The HealthEdge® 2026 Annual Payer Report, “The Great Rebalancing: Inside the New Realities Shaping Health Plan Performance,” reveals how health plans are navigating growing financial pressure,...
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See how over 450 health plan leaders are preparing for 2025!
Learn MoreManaging payments for a health plan is not as simple as it was a few decades ago. Updated billing models, new compliance mandates, and complex provider networks can make it challenging for payers...
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AI is reshaping how software gets built—enabling faster delivery, real-time iteration, and deeper collaboration between technical and business teams. At HealthEdge®, we’re exploring how AI-driven...
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In an industry flooded with point solutions, health plans are realizing that using more tools don’t necessarily lead to more value. From member engagement apps and wellness portals to survey...
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Health plan leaders have dozens of digital solutions to choose from—so many that it can feel like real partnership is rare. Too often, vendors deliver software and walk away, leaving health...
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Better outcomes, lower costs: Why health plans are turning to HealthEdge® Wellframe Across the healthcare industry, many health plans grapple with vendor sprawl—a web of disparate systems and...
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See what 3,500 consumers say about their healthcare experiences
Read the report!By Rob Duffy, CTO, HealthEdge It’s easy to talk about innovation in healthcare technology; it’s harder to build it in a way that scales for health plans and improves real outcomes. At HealthEdge,...
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At HealthEdge, we know that deploying AI tools is just one piece of the puzzle. True transformation happens when people across the organization not only understand what AI can do but also begin to...
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On June 10, 2025, the One Big Beautiful Bill Act (OBBBA), also known as H.R.1, was signed into law, marking the beginning of one of the most sweeping healthcare reforms in recent memory. Given the...
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Sweeping policy changes are nothing new in U.S. healthcare, but the One Big Beautiful Bill Act (OBBBA), also known as H.R. 1, represents a particularly consequential inflection point for health...
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Health plans are under increasing pressure to modernize operations while managing rising costs, regulatory complexity, and evolving member expectations. Many have adopted tech-enabled services to...
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At HealthEdge, AI is becoming a foundational capability that’s changing how we operate from the inside out. In this fireside chat, I had the opportunity to sit down with @Andrew Witkowski, who...
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Operational efficiency isn’t just another key performance indicator—it’s the base that enables health plans to scale based on industry demands. As payers face mounting pressure to reduce...
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HealthEdge® continues to deliver leading technology solutions that empower care teams, reduce administrative burden, and support whole-person care. Solving Healthcare’s Hidden Data Disconnect It...
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At HealthEdge®, we are undertaking a structured migration of our systems to Amazon Web Services (AWS). This move reflects the ongoing evolution in healthcare, driven by the need for greater...
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By Alice Zhan, AI team Part 2: Technical Implementation This is part two of a two-part blog series on HealthEdge’s AI Summarizer feature; this post focuses specifically on the feature’s technical...
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Discover how payment integrity analysts use HealthEdge Source to solve complex issues in hours, not months. Real-time data, instant deployment.
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In today’s healthcare environment, care managers are at the heart of improving outcomes for members with complex needs. Yet, the growing volume of documentation, assessments, and free-text notes...
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Fax-based communication and the manual work required to process physical documents remain daily challenges for health plan care teams. Communications related to authorizations, appeals,...
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Operating within the U.S. healthcare industry can be challenging. Decades of layered regulations, siloed processes, and a sprawling network of stakeholders have created an environment where...
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