Learn How the Dell ikaSystems Alliance Can Benefit You

September 28, 2011

Download this presentation at www.slideshare.net/dellservices

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Introductions

Ravi Ika

Executive Chairman & Founder,

ikaSystems

Jeff Broocks Executive Director,

Payer Solutions, Dell HCLS Services

Tim Quigley

Vice President,

National Healthcare Group,

Dell HCLS Services

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Topics of Discussion

• Introductions

• State of Dell

• State of Healthcare Market

• State of ikaSystems

• Dell / ikaSystems Strategic Alliance

• Q&A

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Dell Healthcare Strength • Leading global healthcare IT and BPO services provider

• 11,000+ healthcare and life sciences professionals

• Support more than 10,000 healthcare providers, health plans, pharmaceutical, biotech, medical devices, diagnostic and scientific instrumentation customers worldwide

• More than 500 technology partners

Dell Healthcare Payer Strength • Support more than 100 insurers, which include commercial, Medicare

and Medicaid lines of business

• Operate the only Health Insurance Exchange of its kind

• Enable the creation of a sustainable insurance marketplace for individuals, employers and employees

• Help payers navigate uncertainty by identifying improvement opportunities and risks

• Support alignment of core business functions with the Exchange environment

• Help health plan customers transition to a consumer-centric model

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Current State of the Healthcare Market We are facing the greatest changes to healthcare in more than a generation

Healthcare Reform

• Accountable Care Organizations (ACOs)

• State Health Exchanges (HIXs)

• Consumer Operated and Oriented Program (CO-OP)

• ALR/MLR

Regulatory Changes

• HIPAA 5010

• ICD-10

• CMS Program

Changes

Market Dynamics

• Cost Pressures

• Product Evolution

• Increased Consumerism

• Aging Population and Increased Membership

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Market Perspective

• Looking for a platform that is highly agile, requires minimal time to implement and has limited or no up-front capital investments

• Interested in seasoned and capable services vendors operating on open architectures and flexible and configurable applications

• Seeking partnership models that include business process and technology outsourcing services

• Expressing increasing interest in rapidly deployable SaaS/BPO models • Looking for an integrated solution that does not require multiple vendor

contracts to achieve their objectives

Health plans are…

• Payers require a highly flexible and configurable application that is better suited to meet the needs of the rapidly evolving post-reform healthcare market

• Payers evaluate their current IT systems’ capabilities to optimize daily operations and reduce administrative costs while meeting changing regulatory demands

Analysts suggest…

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Why ikaSystems?

• Strategic alliance combines Dell’s extensive payer business process experience and healthcare cloud expertise with ikaSystems’ flexible, scalable, rapidly deployable cloud-based suite of integrated administrative and care management solutions

• Ability to help payers optimize daily operations, reduce administrative costs and increase operational efficiencies while meeting changing regulatory demands

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ikaSystems

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ikaSystems Overview

• Enterprise-level cloud computing solutions for payers

• Single, modular system for all business lines

• Backed by Providence Equity Partners, 7th largest private equity firm

• 350+ employees focused exclusively on payers

ikaSystems is delivering today on a fundamentally different model focused on helping health plans radically reduce administrative, technology and medical costs

Revenue Growth

2008 2009 2010 2011P

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ikaEnterprise

• Comprehensive suite

• Modular but integrated

• Implement at client’s pace

• Fully user-configurable

• Efficient work flow for today’s plans

• Intuitive for minimal training

• Scalable for largest plans

• Highly secure

• Centralized data for powerful reporting available across business

• Leveraged investment: Compliance, innovation managed by ikaSystems

IKAPORTALS

IKASALES

IKACLAIMS

IKAMEDICARE

IKAMM

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ikaEnterprise: Modular Solutions for All Business Lines

ikaSales ikaPortals ikaClaims ikaMedicare ikaMedicalManagement

ikaCRM, designed specifically for health plans

Sales Portals

Individual

Group

Medicare

ikaBilling

ikaCommissions

Sales Portals

sales

underwriting

enrollment

fulfillment

marketing effectiveness analysis

Employer Portal

Member Portal

Provider Portal

ikaClaims

ikaEnterprise Service (customer service application)

ikaNetwork Manager

provider network management

contracting

fee-schedule negotiation

payment reconciliation and 1099 production

ikaMedicareGateway

automate the complexity of CMS data exchanges for enrollment

payment reconciliation

membership reconciliation

ikaD4C (Diagnosis for Care)

enhance diagnosis accuracy and coding

optimize care

accurate reimbursement

Medicare Sales Portal

ikaDWH, a consolidated database of administrative, financial and clinical information

ikaUA, utilization analytics for executive, actuarial, underwriting, finance, quality and med management decisions

ikaProfyle (physician profiling)

ikaDM (disease management)

ikaCM (case management)

ikaAM, supporting authorization management, pre-certification and concurrent review

ikaHEDIS/ikaProHEDIS+ (proactive HEDIS program management)

ikaP4P (pay-for-performance)

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Today’s Choice Health plan business solutions “in the cloud,” with zero technology footprint

• Rapid implementation

• Lower costs

• Seamless upgrades

• Consistent data

• Predictable availability, full redundancy

• Industry-leading Microsoft, Dell and Oracle platforms

• Extends existing technology investments

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Why ikaSystems Selected Dell

• Superior healthcare BPO expertise, sophisticated service level tools

• Exceptional brand and market reputation

• Provides large bench strength of implementation expertise

• Power to leverage other Dell resources including infrastructure

• Commitment to..

– Healthcare

– Customers

– Service excellence

• Philosophical alignment with ikaSystems

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Dell / ikaSystems Value to Health Plans

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Dell/ikaSystems Partnership… …empowers healthcare transformation

Responsive Delivery

Process Improvements

Increased Efficiencies

Customer Commitment

Value

• Two world class solution providers combining forces in a long-term partnership

• Combination of services and end-to-end software solutions

• Solutions help customers reduce administrative costs, manage medical expenses and meet regulatory requirements

“Health plans should include Dell/ikaSystems on any short list for business outsourcing and technology outsourcing assessments.”

Janice W. Young, Program Director, IDC-Health Insights

Dell/ikaSystems delivers integrated solutions that enable healthcare organizations to solve critical problems while improving quality of delivery.

Q&A

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Thank You

Download this presentation at www.slideshare.net/dellservices