SelectHealth Chooses Infogix to Manage Cost Sharing Reduction Provision of the Affordable Care Act

    NAPERVILLE, IL, February 05, 2016 /24-7PressRelease/ -- SelectHealth, a not-for-profit health insurance organization serving clients in Utah and Idaho, has selected Infogix, a leader in helping companies provide end-to-end data analysis across the enterprise, to manage Cost Sharing Reduction (CSR)--a provision of the Affordable Care Act (ACA). Infogix will provide a software solution that includes claims re-calculation, shadow accumulator calculation, monthly financial reporting, and an annual CSR report.

The CSR provision introduces a process to subsidize member out-of-pocket costs, based on income, for variant plans. Issuers like SelectHealth receive a per-member-per-month (PMPM) payment from the government to offset the higher claims cost. SelectHealth reconciles these payments with the actual cost incurred based on their members' claims experience using the standard methodology.

Using Infogix's CSR solution, SelectHealth can accurately recalculate 100% of the medical and vendor claims which are integrated to ensure member and subscriber level accumulators are calculated properly. The flexibility of Infogix's software to meet SelectHealth's unique benefit rules and adjudication logic gives SelectHealth confidence that they are properly calculating CSR and the service provided to the member is being directed to the right benefit on the corresponding base plan.

"During our evaluation, ensuring regulatory compliance was a key factor. Infogix provided us with a solution that was easily operationalized and their month-over-month financial overview of our CSR liability proved invaluable in helping to manage our financial risk," said Jim Murray, director of government programs at SelectHealth. "Infogix worked diligently with our team to identify our unique business requirements, build the rules and ensure an accurate CSR calculation."

The Infogix solution also creates the final CSR report for SelectHealth to submit to the Department of Health and Human Resources (HHS) annually in April. The pre-built dashboards provide real-time access to the incurred claim costs of the members and how they relate to the PMPM estimated payments provided by HHS. Each dashboard is configured to meet the needs of SelectHealth.
"We're thrilled that SelectHealth has partnered with Infogix on our CSR solution to address the ACA regulation," said Paul Skordilis, executive vice president at Infogix. "We believe our comprehensive package of automated rules and reports will provide visibility and financial insight to the health plan, long before the final reconciliation and submission process each April."

About Infogix, Inc.
Infogix helps solve business challenges by analyzing data as it moves through complex business environments to improve the customer experience, corporate profitability and operational efficiency. The Infogix Enterprise Data Platform improves data quality, ensures effective transaction monitoring, provides balancing and reconciliation, identifies and predicts fraud and customer behavior. Infogix provides best-in-class solutions that seamlessly integrate into operations and allow clients to manage highly complex, data intensive business environments. By analyzing, processing and monitoring 100 percent of data in real-time or in batch, Infogix is able to provide proactive and actionable intelligence to manage operational workflows and steps. To learn more visit http://www.infogix.com or @Infogix.

About SelectHealth
SelectHealth is a not-for-profit health insurance organization serving members in Utah and Idaho, and is committed to health improvement, superior service and providing access to high-quality care. As a subsidiary of Intermountain Healthcare, SelectHealth is part of one of the nation's top-ranked integrated health systems. SelectHealth is also recognized as Utah's top-ranked health plan, according to NCQA's Private Health Insurance Plan Rankings, 2013-2014. To learn more visit http://www.selecthealth.org.

To learn more about Infogix visit http://www.infogix.com.

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