HealthEdge Survey Illuminates Key Payer Insights

Over 200 health payer executives share insights on pressures and future investments

Burlington, MA, May 4, 2021 – HealthEdge Software, Inc.® (“HealthEdge”), a leading provider of next-generation technology solutions for healthcare payers and plan administrators across core administrative processing systems, payment integrity, and care management, announced today the results of its Voice of the Market Survey: Market Pressures Shifting Priorities for Health Plan Executives (“survey”).  The survey reflects the opinions of over 200 health insurance executives weighing in on the challenges and benefits impacting their key constituents.  Survey results can be downloaded on the HealthEdge website.

As 2020 stretched operating margins and impacts of the unprecedented global pandemic created provider financial stressors, health payer executives adapted and met challenges head-on. Employee-sponsored insurance percentages declined while government-sponsored enrollment swelled from rising unemployment. And continuing today, workplaces are mitigating staff burnout, flex capacity, and vaccine rollout, while balancing bottom-line stability.

Results of the survey indicate competitive pressures, IT and business alignment, member satisfaction, and managing costs dominate boardroom agendas. As health plans have become more business-minded, they’re increasingly focused on factors outside of their own operations.

Executives said the lack of access to real-time data and information sharing and payment inaccuracies have the greatest negative impact on provider relations, while surprise billing/difficult transactions have the greatest negative impact on customer satisfaction.

Accurate payments to providers and accurate billing to members are essential for provider and member satisfaction and are a key product offering under the HealthEdge solutions suite. 

Respondents also said payment accuracy would help reduce administrative costs at their organization, directly impacting savings that can be reallocated for business priorities such as considering partnerships or acquisitions or investing in a new geography or line of business. This represents a substantial shift from the past, demonstrating how health plans today want to take advantage of all available resources to expand in the current landscape. Vertical footprints of health plans are growing, and many plans seek to simplify the member experience connection with the intent of having “the plan” being the single source of entry to healthcare services.

A continuing theme from 2018’s baseline survey is the need to modernize technology,  as the need for next-generation technology never subsides. Many share a frustration that outdated, disconnected technology and infrastructure create significant challenges.

The survey, administered by Upwave, the brand intelligence platform based in San Francisco, tapped 222 health payor executives between March 08, 2021 and April 01, 2021. No monetary payment was provided for their participation.

About HealthEdge 
HealthEdge® is the health insurance industry’s first digital nervous system that provides automation and seamless connectivity between all parts of a payer’s administrative and clinical systems. HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. In 2020, Blackstone became majority owner. HealthEdge, along with its portfolio of mission-critical technology assets for payers, including The Burgess Group and Altruista Health, are collectively driving a digital transformation in healthcare. Follow HealthEdge, on Twitter or on LinkedIn.

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Lori Taylor
Vice President, Corporate Communications 
HealthEdge 
813-220-9702
[email protected]