Our Solutions

Regional Health Plans

Can Your Health Plan Compete?

Although there are areas of growth potential, regional plans are struggling to compete. In addition to managing margins, regional plans also have limited resources to manage changing regulations and configure their solution quickly to meet the market demands.

Hidden Gems
Agility & Go-To-Market

HealthRules® Payor allows health plans to design and implement any type of benefit plan or provider contract

Benefit & Contract Modeling

HealthRules Payor empowers health plans to model benefit plans and provider contracts

Network Design

HealthRules Payor network design options are highly flexible to support easy and rapid configuration

Case Study
Elderplan Reaches 92.5% Auto-Adjudication

To learn more about Elderplan’s success after implementing HealthRules®, read the case study

Independent Health Testimonial

Listen to Dave Mike, Vice President, Core Systems at Independent Health discussing Value-Based Reimbursement

McLaren Health Plan Captures New Business in a Competitive Landscape

To learn more about McLaren's success after implementing HealthRules, read the case study

Medicare Advantage: The Ups and Downs of Growth and Regulations

UCare's Senior Vice President of Public Affairs and Chief Marketing Officer Ghita Worcester and HealthEdge's Regulatory Compliance Manager Maggie Brown explored how health insurance providers are handling changing regulations and updates to Star Ratings in the recent webinar, co-sponsored by AHIP. 

Learn more about the HealthRules product suite