FLORHAM PARK, N.J., Nov. 24, 2020 -- Conduent Incorporated (Nasdaq: CNDT), a business process services and solutions company, today announced a new agreement with Vaya Health that will help the managed care organization (MCO) simplify and optimize the administration of behavioral health benefits to Medicaid recipients in North Carolina. Under the terms of the seven-year agreement, Conduent will deliver and host a custom version of its HSP Core Claims Administration software solution allowing Vaya to more efficiently operate and manage benefits in 22 counties.
As one of only seven behavioral health MCOs in the state of North Carolina, Vaya is moving forward with preparations to operate under new program rules that will require MCOs to coordinate payment of benefits with one of four statewide prepaid health plans (PHPs) by July 2021. Vaya chose Conduent for the company’s proven success with embedded automation and artificial intelligence tools to effectively manage medical cost and complex healthcare claims. Prior to the agreement, Conduent developed a systems modernization model using Vaya’s claims data that projected the efficiency gains and cost savings that artificial intelligence, advanced automation and analytics can deliver.
“As an organization with nearly 50 years of experience in behavioral health and managed care, we understand the importance of innovation in the changing Medicaid landscape,” said Robert Webb, Executive Vice President and Chief Information Officer at Vaya Health. “Vaya’s partnership with Conduent demonstrates our ongoing pursuit of excellence as we prepare for the evolution of Medicaid managed care in North Carolina.”
The North Carolina Department of Health and Human Services (NC DHHS) recently announced plans resuming efforts to shift the state’s Medicaid program from a fee-for-service to a pay-for-performance model to improve members’ health outcomes while reducing overall costs. Currently, more than one in five North Carolinians, or 2.36 million people, depend on and are in enrolled in Medicaid.
“We are proud to partner with Vaya to enable their successful transition into a pay-for-performance model that lowers operational costs while enhancing positive digital experiences for beneficiaries,” said Lisa Hopper, General Manager, Healthcare Payer Solutions at Conduent. “Our award-winning core claims administration solution enables Vaya to streamline processes and apply advanced data analytics to control costs while enhancing services.”
Conduent’s Healthcare Payer Solutions span all touchpoints for insured members, helping them navigate through healthcare choices and connect to care teams through automated business processes. Its Payer Solutions portfolio includes its ‘ Best in KLAS’ HSP Core Administration Services , Payment Integrity Services and Care Integration Services.
More information on Conduent’s Healthcare Payer solutions can be found here .
About Vaya Health
Based in Asheville, N.C., Vaya Health manages public funds for mental health, substance use disorder and intellectual or developmental disability services in 22 western North Carolina counties: Alexander, Alleghany, Ashe, Avery, Buncombe, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Swain, Transylvania, Watauga, Wilkes and Yancey. Access to care and crisis assistance are available 24/7 at 1-800-849-6127. Learn more at www.vayahealth.com .
Conduent delivers mission-critical services and solutions on behalf of businesses and governments – creating exceptional outcomes for its clients and the millions of people who count on them. Through people, process and technology, Conduent solutions and services automate workflows, improve efficiencies, reduce costs and enable revenue growth. It’s why most Fortune 100 companies and over 500 government entities depend on Conduent every day to manage their essential interactions and move their operations forward.
Conduent’s differentiated services and solutions improve experiences for millions of people every day, including two-thirds of all insured patients in the U.S., 11 million employees who use its HR Services , and nearly nine million people who travel through toll systems daily. Conduent’s solutions deliver exceptional outcomes for its clients including $17 billion in savings from medical bill review of workers compensation claims, up to 40% efficiency increase in HR operations, and up to 40% improvement in processing costs, while driving higher end-user satisfaction. Learn more at www.conduent.com .
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Conduent is a trademark of Conduent Incorporated in the United States and/or other countries.