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 May 10, 2022
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Impacts of COVID-19 on Care Management in the Dual-Eligible Population
COVID-19 has highlighted weaknesses in our healthcare system and shone a spotlight on fault lines, especially for the most clinically and socially vulnerable l…
Blog Post May 05, 2022
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Why Using Modern Technology is Critical to Serving the D-SNP Population
As the dual eligible population grows, Dual Eligible Special Needs Plans (D-SNPs) are also experiencing tremendous growth across the country. CMS reports that …
Blog Post May 03, 2022
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State of the D-SNP Market
Within Medicare Advantage (MA), there are Special Needs Plans (SNP) with specialty cohorts that provide coverage for members who qualify for both Medicare and …
Blog Post April 28, 2022
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Public Health Emergency Clock Ticks Forward to July
As expected, the Biden administration extended the mid-April expiration of the Public Health Emergency (PHE) another 90 days, so the countdown again restarts f…
Blog Post April 26, 2022
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CMS Opens Portal for IDR Under No Surprises Act
In the ongoing struggle to achieve clarity around how Surprise Billing regulations will work, the Centers for Medicare and Medicaid (CMS) opened a Federal IDR …
Blog Post April 21, 2022
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Healthcare Rules and Regulations are Constantly Changing, But Your Payment Accuracy Doesn’t Have To
Healthcare is unique in so many ways – services are customized to each person, experience is impacted heavily by the provider, and quality of care is affected …
Blog Post April 19, 2022
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Top 5 Challenges of Payment Accuracy
Health plan payers receive hundreds of millions of claims each year. With such an inundation, it’s easy to understand how complicated and challenging payment p…
Blog Post April 14, 2022
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Taming the Mess of Medicaid Payments Through Technology
Bad data is estimated to cost the healthcare industry $314 billion annually and negatively impact an organization’s revenue by 10-25%. The claims payment struc…
Blog Post April 12, 2022
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The Many Dimensions of Value-Based Care
Value-based care aims to improve the quality and outcome for patients by linking provider reimbursement to the quality of care provided. Under this system, pro…
Blog Post April 07, 2022
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New Attention Falls on Mental Health Parity Regulations
Mental health is receiving more attention across healthcare and as President Biden unveils broad changes in his budget bill released in March. Many see the pan…
Blog Post April 05, 2022
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Introducing HealthEdge Innovation Lab
As healthcare pioneers, HealthEdge understands the challenges of turning an idea into a real-world solution. Even some of the best ideas need nurturing to help…
Blog Post March 31, 2022
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What does composability mean for care management… and why should I care?
The term composability has emerged as a popular topic among healthcare industry analysts and CIOs. But what does composability really mean and why should care …