How We Help Health Insurers

  • Soup to nuts process design, system development, software and TPA selection, and systems integration for a brand new health plan
  • eBusiness applications for brokers, providers, employers and members, enabling self-service web and mobile applications integrated with enterprise transaction processing systems
  • Population health management solutions including the acquisition and integration of social, behavioral, and physical health data from organizations across the community
  • Utilization management and care management systems implementations, including the selection and integration of vendor software and carve-out service providers
  • Design and delivery of custom small group and individual product systems, including quoting, enrollment, renewals, broker commissions, integration with legacy systems
  • Systems to estimate the cost of care episodes for providers and patients based on benefit plans and contracted rates
  • Health Care Economics consulting, including predictive modeling, cost of care analysis, and enterprise reporting
  • Requirements definition, planning and testing of systems that support the processing for 20+ state health reinsurance pools
  • Design, delivery and hosting of a physician and facility credentialing system for a national insurer, enabling our client to resell credentialing data to third parties
  • Enterprise data warehouse and analytics assessment, development, and ongoing support
  • Selection and implementation of carve-out and disease management vendor solutions
  • Design, development and PMO support for hospital and physician pay-for-performance programs
  • Post-acquisition integration including sales and marketing integration, claims re-pricing, network and contract rationalization

Our Capabilities


Population Health

We work to enhance wellness and optimize service utilization for the people you serve.

Practice Transformation

Compete in a value-based payment environment while growing your customer base.

Data Management

Acquire and analyze the vital data you need to demonstrate and improve your performance.

Health Information Exchange

Automatically share customer data within your enterprise and with trusted members of your community.

Process Design

Simplify and automate inefficient processes.

Innovation & Discovery

Identify, experiment, learn and adopt new digital applications.

System Design & Development

Custom and marketplace information systems implemented to create value.

Project Management

Planning, execution and risk management with no surprises.

What They're Saying About Us

Hiring SMC Partners to take the lead of our I.T. project was the best decision we could have made. SMC’s very logical, concrete approach to this very complex project resonated with me from the start. The qualities that stand out the most for me is their open honest approach and the fact that they listen, they understand, and offer concrete solutions.

Joe ConsorteChief Financial Officer, Connecticut Community Care Inc.

I have worked with SMC on a continuous basis since 2006, both on the statewide level in the development of a DataBridge and on an agency level to design a custom Case Management System. CMS has been operational for nearly five years, and it has been an invaluable tool in supporting the work of agency staff. The system supports more than 100 users and they love it! Scott, Sheri and the SMC team have been great partners since day 1, and it is without hesitation that I recommend them.

Bill RybczykDirector of Research, Development and Planning, New Opportunities, Inc.

Working with SMC has been a very positive experience for our senior management team. We are in the ‘care business‘, so we are not a company that has a lot of technologically savvy professionals to leverage. The SMC management and project teams have worked closely with us to ensure we are provided with truly what we need and have made the experience both educational and enjoyable.

Linda GrigerekFounder & President, Companions & Homemakers, Inc.

SMC Partners is the best IT firm that I have worked with in my professional career. They take the time to understand their customers and their needs and develop solutions in a collaborative manner that is participatory, respectful and thoughtful. Truly a great company to partner with!

Rhonda Evans Deputy Director Connecticut Association for Community Action

Ready to Talk?

We’re always open to discussing new projects and how we can help.