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 December 02, 2020
Regulatory Highlights that Health Plans Should Know
The Patient Access API and the Provider Directory API will be enforceable on July 1, 2021. HealthEdge is confident that we will have our standardized data requ…
Blog Post November 30, 2020
The Path to Point-of-Service Payment Success
Imagine an expectant mother has high blood pressure and sees a specialist. After the visit, the provider submits the claim to her insurance plan, and from ther…
Blog Post November 23, 2020
Health Plans Bring Innovation to The Forefront In Strategic Planning
With the rise of telehealth and virtual care, innovative ideas are getting a big push forward in 2020.  I recently moderated a webinar with HealthEdge …
Blog Post November 19, 2020
Provider Satisfaction: A Consistent Pain Point for Health Plans
Just about every health plan that I have talked to in my career is currently experiencing, or has had experienced, problems keeping their provider population a…
Blog Post November 17, 2020
As Medicare Advantage Grows in Popularity, Health Plans Must Meet Market Demands
According to Medpac, the country's baby-boom generation (born between mid-1946 and 1964) began aging into Medicare in 2011 at a rate of about 10,000 peopl…
Blog Post November 12, 2020
IT Leaders Agree: For Successful Investments, Align Tech and Business Goals
Technology, especially next-generation technology, plays a massive role in allowing health plans to embrace change, innovate, and remain competitive. However, …
Blog Post November 09, 2020
Improving Provider Relations
Many factors can impact the claims payment process. With so many legacy solutions still present in the market, there is significant opportunity for inefficient…
Blog Post November 04, 2020
Health Plans See Positive Results With Value-Based Care Reimbursement
Value-based reimbursements have been much debated since both houses of Congress overwhelmingly passed the Medicare Access and Children’s Health Insurance Progr…
Blog Post November 02, 2020
The Importance of Patience and Understanding in the Payer Industry
Regional non-profits and health plans wholly owned by hospital systems may be facing challenges in the market today, especially considering COVID-19. Analytics…
Blog Post October 30, 2020
Transparency in Coverage Final Rule and Other Regulatory Highlights Health Plans Need To Know
Transparency in Coverage Final Rule On October 29th, the Transparency in Coverage Final Rule was released and will be published in the Federal Register. We …
Blog Post October 28, 2020
Never Load In A Fee Schedule Again
For claims and pricing teams, managing fee schedules can be a massive headache. With Medicare undergoing major quarterly updates as well as policy adjustme…
Blog Post October 26, 2020
The Opportunity In Interoperability
I know regulations can seem overwhelming, but if you look beyond checking the boxes to ensure compliance, there is so much opportunity. I always try to remind …