Advisory Services
Advisory Services provides health plans an expert-led, data-backed benchmark of total administrative spend, operational performance, and modernization readiness.
See How It Works
Benchmark What Matters
Benchmark total cost of ownership across staffing, workflows, technology, vendors, and operational performance. The assessment reveals the true drivers of cost and creates a fact-based view of where efficiency, accuracy, and outcomes can improve.
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Establish a clear baseline across people, processes, technology, and operational performance.
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Identify the highest-impact cost drivers, inefficiencies, system gaps, and modernization priorities.
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Receive a blueprint with quantified financial and operational outcomes to guide investment decisions.
The Modernization Path: Insight to Action
A focused, minimally disruptive assessment that turns operational and financial data into clear priorities for improvement.
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Gather targeted data through questionnaires and interviews covering costs, staffing, workflows, technology, and performance.
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Compare operating metrics and cost drivers to identify gaps, inefficiencies, risks, and high-impact savings opportunities.
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Translate findings into prioritized recommendations, quantified outcomes, a practical modernization path, and an opportunity to explore guaranteed PMPM savings with Enduring Edge BPaaS model.
Benchmark Today. Build The Future State.
Gain an independent view of where costs originate, where performance breaks down, and which investments can create the greatest impact.
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Move forward with a clear, evidence-based roadmap that reduces uncertainty and supports smarter operational and modernization decisions.
HealthRules Edge
The industry-leading core administrative processing system, delivering 90–97% first-pass auto-adjudication.
Payment Accuracy Edge
Prospective payment integrity that helps health plans pay accurately in real time.
Revenue Align Edge
Real-time risk adjustment that captures accurate risk across the enterprise.
Clinical Edge
The nation’s most widely adopted care management platform for whole-person care.
Provider Atlas Edge
Clean provider data, less friction, and stronger compliance across the enterprise.
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Frequently
Asked Questions
Total Cost of Ownership is the full cost of running a health plan’s operations across people, processes, technology, vendors, maintenance, integrations, and rework—not just software expenses.
It examines staffing, workflows, technology, vendor spend, productivity, and performance metrics to reveal total cost of ownership, inefficiencies, and operational gaps.
Health plans receive a true cost baseline, prioritized savings and modernization opportunities, a report card on key gaps, and an independent roadmap with quantified outcomes.
The findings align operational readiness, financial goals, and performance priorities to help plans evaluate different modernization models and identify the best path forward.
HealthEdge offers Integration Edge, an EPaaS model for technology modernization with operations retained in-house, and Enduring Edge, a BPaaS model that combines technology with managed operations and guaranteed financial outcomes.