Headquartered in Pittsburgh, Pennsylvania, HM Health Solutions (HMHS) delivers business solutions to health plan payers to administer business efficiently and effectively in a competitive and ever-changing market. HMHS' offering is the Enterprise Health Solution, which combines an integrated platform, proven business processes, and experienced people supporting all aspects of a health plan partner's operations.
In 2017, HMHS' more than 3,500 employees partnered with eight health plans and served 10 million members. Health plan partners already using the Solution include AmeriHealth, AmeriHealth New Jersey, and several separate health plans that serve members in various states, including Pennsylvania, Delaware, West Virginia and Minnesota. The health plan partners who most recently started their journey to the Enterprise Health Solution include two separate health plans in North Dakota and Wyoming, and Gateway Health Plan.
With the introduction of the Medicaid line of business in 2017, the Enterprise Health Solution now supports every health care line of business. This allows health plan partners to use one platform for all lines of business, saving costs as well as positioning partners for markets that may have previously gone untapped.
In addition, HMHS is a strong supporter of the community. The company and its employees regularly donate time and resources to several nonprofit organizations. For example, HMHS employees volunteered skills and resources to Variety, providing software and devices that help children with disabilities that prevent speech to communicate with their families and caretakers.
The HMHS pass-through rate is 92 percent, compared to an industry average rate* of 80 percent.
HMHS serviced 10 million members of separate health plans via the Enterprise Health Solution.
HMHS processed 175 million claims on behalf of health plan partners.