Medicare Special Needs Plan Increases Scalability With PLEXIS Composable Core Administrative Architecture

The implementation of next-generation enterprise core administrative payer technology from PLEXIS allows payers a greater capacity to transform at scale and meet the needs of a highly competitive and rapidly evolving industry.

PLEXIS Healthcare Systems

PLEXIS Healthcare Systems, a leading healthcare payer technology company and innovator in next-generation digital core administrative processing solutions (CAPS), today announced another payer administrator selecting the Quantum Choice™ next-generation enterprise administrative platform provided by PLEXIS Healthcare systems. The Medicare Special Needs Plan (SNP) is based in the Western United States and operates 250 healthcare facilities nationwide.

Anticipating large-scale growth of membership as well as regulatory requirements, the plan chose the PLEXIS Quantum Choice enterprise administrative platform, augmented with the flexible architecture of Quantum Choice's data integration layer, to facilitate a more efficient real-time system-to-system integration. The Quantum Choice solution effectively sets the foundation for significant componentization, interoperability, and scalability to meet growing membership, all while optimizing the IT ecosystem to integrate efficiently with other applications, legacy systems, and vendors.

Gartner, a leading technology research and consulting firm, quantifies the importance of "Composable Architecture" within the context of a rapidly evolving Healthcare Payer market landscape: "...Only a composable digital healthcare payer platform (DHPP) architecture will enable (Payers) the adaptability needed to deliver health value in the dynamic future of healthcare."

"Utilizing the Quantum Choice solution, payers take advantage of a granular message-based infrastructure delivering batch file and real-time integration capabilities to support a multitude of diverse workflows," Said Sean Garrett, chief operating officer for PLEXIS Healthcare Systems. "We're proud to deliver a composable architecture solution to support a health plan's business objectives, both within the Operations and Information Technology realms."

About PLEXIS Healthcare Systems

Celebrating 25 years of service, PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the globe. More than 100 organizations trust PLEXIS core administrative enterprise solutions to manage over 55 million lives in all 50 states and around the globe. PLEXIS provides mission-critical solutions that catalyze efficiencies and connect evolving business ecosystems to a wide range of payer organizations. PLEXIS Healthcare Systems is featured in Gartner's 2022 Market Guide for U.S. Healthcare Payers' Core Administrative Processing Solutions (February 2022) as a Representative Vendor.

Source: PLEXIS Healthcare Systems

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Categories: Healthcare Insurance

Tags: all inclusive care, API, API/webservices, Healthcare claims processing, Healthcare insurance, IT ecosystem, Medicare Special Needs Plan, Next-generation CAPS, PACE, SNP


About PLEXIS Healthcare Systems

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PLEXIS Healthcare Systems is a leading payer technology company that delivers trusted enterprise core administration and claims management solutions to healthcare payers and delivery systems around the world.

Dennis Hubbard
Marketing Manager, PLEXIS Healthcare Systems
PLEXIS Healthcare Systems
P.O. Box 1808
Medford, OR 97501
United States