At Catalyst, we are firm believers in measurable improvement and tangible results. Through our six key focus areas we support the complex needs of our health plan clients, ensuring we deliver value every step of the way.

STRATEGY

The healthcare industry is undergoing a period of unprecedented change. Financial pressures, extraordinary advances in technology, regulatory changes and an increasingly sophisticated consumer base require health plans to be far more proactive than ever before. Moreover, competition between plans is high. Plans need to understand what products to bring to market and what tools are available to engage their members and providers-all while navigating a landscape full of regulatory, compliance and accreditation complexity. With over 20 years of experience and the knowledge gained from working with over 185 payers, Catalyst can provide health plan executives and board members insights and solutions for strategic initiatives.

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Operations Optimization

This practice focuses on the metrics, opportunities for cost reduction, and ways to gain efficiencies in the operations of a health plan.

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Specialty Services Optimization

Catalyst has developed an integrated and coordinated portfolio of services that are customized and managed for each plan. Using an intelligent, data-driven design process we work with the plan to identify probable targets of improvements, including:

MLR Reduction

Pharmacy

DME Management

Diagnostic Imaging

Utilization Management

Premium Enhancement

Recoup any underpaid capitation

Identify under/ overpayments

Soc. Sec. Disability Benefits Identification

Together, we propose to partner with you to pursue on-going improvements which will enable you to decrease your overall expenses, improve the health of your constituents, and manage financial and regulatory risks.

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PMO Services

From establishing a Project Management Office to providing basic project training, Catalyst’s PMO Services practice enables health plans to turn project management and governance in to an organizational asset. Click to learn more.

Facets QNXT HealthRules AMISYS NetworX OHI CareAdvance ITS ZeOmega HSP HealthSuite Pega HealthAxis CareAdvance ITS/Blue Card Altavista Health Optum

TECHNOLOGY & CORE PLATFORMS

A modernized core platform can improve a healthcare plan's ability to respond quickly to a market with ever-changing customer and regulatory demands. New platforms provide plans with greater control over architecture and configuration, allowing for increased automation and decreased manual labor. Further, integration with other solutions and technologies helps drive member and provider satisfaction. Catalyst has extensive knowledge and expertise in most major claims and ancillary systems as well as supporting tools and leverages this intelligence to the benefit of our health plan clients.

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Claims Systems Care Management Systems Provider Data Management Systems Integrated Pricing Systems Plan Modeling Pharmacy Pharmacy Benefit Management Customer Relationship Management ITS/BlueCard Learning Management Systems Content Management Systems Workforce Management Workflow Management

Support Services

Interim Health Plan Executives

Staff Augmentation:
Health Plan Operations & IT

Claims & Customer Service Teams
Team Build/Outsource/Co-Source
Catalyst On Demand

Catalyst offers several solutions to help health plans accomplish their human capital objectives. Whether a health plan needs an interim executive, a team of claims analysts, or a co-sourcing arrangement, Catalyst can provide staffing support.
Catalyst On Demand allows health plans the opportunity to subscribe to a “bucket of hours” across Catalyst’s focus areas to meet diverse subject matter expertise needs on an ad hoc basis.

Get in touch

Want to know more about Catalyst? We would love to hear from you.

Address

2353 South Broadway, Denver, Colorado, 80210

email

[email protected]

2353 S/b Broadway. Denver, Colorado. 80210
303-393-8818 | 800-903-9574 | 303-393-8838