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Payer-Provider Collaboration in an Uncertain Environment
There is a lot of uncertainty in healthcare today. Health plans like to know what the risk is and manage the risk. And when that risk is uncertain, it is …
Industry consolidation is one of the biggest trends in the payer space right now. National health plans might acquire other regional plans or enter a new line …
A recent study of 245 IT executives at leading health insurance companies revealed that larger health plans are interested in consolidating core syst…
Partnerships that Drive Quality Care and Improve Patient Outcomes
Like any other organization, communication is crucial for health plans to serve their mission: deliver the best care for their members and improve health …
In a Digital World, Lessons Healthcare Can Take from the Financial Industry
One of the biggest problems the healthcare industry must overcome is learning to communicate in a digital world. Our systems all speak in different languages, …
How Can Medicare Advantage Plans Gain Members in a Competitive Market?
11,000+ baby boomers turning 65 every day and become eligible for Medicare. The Centers for Medicare and Medicaid Services (CMS) predicts that Medicare enrollm…
Payers are investing in Payment Integrity practices more than ever before, but inaccuracies continue to plague the healthcare system—contributing to the estima…
Improve Transactions, Enhance Member and Provider Relationships
Every day, the limitations of legacy systems cause health plans to waste money and time fixing improper payments, leading to strained budgets and relationships…
Regulation: Innovation Springboard Rather Than Compliance Checkbox
The industry traditionally has addressed compliance requirements by solving for the Rule and waiting for specifics to come out of CMS, or other agencies, befor…
Business Process as a Service, Redefining the Future Health Plan Operations Model
An uptick in the market trending over the past three years is the Business Process as a Service (BPaaS) model, where health plans outsource their platform and …
I've worked in the healthcare industry for over 30 years and with Burgess for a little over ten years. At Burgess, we strive to anticipate the clients' needs b…
HealthEdge CEO Steve Krupa and I both graduated from The Wharton School at the University of Pennsylvania. Benjamin Franklin, who founded the institution that …
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