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 November 09, 2020
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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
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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
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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
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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
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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
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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 …
Blog Post October 21, 2020
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For CFOs, Knowledge Is Power
Health plans face financial decisions every day that impact their bottom line. What terms will make a new provider contract more beneficial? How should a new p…
Blog Post October 20, 2020
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CIOs Must Understand The Business They Support
The alignment of business and technology, especially in this industry, is becoming increasingly important. To be successful, technology leaders must understand…
Blog Post October 14, 2020
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Keeping Information Secure Remains Top Of Mind For Health Plans
Security incidents that involve customer or member data are completely debilitating for a health plan’s business. On average, a data breach costs hea…
Blog Post October 12, 2020
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Challenge The Inefficient Status Quo In Claims Administration
Today, many health plans use homegrown or legacy systems that assume manual work as part of the process. With limited automation and integration, organizations…
Blog Post October 08, 2020
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Systems That Easily Integrate Necessary For Improving Claims Accuracy Rates
Once a health plan finalizes a claim, they do not want to go back and fix it retroactively. Claims accuracy rates improve productivity, reduce errors, and are …
Blog Post October 06, 2020
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Regulatory Compliance For A Competitive Advantage
So many regulations are intertwined; health plans cannot ignore the ones that may seem insignificant. Every year these smaller regulation changes get bigger. …