SNPs and I-SNPs). Additionally, the list of conditions has increased to include Chronic and Socioeconomic factors and the benefits have also been expanded to include telehealth and Social Determinants of Health (SDOH). 2020 has also seen the elimination of cost shares for high value services as well as disease specific Care Management programs.
In addition, 2021 will see even more changes to the VBID Model, including the incorporation of Hospice / End-of-Life Care which will require the ability to accurately identify members in coaching / disease management; waive the patient responsibility for procedures related to the coaching program; provide support for multiple benefit definitions; and more.
“The goal of the VBID program is to reduce overall costs and enhance the quality of care for beneficiaries. The VBID capabilities available with HEALTHsuite Advantage and Medicare Advantage-in-a-Box meet these needs and provide our clients with the ability to apply the program specific benefits to their membership,” stated Robert A. Tulio, President of RAM Technologies. “Overall, the aim of the program is a complete modernization of the Medicare Advantage program and we are pleased to be able to provide our clients with the tools needed to achieve this objective.”
RAM’s offerings, HEALTHsuite Advantage and Medicare Advantage-in-a-Box, represent a revolution in the way health plans modernize their MA administrative infrastructure. The pre-configured solution deploys out-of-the-box, ready to administer ‘Original Medicare’, thereby slashing implementation durations, eliminating risk and greatly reducing costs. This RAM offering brings robust functions and features including all of the essential core capabilities and complete integration with CMS, and delivers them in a truly innovative fashion.
In addition to the enterprise capabilities provided by HEALTHsuite Advantage and Medicare Advantage-in-a-Box, RAM also makes available solutions from their strategic alliance partners, solutions to facilitate the management of population health, quality, cost containment, analytics and more. These combined solutions represent a one-stop-shop for all of a health plan’s MA needs and the simplest solution for organizations looking to enter the MA market.
About RAM Technologies:
RAM Technologies is a leading provider of enterprise software solutions for Medicare Advantage and Special Needs health plans. For over 39 years RAM Technologies has led the way in the creation of superior software solutions for health plans serving government sponsored healthcare programs (Medicare Advantage, Special Needs, Managed Medicaid, Federal Employee Health Programs, etc.). RAM Technologies has merited a top spot in the Philadelphia Business Journal’s “List of Top Tech Employers” for twelve consecutive years, has been featured in Inc. Magazine’s List of Fastest Growing Private Companies for five years and has been named Most Promising Insurance Technology Solution Provider by CIO Review. To learn more about RAM Technologies call (877) 654-8810 or visit www.ramtechinc.com.