Oracle's health insurance exchange platform will enable states to meet federal mandates on affordable care and allow consumers to choose and manage health plans.
has announced a health insurance exchange (HIX) platform that aligns several of
its existing applications to allow states to create a marketplace for
purchasing health insurance.
the 2010 Patient Protection and Affordable Care Act (PPACA), states must
establish health insurance exchanges by 2014.
impending rollout of health insurance exchanges will require state governments
to establish state-regulated and standardized health care plans, from which
individuals may purchase health insurance that is eligible for federal
subsidies," Mark Johnson, senior vice president for Oracle's public
sector, said in a statement.
HIX will enable citizens and small employers to determine eligibility for
health plan subsidies, according to Oracle.
platform, announced on Sept. 26, conforms to guidelines by the Center for
Consumer Information and Insurance Oversight (CCIIO) and the Office of the
National Coordinator for Health Information Technology (ONC) on integrated IT
HIX's rules engine allows states to meet federal rules on eligibility and
provide capabilities to accept patient applications, Kevin Curry, Oracle's
group vice president, public sector, told eWEEK
designed the platform to support multiple programs to allow states to deploy
HIXs quickly and cost-efficiently, the company reports. Oracle will phase in
additional applications as legislation changes dictate.
help address the challenges state governments will face related to these
requirements, Oracle offers a robust solution which consists of proven
technologies that are architected to work together and include the necessary
capabilities needed to deliver a successful program," Johnson said.
foundation of the HIX platform includes Fusion Middleware, particularly the Oracle
. Fusion is a leading application infrastructure platform.
service-oriented architecture suite features hot-pluggable software and the
ability to reuse existing application development tools to reduce development
and maintenance costs. The suite provides end-to-end security and unified
state governments roll out the insurance exchange, it will allow for companies
to broker insurance plans, manage the details of plans, measure eligibility and
automate enrollment. In addition, the platform will allow insurers to collect
premiums, provide customer service, and keep track of tax credits and payment
HIX also helps states manage reporting of financial details to the government.
customer relationship applications provide states with the infrastructure to
operate multichannel customer service and include analytics tools for
evaluating calls. Siebel also handles case management for the exchange, Curry
key component is the Oracle Policy Automation (OPA) rules-based engine,
according to Curry. OPA allows states to use Word and Excel documents through a
Web-based service to determine how government policies affect coverage. The
software also makes calculations based on entitlement and provides decision
middleware components include Identity Management, which provides automated
user account provisioning and security challenges at each stage of the
application life cycle.
the HIX also includes Master Data Management Suite, a set of programs that
distribute master data to other operational and analytical applications as a
is already working with Oregon on an initial HIX platform.
Feb. 8, Microsoft
also announced a state health insurance exchange platform
with Extend Health, which runs a large private Medicare insurance exchange.
addition, on June 20 Adobe
unveiled its Digital Enterprise Platform
to enable the health care industry
to create HIXs. The platform runs applications on a modular open-standards
infrastructure. It integrates online chat, electronic health records (EHRs) and
Google Maps to locate doctors.