The 'Edge Report

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.

Blog Post July 05, 2022
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The Future of Clinical Interoperability
Interoperability Challenges and Recommendations  Introduction The U.S. Department of Health and Human Services (HHS) aims to have an interoperable h…
Blog Post June 30, 2022
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5 Tips for Developing Empathy in the Workplace
The Importance of Leading & Living with Empathy  When people feel cared for, valued, and supported, they tend to: Perform better Have stro…
Blog Post June 28, 2022
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The Return to Operational Efficiency
In 2022, HealthEdge once again commissioned an independent survey of health insurance executives to capture and monitor perspectives regarding current challeng…
Blog Post June 23, 2022
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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…
Blog Post June 21, 2022
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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…
Blog Post June 16, 2022
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How to Achieve Claims Automation for Health Plans
Step 1: Objectively Measure Impact of “Stacking” vs Prospective Payment Integrity With complementary access to Gartner® research, Adopt Prospective Payment …
Blog Post June 14, 2022
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Providers Struggle with Realities of Transparency
Providers Grapple with Regulatory Realities Providers appear to be grappling with the regulatory realities of value-based care, especially when it comes to …
Blog Post June 09, 2022
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“Stacking Claims” vs Prospective Payment Integrity
With complementary access to Gartner research, Adopt Prospective Payment Integrity to Thwart Healthcare Fraud and Improper Claims Payment. Improper claims p…
Blog Post June 07, 2022
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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 …
Blog Post June 02, 2022
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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…
Blog Post May 31, 2022
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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…
Blog Post May 26, 2022
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‘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 …