The TriZetto Group announced it has acquired Chandler, Ariz.-based Medical Data Express (MDE), with an eye toward expanding its managed solutions that serve more than 14 million Medicare Advantage and Part D members and more than 12 million Medicaid members.

MDE’s technology is used by health plans to meet federal and state mandates for claim submissions that require medical encounter data formats. Plans also use MDE technology for automated end-user claims-testing technology to complete system upgrades, migrations and configuration changes, helping to ensure accuracy and reduce costs.

The use of encounter data supports better quality measures for managing Medicare beneficiaries and building more accurate risk adjustment models. Such data includes diagnosis and treatment information for all medical or behavioral services obtained by a patient. Through the analysis of encounter data, the Centers for Medicare & Medicaid Services (CMS) and states can improve beneficiary care and overall health, and reduce healthcare costs.

“By acquiring MDE, TriZetto is cementing its ability to offer customers a proven, comprehensive and reliable solution that helps payer organizations meet federal and state requirements for medical encounter data processing,” said Trace Devanny, chairman and CEO of TriZetto. “We are committed to continuing to enhance our suite of solutions helping Medicare and Medicaid plans leverage the efficiencies they gain for strategic advantage while maintaining compliance.”

MDE supports Medicaid and Medicare plan customers that submit encounter data to more than 35 Medicaid state organizations and is positioned to meet the timelines established by CMS for Medicare Advantage plans.

“Combining MDE’s encounter data knowledge with TriZetto’s technology-enabled solutions and industry experience will provide payers with a powerful tool for submitting encounter data in an accurate, streamlined and timely manner," said Dave Abraham, managing partner of MDE. "In addition to customer on-site implementations, MDE’s automated claims testing tool will be bundled with TriZetto services for smooth migrations and upgrades to TriZetto’s world-class enterprise administration systems.”