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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See how over 450 health plan leaders are preparing for 2025!
Learn MoreBetter 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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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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See what 3,500 consumers say about their healthcare experiences
Read the report!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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In our first blog, we explored how HealthEdge’s AI-powered optical character recognition (OCR) platform is transforming prior authorization and other document-heavy workflows. Now, we’re taking...
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The One Big Beautiful Bill Act (OBBBA) introduces far-reaching, fast-moving regulatory changes that demand adaptability from health plans. Some provisions are already in effect, while additional...
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The healthcare industry is in constant motion. Regulations change and care models evolve, while competitive pressures and member expectations grow more complex every year. For health plans, this...
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Artificial intelligence (AI) is quickly becoming foundational to the future of healthcare. From automating claims reviews to powering proactive care management, AI has the potential to help health...
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