CARE MANAGEMENT

Increase quality of care and control costs

The healthcare marketplace is moving fast. How are you keeping up? Health plans must transform to effectively compete in today’s dynamic market.

For maximum success, health insurers must:

  • Improve the overall quality of care
  • Create better outcomes with effective care coordination and management of at-risk populations
  • Drive member engagement with health and wellness incentives
  • Embrace the shift to new benefit and payment models
  • Reduce clinical costs

Outdated technology is often a barrier to achieving the necessary transformation.

HealthEdge has a proven history of working with leading health plans for their competitive advantage. With the award-winning HealthRules CareManager platform, health insurers can effectively:

  • Boost quality metrics resulting in increased revenue
  • Stay compliant for maximum reimbursement levels
  • Launch and execute effective care coordination and chronic condition initiatives
  • Provide the best customer experience
  • Anticipate and leverage new business models and opportunities
  • Reduce clinical costs

Markets We Serve

HealthEdge works with health plans serving many markets including Commercial, Individual, Medicare, Medicaid, Third Party Administrator and Dental.

Our Products

The HealthRules product suites helps health plans achieve their goals, and includes HealthRules CareManagerHealthRules PayorHealthRules Answers, HealthRules Portal and HealthRules Connector.