Get the latest perspectives on healthcare issues from a panel of contributors from both inside and outside HealthEdge. Visit often or subscribe to stay up to date.
Interoperability Challenges and Recommendations
Introduction
The U.S. Department of Health and Human Services (HHS) aims to have an interoperable h…
In 2022, HealthEdge once again commissioned an independent survey of health insurance executives to capture and monitor perspectives regarding current challeng…
ACA and Medicaid Membership Cliffs Loom for Fall and Year-End
There’s likely to be movement among Medicaid and Affordable Care Act (ACA) membership as the nation seems to be inching toward the end of the pandemic, at leas…
Guide to RFP Evaluation: Payment Integrity Vendors for Health Plans
Step 2: Evaluating Vendor RFPs
“Improper claims payment and fraud contribute more than $200 billion to the annual cost of U.S. healthcare…”.1 Here’s what he…
Providers Grapple with Regulatory Realities
Providers appear to be grappling with the regulatory realities of value-based care, especially when it comes to …
6 Leadership Skills for Building a Resilient Workforce
How health plan leaders can maximize productivity without burnout.
Why Resilience Matters
Think about the last time your health plan faced a large …
5 Requirements for Health Plan Vendors to Achieve Payment Integrity
Standard Manual Processes and Disjointed Tech Stacks Combat Payment Integrity
Traditionally, payer’s internal IT and business operations have implemented g…
Why Automation Technology Will Disrupt Claims Processing
Summary
Automated claims technologies are uniquely positioned to increase accuracy of claims because:
Most claims paid by health insurers are based on…
‘500 Shoppable Services’ Could Be the Next Healthcare Buzzwords
The healthcare ecosystem is rolling slowly toward greater transparency, but there are many challenges. Among them is predicting consumer behavior in …
Skip to main content
