Provider abrasion is an ongoing challenge for health plans, resulting in damaged trust, increased workloads, and unhappy providers. The problem usually arises from claim denials, payment delays,...
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See what 3,500 consumers say about their healthcare experiences
Read the report!The healthcare industry, care management practices, and software that enables health plans to provide exceptional service to members are all undergoing significant changes. Market dynamics,...
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Healthcare consumers are demanding more from their health plans. Personalized experiences are becoming the gold standard across industries. Many health plans are turning to digital health...
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Unlocking the Future with Digital Care Management Integrations There has been a lot of talk about digital member engagement and integrated care management in the market today. But for many payers,...
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Today’s health plans face many challenges, including increased competition due to factors including the abundance of options available to beneficiaries, an aging population, rising member...
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In an era where healthcare demands are rising exponentially, and health plans are stretching their budgets, increasing the capacity and efficiency of care management is becoming a key area of...
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As the healthcare industry evolves, health plans face increasing pressures from virtually every area of their businesses. Care management teams are particularly challenged to address these...
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For healthcare payers, offering digital health solutions to members is no longer a novelty—it has become table stakes for organizations looking to improve engagement and outcomes. The right...
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In the dynamic California landscape of health care, capitation is gaining popularity as a reimbursement model. Capitation is the practice of paying care providers a fixed amount for each patient....
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Managing complex healthcare claims requires a flexible editing system that adapts to the unique needs of your health plan. Traditional claims editing tools often fall short, leaving you vulnerable...
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Navigating the labyrinth of healthcare regulations is no small feat. This is especially true for health plans operating in California. The state has the largest population in the U.S., with varied...
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In any organization, maintaining a culture of integrity and accountability is a top priority. At HealthEdge, one of the ways we uphold these values is by providing a hotline for employees,...
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When it comes to optimizing care management, it’s common to hear stories about care managers losing valuable time playing phone tag, and members feeling frustrated because they don’t know when or...
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In today’s competitive healthcare landscape, operational efficiency isn’t just a goal—it’s a necessity. Health plans are constantly seeking ways to streamline their processes, reduce overhead, and...
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Transformation throughout the healthcare industry is reshaping the relationship between consumers and their health plans. Consumers are demanding more personalized and dynamic experiences, making...
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Over the past four years, healthcare payers have faced immense pressure to adopt new technologies that aim to increase member engagement, improve clinical outcomes, and control costs. But it can...
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The healthcare industry is experiencing unprecedented change. New technologies in care management are now widely available to help healthcare payers streamline care delivery, improve operational...
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Digital care programs have emerged as a transformative tool to improve clinical outcomes and member engagement. From supporting maternity populations to managing chronic conditions like Diabetes,...
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The healthcare landscape in California is undergoing a significant transformation as part of the California Advancing and Innovating Medi-Cal (CalAIM) initiative. A pivotal change involves the...
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A staggering 29% of healthcare consumers said they intend to change health insurance carriers in the coming year, signaling a wake-up call for the industry. HealthEdge conducts an annual...
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