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Employee feedback drives our decisions as a company. To create a forum that allows us to hear directly from our people, human resources created the Employee Council. The council meets once a month to discuss HealthEdge happenings and ways to do things better, share news, initiatives, and ideas, and improve cross-collaboration.

Last year, the Employee Council launched the EDGIE Awards to recognize our consistent contributors and unsung heroes that may not necessarily be visible to the larger part of the organization.

What makes the EDGIE Awards special are that all recipients are nominated by their peers across different categories, based on HealthEdge’s five pillars: Customer Value, First Principles, Cross-Functional Collaboration, Continuous Improvement, and Engineering Excellence.

HealthEdge employees submitted more than 200 nominations across all categories! Congratulations to the 2020 EDGIE Award winners:

Internal Customer SuperHEro: Shirish Dandge, Principal Support Engineer, and External Customer SuperHEro: Yu-Bing Chen, Principal Software Engineer, for always putting the customer first and consistently adding end-to-end value. They take time to understand the customer’s problem and determine the best approaches to fix the root cause.

The Principle Award: Arijit Das, Manager, Engineering, for constantly finding ways to do things smarter and uncovering ways to better approach the way we work.

Cross-Functional Champs: Gail Winslow, Director of Marketing Communications, and Dina Maiorana, Product Manager, who always know when to pull in their stakeholders. Other departments and teams view them as valuable resources and the first points of contact.

Continuous Improvement, Continuous Delivery: Ram Mamidenna, Manager, Engineering, for demonstrating superior proficiency in the use of open communication and seeking feedback. They are skilled at defining, measuring, experimenting, mastering processes, and determining improvements through retrospectives.

Excellence Award: Liz Black, Executive Assistant to the CEO, who takes an “engineers” approach to all areas of her work by using creative thinking and problem solving, demonstrating behaviors and skills to drive positive results. 

In addition, VP-level individuals and above are not eligible. However, the Honorable Mention category recognizes individuals who may fit into more than one category or are all-around an irreplaceable piece to our organization: Brittany Long, Senior Operations Manager, Wilda Todd, Sales Solution Engineer, and Amaresh Panda, Manager, Customer Services.

The EDGIE Awards foster a culture of recognition and thank the individuals who practice HealthEdge pillars in their day-to-day work, making a positive impact on their teams and the larger organization while serving our customers’ needs.

The Employee Council and EDGIE Awards are just two of the reasons HealthEdge was named to Boston’s 2020 Best & Brightest Companies to Work For® award, three years in a row, Boston Globe Top Places to Work, and Top Places to Work in the Nation in 2021.

Every talent development team can tell you. Attracting quality candidates and attracting ethnically and gender diverse candidates not only strengthens an employer it results in creating an authentic and truly representative workforce.

At HealthEdge, our goal is to create a culture where employees feel comfortable and proud to bring their whole, authentic selves to work. However, we know that with a workforce spanning a range of social identities —gender, ethnicity, religion, sexuality, age, and more —not everyone experiences the same levels of comfort and openness.

HealthEdge has embarked on a focused journey to address building a global workforce where diversity, equity, and inclusion (DE&I) are at the forefront.

As part of our Black History Month kick-off, we launched a new speaker series inviting HealthEdge team members, around the globe, to listen to an engaging presentation by Cindy Joseph, Founder and CEO of The Cee Suite, addressing unconscious bias.

As humans, we all carry biases; they help us navigate the world as we face millions of pieces of information at any given moment. Our brains create these biases like shortcuts to help us process our environment. By their nature biases are often subconscious and unintentional. The danger is that these biases are persuasive and encourage us to make assumptions without us even knowing that it’s happening. If left unchecked, our biases can cause errors in our decision-making that significantly impact those around us.

Many of us found ourselves last year asking, “what can I do to make a difference?” At HealthEdge, we offer a series of opportunities to learn and grow and to explore the dialogue of DE&I in a safe space.  We all agree that our work culture is where we can exert the greatest amount of impact.

And that is why we are strengthening our employee-driven, I Belong HealthEdge (IBelongHE) committee, with monthly presentations, welcoming all voices to the table. HealthEdge has taken every effort to ensure that we learn from our past and grow into our future. The initiatives that we are committed to extend beyond window dressing. As a company, we committed to the MassTLC Compact for Social Justice. Our work on rooting out racial inequity was spotlighted in the Boston Globe’s Top Place to Work.

As Ms. Joseph said, “you cannot recruit your way out of diversity challenges; it goes beyond representation.” This is why we are focusing not just on recruiting but also on community, training, and communication. We believe this multi-prong approach will help us create an organization where people of all backgrounds and social identities feel a sense of belonging and have the opportunities to do their best and succeed.

While there is no quick fix to this work, HealthEdge is committed to taking concrete steps to facilitate change and making strides to improve every day. Understanding and addressing biases will help us become more inclusive and dynamic as a community and create a better and more equitable work environment.

Do you have what it takes to be on our team? Are you as committed as we are to building a culturally-enhanced workforce.  Check out our career openings or follow us on LinkedIn to learn more.

It’s been a long journey since the first line of code in GuidingCare® was written in 2007 to the present day. Altruista Health has evolved as a company into its market leadership position and we plan to stay here.

Those of you who know my background are familiar with my reasons for starting Altruista Health. I have a strong desire to serve because I survived a difficult early life in India and was very fortunate as an adult to come to the United States and gain an education. I can think of no other place in the world where I would have had the same opportunities that I have had in this country. I’m continually grateful.

One of my early work positions was at a large national health plan, where I was on an executive track. It quickly became clear to me that the system was deeply enmeshed in a reactive cycle in managing member health. Wanting to make change, I co-founded Altruista Health to serve some of the nation’s most vulnerable people – those with complex medical conditions, serious mental illness, the frail elderly and others. Altruista has sought to intervene proactively and with a full 360-degree view of the member to prevent bad outcomes and needless suffering. I believe we are making a difference.

Becoming part of the HealthEdge family is the next part of our journey, in which we have a chance to work with like-minded colleagues to deliver even more value to health plans and their members. Through HealthEdge, a Blackstone-backed company, Altruista gains the financial muscle of the world’s largest investment organization, and that gives us leverage to continue innovating and fulfilling our mission.

I could not be more proud or excited about GuidingCare and the future of Altruista Health. We are not stopping or slowing down in our quest to build a better health system. In the end, it’s all about the people we serve and their quality of life. We have never lost sight of that and never will.

According to the most recent numbers from Centers for Medicare & Medicaid Services, healthcare spending represents 17.7% of the U.S. Gross Domestic Product, growing to $3.8 trillion in 2019. Americans spend more money per capita on healthcare than any other country in the world. However, as life expectancy is increasing across the globe, it has actually declined in the U.S. since 2014.

Healthcare costs are out of control, and value-based care is recognized as the most significant initiative that can turn things around. With the fee-for-service model, the healthcare system is waiting to treat people who get sick. With value-based care, the providers get paid for  keeping patients healthy and avoid expensive encounters and hospitalizations.

The concept of value-based care is the opposite of how the U.S. healthcare system operates today. So naturally, there has been resistance by both health plans and providers. The fee-for-service model is so entrenched in care delivery that providers rely on a constant revenue flow when paid for treating patients. And while providers are interested in making patients healthy, proactively keeping patients healthy is an entirely different approach to care. The burden is on the provider to ensure the patient receives preventative treatment; this requires keeping up with people, making sure they’re proactive with check-ups and other services, and taking medications, among other things.  It also means that providers must take on some of the risk that health plans have traditionally borne.

For successful value-based arrangements, health plans must provide actionable data and analytics to the providers. In order to hold a primary care physician (PCP) accountable for a patient’s health outcomes, the health plan must offer a comprehensive, 360-degree view of the patient and their claims and encounters.

For example, if a patient with diabetes goes for an annual eye check-up—which they need to do—their health plan must provide that data in an easy to consume way for the physician to know what kind of care the patient is receiving. It’s up to the health plan to provide the data that lets the PCP know everything about the patient’s condition and treatment. Without the data, the PCP will be disconnected from the actual maintenance or proactive steps a member needs to take to stay healthy, often resulting in costly treatment.

In a recent webinar, HealthEdge customer Eric Decker, SVP of Information Technology and CIO at Independent Health, shared that his organization has value-based arrangements with 100 percent of their primary care physicians. They understood that information sharing was critical to the success of these agreements. To effectively share data, they built capabilities available to the PCPs in their provider portal to communicate with the providers with scorecards that show how each physician is performing relative to their peers and view outstanding gaps in care.

If the entire healthcare system embraced value-based care, everyone would be working together to keep patients healthy. With value-based care, the quality of care and outcomes that come from preventative measures will keep costs down and, hopefully, cause life expectancy to climb back up.

HealthEdge’s culture values a deep sense of community, understanding, and most importantly, belonging. We want our employees to know that HealthEdge strives for an inclusive environment that welcomes people of all backgrounds, ideas, and voices. That’s why HealthEdge created iBelong, an internal group that has regular, open conversations about diversity, equity, and inclusion and discuss ideas on how we, as a company, can do better.

In October 2020, HealthEdge took our commitment to diversity and inclusion a step further and joined MassTLC Compact for Social Justice. As part of this initiative, we promised to introduce and expand educational programming related to diversity, inclusion, racial inequality, managing diverse teams, and creating a judgment-free culture.

It was important from the beginning that our employees had a voice and drove the educational content by helping us identify the most impactful topics. A few members of our iBelong group worked together to define what we wanted to accomplish with the programming. They also volunteered to take the training before we launched company-wide to provide feedback on what resonated and what was missing.

We realized quickly that the training needed more than just definitions of diversity and inclusion. The number one question we received was, “what can I do to make a difference?” To make an impact, the sessions required actionable information with steps employees can take to create a more inclusive workplace. For example, certain sessions took deeper dives into recognizing unconscious bias and steps to overcome your own biases, as well as the LARA/I method of active listening that opens the door for meaningful conversations and connections. We encouraged all employees to complete the courses and begin to take actions that will help us progress toward expanding our diversity and inclusiveness.

We understand that we cannot create a diverse, inclusive, or equitable workplace through just emails or handouts; we need to build trust and strong relationships. We want our employees to feel comfortable talking to each other about difficult topics, sharing their points of view, and make these discussions part of our culture.

The next step is to build on what we’ve learned through a speaker series. The series will take the concepts we already introduced and take a deeper dive into what does it mean and how as a culture, we can get better, be more diverse, make sure everyone feels included.

As all health plans have continued the conquest of adding lives to their risk pools, the industry has witnessed vast membership consolidations over the past decade, resulting in a shrinking number of smaller regional plans operating independently.

Looking at the payer industry today, there are only a handful of major players left spread out across the nation. Almost every regional plan is becoming a subsidiary of those larger entities. As these smaller plans are acquired and absorbed into the landscape, there often comes a system consolidation of the core platforms fueling a competitive market for the remaining opportunities that evolve.

The larger the enterprise is, the harder it seems to implement change. That’s one reason why so many larger insurance providers take the minimum viable product (MVP) approach to reinvent themselves because they become stale, stagnant, and are too huge to create meaningful change. A common strategy is to take one of these smaller regional plans and rebrand that smaller plan using the MVP approach.

How can smaller payers continue to compete against larger payers as they continue to grow and add lives? How do they create operational efficiencies and lower PMPM costs?

One obvious way a health plan can gain efficiencies is through technology. However, it should be mentioned we must embrace the culture of change when implementing a new core solution. Often new software solutions can be the adversary to existing states.

Technology is just a tool, after all, so it is really the ability to adopt and master the application that determines the new solution’s success.

From a technology view, once the playing field is leveled, it becomes the savvy users who understand the system advantages; those who can embrace change often determine the outcomes of success or failure. Those that will ensure your organization is not “paving the cow path” and recreating a legacy approach in a modern system nor achieving inefficiency faster.

For additional competitive advantage, if a smaller health plan adopts new technology, should they truly partner with the software vendor for success —they will continue to gain efficiencies, remain competitive, and get further, faster.

Without a direct partnership with our customers, success can be challenging at best.

A great example of that investment or partnership in the effort to increase system adoption is providing end-user training. While initially is crucial, ongoing training is especially critical to build the culture of continual optimization.

As my colleague Wilda Todd wrote, smaller plans with fewer resources to invest in training are not alone! They should lean on their vendors and leverage their knowledge and expertise, not only in training but in all the many aspects of building the ecosystem and total solution.