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HealthRules® Payor, named “Best in KLAS” by KLAS Research for claims administrative processing system (CAPS).
Gartner named HealthEdge as a Sample Vendor for its next-generation core administrative system in its July 2021 Hype Cycle for U.S. Healthcare Payers Report, 2021 for the 11th consecutive year.*
The international COVID-19 outbreak has introduced unforeseen changes and uncertainty to all parts of our lives. During this time, HealthEdge wants you to know that we are here for you and committed to helping you continue running your business as you work with your providers and members.
The move to value-based care and value-based reimbursement is gaining momentum in healthcare and will only increase over time. Is your organization equipped to succeed in this new world?
Payers, providers, the U.S. government, and other entities have made initial investments in value-based reimbursement. And while these initial investments have, in some cases, made great strides in the march toward quality-based care, costs are still increasing, payers and providers are no closer to a trust-based relationship, and fee-for-service is still a large part of reimbursement.
There are significant market forces impacting Medicare, both today and in the future. The rise of value-based reimbursement models along with innovative pilot demos is forcing a different awareness for providers and a changed reality for payers. Read how regulatory reform continues to provide a layer of uncertainty that directly impacts the ability for payers to plan ahead.
*Gartner, Hype Cycle for U.S. Healthcare Payers, 2021, Bryan Cole, Jeff Cribbs, Mandi Bishop, 13 July 2021
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