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Affinity Health Plan (Affinity), an independent, not-for-profit organization offering quality healthcare coverage to New York area residents, has selected Dell Services and ikaSystems, a premier provider of enterprise, cloud-based business process and automation solutions for health plans, to connect to the New York State of Health – Health Plan Marketplace and assist in the administration of the new Exchange business line. The services and solution will automate and streamline Affinity’s administrative processes on the Health Plan Marketplace to enable the plan to successfully participate in the Exchange.  

Affinity, headquartered in the Bronx neighborhood of New York, has been working closely with community health centers and other primary care practices to offer affordable, high quality health care coverage to New York residents for more than 25 years. Affinity works with over 30,000 doctors and 68 of the area’s best hospitals to provide access to quality health coverage for more than 265,000 customers in the New York metro area. 

The Congressional Budget Office estimates that within 10 years, the health insurance market will swell by 33 million people who would otherwise be uninsured. In particular, Medicaid health plans are helping to improve the quality of care for covered individuals and lower costs by providing access to the right care in the right setting. To attract a broad range of consumers and maximize enrollment, exchanges must provide enrollment processes that are fast, efficient, exceptionally well designed and easy to navigate.   

“Affinity is proud to be selected to offer its products on the New York State of Health,” said Bob Allen, Affinity’s senior vice president and CIO. “We needed additional expertise and resources beyond our team in order to enter this market, and we are confident that Dell’s healthcare BPO team and the ikaSystems solutions will help us get there.”

Affinity will utilize Dell’s BPO services with the following ikaSystems’ solutions to automate and streamline administrative processes associated with the exchange business, improving agility, accuracy and compliance:

  • ikaExchange – delivers rich functionality via a highly configurable, easily maintained technology platform to help health plans meet the complex demands of the new HIX environment
  • ikaClaims – automates claims administration to reduce errors and administrative and IT expenses while maximizing flexibility
  • ikaEnterpriseService – provides constituent-facing service representatives the tools and information they need to provide exceptional member service
  • ikaBilling – delivers a level of accuracy that reduces time spent on manual processes and rework, improving productivity and member satisfaction
  • ikaPortals –  enables payers to give members and providers control over data and processes that directly affect them in a real-time, HIPAA-compliant environment

“We are able to apply our deep healthcare expertise and exchange experience to help Affinity further realize its mission by building the range of capabilities needed to operate on the exchange. Updated technology approaches — including more modular and scalable cloud-based platforms like ikaSystems’ solutions — will help Affinity stand out in the new marketplace,” said Sid Nair, Dell Services Vice President and Global General Manager, Healthcare & Life Sciences.

“Adapting to evolving Exchange requirements will be critical to payers’ success. Our solutions are designed with the flexibility and efficiency payers require to quickly seize market opportunities, while simultaneously improving overall processes,” said Joe Marabito, CEO, ikaSystems. “We’re very pleased to work with Dell to serve Affinity and enable them to compete and thrive in the exchange environment.”

Dell is the leading provider of healthcare information technology services globally, based on a recent Gartner report.[1] The ranking, which is based on 2012 revenue, marks the third consecutive year Dell has achieved the No. 1 ranking for healthcare services.

Dell works with health plans representing approximately 100 health insurance organizations. On an annual basis, Dell processes more than 96 million claims, handles more than 1.3 million enrollment transactions and manages call centers that receive more than 11 million calls per year for these customers.

About ikaSystems

ikaSystems delivers business automation and process solutions that transform how health plans conduct commercial, Medicare, Medicaid, Exchange, and ACO business. Our solutions automate key processes for sales, marketing, regulatory compliance, claims administration, customer service, quality management, and revenue optimization – all on an integrated, Web-based platform that’s fast and scalable. Partner with us, and take a bold step forward: one that can lower costs, increase agility, and improve constituent satisfaction for all your lines of business. For more information visit us at www.ikasystems.com.

About Affinity Health Plan

Affinity Health Plan is an independent, not-for-profit organization offering quality health care coverage to underserved New Yorkers. Affinity is proud to be an approved health plan for the NY State of Health: The Official Health Plan Marketplace, and to continue providing programs sponsored by New York State Medicaid managed care and Medicare. Founded in 1986, Affinity serves over 265,000 members in New York City, Nassau, Suffolk, Westchester, Rockland and Orange counties. For more information, visit www.affinityplan.org or follow Affinity on Facebook and YouTube. 

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[1] Gartner, Inc., Market Share: IT Services, 2012, Kathryn Hale et al, March 29, 2013