Markets

Overview

The dynamics of the healthcare industry are ever-changing and fast moving. Health insurers must be able to act quickly to launch new offerings targeted at member populations in specific market segments. Whether it is a government program, a commercial or individual product or a dental or TPA offering, HealthEdge works with transformative health plans to create and maintain competitive advantage across many markets. With innovative payment reform, including value-based reimbursement, gaining momentum, agility is more important than ever. And health plans must be able to respond rapidly and confidently to changing regulatory requirements.

Support the successful introduction of a new line of business or new set of unique products with HealthEdge’s HealthRules product suite. Lower administrative and medical costs, comply with new regulations, boost quality scores and outcomes and effectively grow and expand without making significant investments to modernize your older system.

Join other HealthEdge customers who:

  • Successfully capture growth opportunities and rapidly launch new lines of business
  • Drastically lower costs with streamlined business processes and fully automated workflows
  • Deliver essential, accurate information in real-time for a superior customer experience, with full transparency among members, providers and the health plan
  • Initiate targeted care coordination initiatives and optimize critical quality measures including HEDIS, Star Ratings, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and NCQA accreditation
  • Achieve and maintain compliance with the latest regulations, both state and national
  • Ensure the highest level of security with HITRUST certification

Markets We Serve