{"id":21636,"date":"2018-06-21T05:00:00","date_gmt":"2018-06-21T12:00:00","guid":{"rendered":"https:\/\/www.salesforce.com\/?post_type=sf_press_release&#038;p=21636"},"modified":"2020-09-18T00:36:26","modified_gmt":"2020-09-18T00:36:26","slug":"salesforce-announces-health-cloud-for-payers-transforming-business-operations-and-member-engagement-for-insurers","status":"publish","type":"sf_press_release","link":"https:\/\/www.salesforce.com\/news\/press-releases\/2018\/06\/21\/salesforce-announces-health-cloud-for-payers-transforming-business-operations-and-member-engagement-for-insurers\/","title":{"rendered":"Salesforce Announces Health Cloud for Payers, Transforming Business Operations and Member Engagement for Insurers"},"content":{"rendered":"<p><i>Built on the world\u2019s #1 CRM platform, the new Salesforce Health Cloud solution gives every health payer a complete view of members in a single dashboard, driving productivity for service agents and clinical professionals<\/i><\/p><p><i>Payers can create customizable, interactive and highly personalized connected experiences to improve member outcomes and satisfaction<\/i><\/p><p><b>SAN FRANCISCO \u2014 June 21, 2018\u2014<\/b>Salesforce [NYSE: CRM], the global leader in CRM, today announced Health Cloud for Payers, a complete solution designed specifically for the health insurance industry. Every payer, such as insurance carriers and health plan sponsors, will be able to use Health Cloud to get a complete view of their members and provide more personalized experiences, helping to improve member outcomes and contain medical costs.<\/p><p>Healthcare payers are facing a highly competitive market where both members and providers expect connected and personalized experiences. As more healthcare costs shift to the member, payers must respond to the growing consumer demand for better services or risk lower enrollment. The stakes are high, as 80 percent of customers say the experience a company provides is as important as its products and services. In addition, inefficiencies across member operations and siloed systems hinder a payer\u2019s ability to get a single view of each member, which is the foundation for providing personalized care management and effective provider collaboration. Finally, members often struggle to understand their benefits and care plans, while at the same time expect more modern ways to connect with their insurers.<\/p><p>\u201cPayers around the world are no longer just competing against one another, they\u2019re being compared to any company providing a convenient user experience that builds loyalty,\u201d said Dr. Joshua Newman, Chief Medical Officer, Salesforce. &quot;With Health Cloud for Payers, Salesforce is providing a solution that makes it easier for insurance companies to streamline workflow and connect with both members and providers in more effective ways.\u201d<\/p><div class=\"wp-block-image__wrapper\"><figure class=\"wp-block-image size-large\">\n\t<a href=\"#\" class=\"wp-block-image__modal-toggle\" aria-expanded=\"false\" data-modal-id=\"2509-modal\"><span class=\"screen-reader-text\">Open Image Modal<\/span><img decoding=\"async\" src=\"https:\/\/www.salesforce.com\/news\/wp-content\/uploads\/sites\/3\/2020\/08\/HealthCloud1.png?strip=all&#038;quality=95\" alt=\"\" class=\"wp-image-2509\" \/><\/a>\n<\/figure><div id=\"2509-modal\" class=\"image-modal\" aria-hidden=\"true\" aria-labelledby=\"image-dialog-title\"><div class=\"image-modal__overlay\" tabindex=\"-1\" data-a11y-dialog-hide><\/div><div class=\"image-modal__content\" role=\"dialog\"><button class=\"image-modal__close-button\" type=\"button\" data-a11y-dialog-hide aria-label=\"Close this image dialog window\"><svg viewBox=\"0 0 26 25\" height=\"16\" width=\"16\" fill=\"currentColor\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><rect x=\".626\" y=\"22.753\" width=\"32\" height=\"3\" rx=\"1.5\" transform=\"rotate(-45 .626 22.753)\"\/><rect x=\"2.747\" y=\".125\" width=\"32\" height=\"3\" rx=\"1.5\" transform=\"rotate(45 2.747 .125)\"\/><\/svg><\/button><h1 id=\"image-dialog-title\" class=\"screen-reader-text\">Image Modal<\/h1><figure class=\"wp-block-image size-large\">\n\t<img decoding=\"async\" src=\"https:\/\/www.salesforce.com\/news\/wp-content\/uploads\/sites\/3\/2020\/08\/HealthCloud1.png?strip=all&#038;quality=95\" alt=\"\" class=\"wp-image-2509\" \/>\n<\/figure><\/div><\/div><\/div><p><b>Introducing Health Cloud for Payers<\/b><\/p> <p>In 2016, Salesforce introduced <a href=\"https:\/\/www.salesforce.com\/products\/health-cloud\/overview\/\">Health Cloud<\/a> to transform the way healthcare and life sciences organizations connect with patients. Today, the company is expanding the power of Health Cloud with new features specifically built for the health insurance industry that will allow these companies to engage with both members and providers in smarter and more efficient ways:<\/p> <ul> <li><p><b>A New Payer Data Model: <\/b>Health Cloud will include an insurance-specific data model that simplifies the integration of systems of record \u2014 including benefits, claims and authorizations \u2014 into one place, driving more productivity for service agents and clinical professionals. With all member information in a single dashboard, payers will be able to work faster, smarter and better understand each member\u2019s needs, whether they are in the call center or in the place of service, from any device. For example, a payer today often needs to log into multiple systems to research different aspects of a member\u2019s claim for an upcoming procedure. With Health Cloud, they can now see all of the member\u2019s prior authorization and information about the procedure in one place, allowing them to service both members and providers quickly and efficiently.<\/p> <\/li> <\/ul> <ul> <li><p><b>More Powerful Utilization Management:<\/b> Care requests \u2014 including prior authorizations, admissions and appeals \u2014 can be streamlined through guided, collaborative and measurable workflows directly within Health Cloud. Agents, clinical professionals and medical directors will be able to deliver more personalized and appropriate care in the most cost effective setting. This enables payers to improve member outcomes and contain medical costs. For example, previously a provider treating a member who needed surgery has to submit a prior authorization request to the payer and often has limited visibility into its processing. Now, with Health Cloud, the provider and member will be able to easily view the progression and status of the request, reducing friction and delays. Once a care request is approved, tasks are automatically triggered for case management based on the diagnosis or service code within Health Cloud.<\/p> <\/li> <\/ul> <ul> <li><p><b>Stronger Member Engagement:<\/b> With Health Cloud, payers can create customizable, interactive and highly personalized digital journeys for members, helping develop stronger relationships by overcoming barriers to care and increasing access to clinical and support services. Members can easily access their insurance plans, receive care alerts via their mobile device and connect with clinical professionals and care managers on any channel like email and text message. For example, a case manager can proactively engage a member to arrange home care, rehab and follow up hospital visits related to their procedure or service through the member\u2019s preferred form of communication, advancing their goal of driving optimal member outcomes.<\/p> <\/li> <\/ul> <p><b>Salesforce\u2019s Partner Ecosystem Brings More Capabilities to Health Cloud for Payers<\/b><\/p> <p>Salesforce continues to build a comprehensive ecosystem of partners that extends the power of Health Cloud. According to a recent IDC study, Salesforce and its ecosystem of customers and partners will create more than 244,000 jobs and enable more than $68 billion in new business in healthcare worldwide by 2022. Health Cloud for Payers will leverage solutions from Salesforce\u2019s ecosystem of partners in the <a href=\"https:\/\/appexchange.salesforce.com\/\">AppExchange<\/a>, the world\u2019s leading enterprise cloud marketplace, to deliver an integrated care platform across providers, payers and community services:<\/p> <ul> <li><p>Leading clinical care partners like Geneia and MCG provide risk analytics and clinical guidelines<\/p> <\/li> <li><p>Virsys12, Vlocity and Zipari have built solutions on the Salesforce AppExchange to better manage provider, broker and member relationships.<\/p> <\/li> <li><p>Leading engagement companies have integrated their educational tools for member engagement, including Elsevier, Healthwise and myStrength.<\/p> <\/li> <li><p>Global system integrator partners Accenture, Deloitte and PwC are leveraging new Health Cloud for Payer functionality to enhance their existing Payer Fullforce Solutions.<\/p> <\/li> <\/ul> <p>\u201cManaging complex relationships and being able to have a single view of a member is now table stakes for all insurance payers, and those who don\u2019t are at risk of falling behind in this incredibly competitive market,\u201d said Rita Sharma, VP of Product Management, Salesforce. \u201cHealth Cloud for Payers provides the technology that connects members and providers in a way that powers the enormously important relationships with each other and themselves.\u201d<\/p> <p><b>Comments on the News:<\/b><\/p> <ul> <li><p>\u201cPayers need to address the market demand to offer clinical programs that meet people where they are based on their health and social risks, care gaps, preferences and needs. This requires a significant breadth of integrated capabilities,\u201d said Heather Lavoie, Chief Strategy Officer, Geneia. \u201cBy leveraging Health Cloud for Payers and integrated ecosystem partners like Geneia, payers can take advantage of features in one solution and one underlying data set that would otherwise have required more than 50 different vendor integrations. As a solution for clinical programs, this is a complete game changer, enabling payers to exceed the expectations of their customers.\u201d<\/p> <\/li> <li><p>\u201cAs health plans look to provide a broad set of member care services, Health Cloud provides members with a rich unified experience throughout their journey,\u201d said John Argenziano, Partner, PwC. \u201cUtilizing Health Cloud&#8217;s plan and provider data model, health plans can accelerate time to market, improve its members\u2019 health and increase member loyalty.\u201d<\/p> <\/li> <li><p>\u201cRapidly shifting consumer market experiences are changing the way patients view their healthcare and forcing healthcare payers to fundamentally rethink member engagement,\u201d said Denis Pombriant, Founder, Beagle Research. \u201cThe new capabilities of Salesforce Health Cloud enable payers to break down data silos and drive more meaningful member interactions.\u201d<\/p> <\/li> <\/ul> <p><b>Availability<\/b><\/p> <ul> <li><p>Health Cloud for Payers is expected to be generally available in October, 2018. Pricing information will be made available at general availability.<\/p> <\/li> <\/ul> <p><b>Additional Information<\/b><\/p> <ul> <li><p>Visit the Salesforce Health Cloud website:<a href=\"http:\/\/www.salesforce.com\/healthcloud\"> http:\/\/www.salesforce.com\/healthcloud<\/a><\/p> <\/li> <li><p>Like Salesforce on Facebook: <a href=\"http:\/\/www.facebook.com\/salesforce\">http:\/\/www.facebook.com\/salesforce<\/a><\/p> <\/li> <li><p>Follow Salesforce on Twitter: <a href=\"https:\/\/twitter.com\/salesforce\">https:\/\/twitter.com\/salesforce<\/a><\/p> <\/li> <li><p>Learn about Health Cloud on Trailhead: <a href=\"https:\/\/trailhead.salesforce.com\/en\/modules\/health-cloud-basics\">https:\/\/trailhead.salesforce.com\/en\/modules\/health-cloud-basics<\/a><\/p> <\/li> <li><p>View healthcare and life sciences apps on the Salesforce AppExchange: <a href=\"https:\/\/appexchange.salesforce.com\/mktcollections\/industry-collections\/healthcare\">https:\/\/appexchange.salesforce.com\/mktcollections\/industry-collections\/healthcare<\/a><\/p> <\/li> <\/ul> <p><b>Connect with Salesforce<\/b><\/p> <ul> <li><p>Like Salesforce on Facebook<a href=\"http:\/\/facebook.com\/salesforce\"> http:\/\/facebook.com\/salesforce<\/a><\/p> <\/li> <li><p>Follow<a href=\"https:\/\/twitter.com\/salesforce\"> @salesforce<\/a> on Twitter<\/p> <\/li> <\/ul> <p><i><sup>1<\/sup> <a href=\"https:\/\/a.sfdcstatic.com\/content\/dam\/www\/ocms\/assets\/pdf\/service-cloud\/state-of-connected-customer.pdf\">https:\/\/a.sfdcstatic.com\/content\/dam\/www\/ocms\/assets\/pdf\/service-cloud\/state-of-connected-customer.pdf<\/a><\/i><\/p> <p><i><sup>2<\/sup> IDC White Paper sponsored by Salesforce, \u201cThe Salesforce Economy Forecast: 3.3 Million New Jobs, $859 Billion New Business Revenues to Be Created from 2016 to 2022,\u201d October 2017. Ecosystem includes all companies that provide the products and services that surround a Salesforce implementation.<\/i><\/p> <p><b>About Salesforce Health Cloud<\/b><\/p> <p>Salesforce Health Cloud brings the world\u2019s #1 CRM to healthcare that harnesses the power and security of the cloud, as well as social and mobile technologies, to deliver more personalized healthcare experiences. It accomplishes this by providing a complete view of the patient and member, intelligent care collaboration and a connected engagement experiences.<\/p> <p>In addition, KLAS recently recognized Salesforce with the Category Leader award in CRM for Healthcare in the <a href=\"https:\/\/www.salesforce.com\/contents\/best-in-klas-report-2018\/\">2018 Best in KLAS: Software and Services<\/a>, acknowledging Salesforce as the top-ranked solution for providers to put patients at the center of their care.<\/p> <p> <\/p><div class=\"wp-block-image__wrapper\"><figure class=\"wp-block-image size-large\">\n\t<a href=\"#\" class=\"wp-block-image__modal-toggle\" aria-expanded=\"false\" data-modal-id=\"2510-modal\"><span class=\"screen-reader-text\">Open Image Modal<\/span><img decoding=\"async\" src=\"https:\/\/www.salesforce.com\/news\/wp-content\/uploads\/sites\/3\/2020\/08\/Health2.png?strip=all&#038;quality=95\" alt=\"\" class=\"wp-image-2510\" \/><\/a>\n<\/figure><div id=\"2510-modal\" class=\"image-modal\" aria-hidden=\"true\" aria-labelledby=\"image-dialog-title\"><div class=\"image-modal__overlay\" tabindex=\"-1\" data-a11y-dialog-hide><\/div><div class=\"image-modal__content\" role=\"dialog\"><button class=\"image-modal__close-button\" type=\"button\" data-a11y-dialog-hide aria-label=\"Close this image dialog window\"><svg viewBox=\"0 0 26 25\" height=\"16\" width=\"16\" fill=\"currentColor\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><rect x=\".626\" y=\"22.753\" width=\"32\" height=\"3\" rx=\"1.5\" transform=\"rotate(-45 .626 22.753)\"\/><rect x=\"2.747\" y=\".125\" width=\"32\" height=\"3\" rx=\"1.5\" transform=\"rotate(45 2.747 .125)\"\/><\/svg><\/button><h1 id=\"image-dialog-title\" class=\"screen-reader-text\">Image Modal<\/h1><figure class=\"wp-block-image size-large\">\n\t<img decoding=\"async\" src=\"https:\/\/www.salesforce.com\/news\/wp-content\/uploads\/sites\/3\/2020\/08\/Health2.png?strip=all&#038;quality=95\" alt=\"\" class=\"wp-image-2510\" \/>\n<\/figure><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Built on the world\u2019s #1 CRM platform, the new Salesforce Health Cloud solution gives every health payer a complete view of members in a single dashboard, driving productivity for service agents and clinical professionals Payers can create customizable, interactive and highly personalized connected experiences to improve member outcomes and satisfaction SAN FRANCISCO \u2014 June 21, [&hellip;]<\/p>\n","protected":false},"author":0,"featured_media":0,"template":"","meta":{"sf_subhead":"","sf_i18n_disclaimer":false,"alternateThumbnailId":0,"sf_product_cta_id":0,"footnotes":""},"sf_content_type":[1755,1792],"sf_theme":[1917],"sf_topic":[1734,1763,1745,1771],"sf_product":[1783],"sf_industry":[1743],"sf_role":[],"sf_multimedia_asset":[],"sf_location":[1724],"sf_collection":[],"sf_visibility":[],"coauthors":[],"class_list":["post-21636","sf_press_release","type-sf_press_release","status-publish","hentry","sf_content_type-press-releases","sf_content_type-press-releases-product","sf_theme-customer-engagement","sf_topic-customer-engagement","sf_topic-innovation","sf_topic-sales","sf_topic-technology","sf_product-industry-solutions","sf_industry-healthcare-and-life-sciences","sf_location-amer"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.2) - 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