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 January 12, 2021
Opportunities, Collaboration and Innovation in 2021
The biggest issue facing payers today is that their business changes every year. The pressure to develop reimbursement methodologies with providers that accoun…
Blog Post January 07, 2021
Healthcare is an Industry of Change, Are You Prepared?
Many people have said that there has been more change now than ever before within the healthcare industry. However, if one reviews history, healthcare has been…
Blog Post January 05, 2021
How Health Plans Capture New Business in a Competitive Landscape
Successful health plans are focused on expanding membership, increasing revenues, and controlling administrative costs. However, administration costs attributa…
Blog Post December 30, 2020
Patient or Member? How About Calling Them Customers?
What are individuals called in a health plan? Members. What are people called when they meet with a provider? Patients. What is an individual person referred t…
Blog Post December 22, 2020
Building a Winning Culture
I joined HealthEdge seven years ago when, like most startup organizations, we were primarily focused on our mission, products, and exciting our customer base. …
Blog Post December 18, 2020
2020 Recap: Key Factors Impacting Payers
Blog Post December 16, 2020
A Possible Survival Guide for Regional Health Plan Expansion?
Regional health plans have generally flourished in the respective local markets that they have served. However, regional health plans only “extended” as far as…
Blog Post December 14, 2020
Payment Integrity in 2020 and Beyond
Health plans with legacy systems, disjointed workflows, and paper-based anything struggled to handle the sheer volume and veracity of new care and pa…
Blog Post December 08, 2020
In Today’s World, Health Plans Must Be Agile
Changes to the health insurance industry have been traditionally very slow. However, the global pandemic has forced health plans to move forward with decisions…
Blog Post December 06, 2020
Three Tips For Building Technology Training Programs
Earlier in my career, I handled implementations for a software vendor and noticed a common occurrence among customers that is still prevalent today. The first …
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…