- Zyter|TruCare

In today’s highly regulated healthcare landscape, payers constantly seek innovative solutions to enhance health outcomes, reduce care costs, and provide exceptional experiences for their members. Zyter|TruCare, a leading, clinically driven, AI-powered health services and technology company, is at the forefront of this transformation. We offer comprehensive population health management solutions that incorporate innovative technology and services to support fully integrated care, case, and utilization management for health plans and other managed care organizations. By leveraging modular healthcare applications, robust wrap-around services, and applied AI, automation, and interoperability, our highly configurable platform and rules engine enable segment and member-specific care coordination, helping to increase engagement, improve health outcomes, and drive better performance of value-based care models.
As a result of this approach, Zyter|TruCare earned significant recognition from the highly regarded analyst firm IDC in three of their most recent MarketScape reports:
Being recognized as a Leader in patient engagement and care coordination highlights the core strengths of Zyter|TruCare’s solutions, especially our solutions’ high degree of configurability and our extraordinary client service. As we continue to innovate with AI to enable co-pilot and agentic functions, we look forward to further advancing our clients’ care management efficiencies and impact in an age of dramatic new technological capability.
The Building Blocks of Better Care: Patient Engagement, Care Coordination, and Prior Authorization
Advancing Patient Engagement
Recent findings from the Office of the National Coordinator for Health Information Technology (ONC) highlight the significant impacts of patient engagement technologies. In just a years time, these tools have achieved an 30% increase in patient satisfaction and a 20% improvement in medication adherence. Engaged patients are more proactive in managing their health, adhering to treatment plans, and avoiding hospital readmissions.
Predictive analytics and AI are pivotal in these advancements, identifying at-risk individuals and facilitating the creation of personalized care plans. These technologies emphasize prevention and proactive interventions, crucial elements in the transition towards value-based care.
Elevating Care Coordination
Care coordination bridges the gap between fragmented care delivery and seamless patient experiences. According to a 2022 report from the National Quality Forum (NQF), hospitals leveraging electronic health record (EHR)-sourced measures for care coordination saw a 20% reduction in hospital readmissions and a 15% improvement in communication among care teams. Interoperable systems and configurable rules engines streamline workflows, enabling providers to focus on clinical decision-making while maintaining compliance with CMS interoperability guidelines.
Improving Prior Authorization Processes
Prior authorization has long been a point of contention due to its inefficiencies. However, automation is changing the game. Practices using automated prior authorization systems reported a 40% decrease in administrative workload and a 50% faster turnaround time for approvals, per a 2024 Medical Group Management Association (MGMA) survey. Moreover, the CMS Interoperability and Prior Authorization Final Rule mandates electronic processes by 2026, pushing the industry toward greater efficiency and reduced delays. Automated solutions also enhance accuracy, ensuring patients receive timely care without unnecessary hurdles.
The Zyter|TruCare Difference
Zyter|TruCare empowers health plans and managed care organizations with solutions that address critical challenges in patient engagement, care coordination, and prior authorization. Key capabilities include:
- TruCare® Population Health Management: Supports care, case, and disease management with configurable workflows tailored to segment-specific needs.
- TruCare® Utilization Management: Streamlines prior authorization processes with automation and compliance-focused tools, reducing administrative burdens while expediting care approvals.
- TruCare® Virtual Health: Enhances patient-provider interactions through telehealth, real-time monitoring, and predictive analytics that identify at-risk patients for proactive interventions.
- TruCare® Medication Management: Helps health plans, providers, and pharmacy benefit managers oversee patients’ medications to reduce drug interactions, improve adherence, and mitigate risks. This module enables proactive medication reviews and reconciliation to support better overall care outcomes.
- TruCare® Home & Community Services: Offers an integrated approach to managing long-term support and services, empowering care teams to track program enrollment, coordinate assessments, and provide personalized, community-focused care.
By integrating advanced AI and machine learning, Zyter|TruCare delivers actionable insights, automates routine tasks, and optimizes workflows for both providers and care teams. These features are designed to improve outcomes and efficiency, ensuring healthcare organizations can excel in value-based care models.
With NCQA pre-certification, HITRUST certification, and SOC-2 compliance, Zyter|TruCare maintains the highest standards for security and quality. Supporting over 38 million members, these solutions offer a trusted foundation for delivering impactful care.
Ready to enhance care management strategies and operational efficiency? Contact Zyter|TruCare today to learn how we can help you achieve measurable results.
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* Reference reports include: