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At HealthEdge, the voice of our customers drives our innovation. Listening to our customers’ needs allows us to accelerate the delivery of valuable features and proactively remove barriers to their success.

Today, some health plans run on decades-old systems built on legacy technologies that do not lend themselves to innovation or shifting market dynamics. The reality is that the healthcare industry is constantly evolving. Health plans need a system that can keep up with rapid change and meets their business requirements as this experience with COVID-19 has shown.

HealthEdge’s solutions are based on modern technologies, modern tools, and modern development and deployment processes.

We actively look for customer input through a variety of channels. HealthEdge frequently participates in monthly user group meetings hosted by our customers, an annual customer conference, and numerous one-to-one user research visits by the Product Management and UX teams. Further, the Product Management team gathers feedback from the Support team, the Professional Services team’s experience during implementations, and gains insights from our account managers, who spend significant time with our customers in the field.

With product and market feedback in-hand, HealthEdge utilizes the Agile and Scrum software development processes, which focus on frequent delivery of working software. This methodology allows us to be extremely responsive to our customers’ requests, evolving marketing trends, or to modify products for compliance mandates.

This constant innovation enables us to ship Generally Available (GA) software releases many times per year, at no additional cost. These regular updates provide new capabilities that allow health insurers to stay current and competitive with the latest industry developments and pivot whenever needed.

HealthEdge’s approach to innovation is unique in the health insurance arena. As Vice President of Product Management, we guide our product, development, and operational teams to help modernize our industry in a way that is similar to other technology segments, where new business value and automation are delivered routinely. Our continued partnership with our customers will help us transform the way this industry operates, bringing more value and efficiency to payers and the members they serve.

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This edition of ‘the Edge Report is authored by Scott Sbihli, Vice President of Product Management. Scott is an experienced business and technology leader with a record of accomplishment in building and managing innovation, product, and business teams. Scott is originally from Michigan and now calls the greater Boston area home.

In the wake of the COVID-19, health plans across the country have had to respond to a multitude of ongoing changes in a short amount of time. Here are some examples of how payers are making adjustments, working with their customers, and keeping their organizations running smoothly.

Keeping members and community healthy tops health plans’ concerns during COVID-19

 Health plans’ concerns extend far beyond operational aspects; first and foremost, health plans want to ensure they are taking care of members from a health and financial perspective during this challenging time.

In a joint letter, Humana President and CEO Bruce Broussard and Cigna President and CEO David Cordani stated, “no patient should have to worry about treatment costs in a time of crisis. We are doing all that we can to remove this uncertainty–not because it is the profitable thing to do–but because it is the right thing to do.”

They, along with several other health plans, have expanded access to care through additional open enrollment periods for individuals, easing restrictions and costs for telehealth services, waiving fees for COVID-19 testing and treatment, providing early prescription refills, and much more.

In this unprecedented time, communication is key. Payers are focused on outreach and connecting members with resources and information.

Aetna’s care managers, for example, proactively reached out to high-risk members and walked them through how to protect themselves and where to get tested for COVID-19. And, members who are diagnosed and hospitalized with COVID-19 receive care packages from Aetna containing cleaning supplies, resources, and information.

Many health plans created support lines that members can call to get answers to their COVID-19 related questions and launched dedicated pages on their websites with regular COVID-19 news and updates, FAQs, and links to community resources, CDC information, and more.

Some health plans are expanding service offerings to address mental health and wellness. Health Partners Plans offers free online health and fitness classes for members, including dancing, yoga, Thai Chi, and cooking classes. And MedCost partnered with Carolina Behavioral Health Alliance and Mood Treatment Center to offer a free wellness webinar series on topics like managing anxiety, tips to better sleep, and sobriety, to help its members, and the public, find ways to cope during COVID-19.

Keeping up to date with regulations and implementing changes and new requirements

State and federal guidelines and regulations on COVID-19 are constantly changing, and health plans must keep track of the updates and adapt quickly to address new requirements.

Telemedicine experienced some of the most significant changes. Traditionally for primary care medicine, telemedicine has drastically expanded during COVID-19. With social distancing guidelines in place, almost all health plans have eased restrictions for telehealth services and are offering these services at no cost. For example, McLaren Northern Michigan Clinics quickly adapted their McLarenNow mobile app to extend the use and enable physicians, nurse practitioners, and physicians assistants to treat patients virtually.

Health plans are also aware that social distancing can cause feelings of isolation and potential for increases and substance use disorders and mental health struggles. Neighborhood Health Plan of Rhode Island waived requirements for providers seeking prior authorizations for all behavioral health and inpatient medical services, regardless of whether it is related to COVID-19.

Elevating care and giving back to their local communities.

In this time of crisis, health plans are going beyond just addressing regulations and increasing access to care. Health plans are part of the communities in which they serve, and many have stepped up to give back.

Colorado-based Friday Health Plans supports local businesses impacted by COVID-19 by placing daily takeout orders from local restaurants to provide meals for their employees. They also partnered with local Blessed Brews Coffee Shop to provide free coffee to essential community workers, including teachers from the Alamosa School District and the Alamosa Police Department.

Health Partners Plans donated thousands of free books that parents of Philadelphia-area children can pick up when they visit local hunger relief nonprofit Bebashi’s food pantry.

Blue Cross Blue Shield of Arizona and Phoenix Suns Charities donated $80,000 for 5,000 COVID-19 antibody test kits for first responders. And more than 20 of the health plan’s medically qualified employees volunteered to work in local healthcare facilities and help provide care to COVID-19 patients.

In Minnesota, Medica donated $1 Million to 18 local nonprofits to meet emergency needs during the pandemic; support will go to children and families, shelters, health clinics, food pantries, mental health/telehealth services, and more. And through its foundation, UCare provided $500,000 to support Minnesotans impacted by COVID-19. They also distributed more than 11,000 individual hand sanitizers across the state and donated bags for packing food to local food banks.

At HealthEdge, we also have looked for ways to give back to our local community. Throughout this crisis, we have donated weekly meals to the staff working tirelessly at the Lahey Hospital Emergency Room to keep our neighbors and community safe.

By helping each other, we will get through this. HealthEdge remains committed to our customers and is working to help them navigate these concerns, and we will be there to help overcome challenges in the future.

Interested in learning more about HealthEdge, our products and services, or want to schedule a 15-minute introductory call to discuss your business opportunities and challenges, contact Janet Barros.

Diversity and inclusion are essential components of HealthEdge’s recruitment and retention efforts. At HealthEdge, we see diversity is a competitive advantage and strive to recruit A-plus talent from a variety of backgrounds, who bring together a mix of skills and experiences that makes us stand out!

“We are constantly striving to do better and to bring different experiences and perspectives together to create something stronger at HealthEdge,” says Katie Conti, Director of Talent Acquisition “Diversity of thought sparks innovation, collaboration, and growth, so we’re always looking to expand the candidate pool that we hire from.”

Diversity and inclusion in the workplace are at the core values driving HealthEdge’s mission. Our HR team provides training, coaching, and mentorship to set the bar high when it comes to making sure HealthEdge employees are happy both in and out of the workplace. In addition to company events in and out of the office, HealthEdge offers and encourages professional development with the help of many free resources.

HealthEdge has been voted best ‘Best and Brightest Places to Work For’ for the two years in a row—a testament to our diversity and inclusion efforts. This year we achieved a National Best and Brightest Gold Standard 101. This gold-star standing says a lot about how the company recognizes, respects, and treats its employees.

“The different perspectives of employees can influence how a company performs. At HealthEdge, we help to foster diverse perspectives, acknowledge religious and cultural differences, and reflect on daily needs and preferences,” Katie noted. “We want HealthEdge employees to feel excited about work. We want people to lean into flexibility, learn the product, and ensure everyone has the necessary tools and resources to be successful at our organization.”

At HealthEdge, we find ourselves in a unique position during these difficult times. We are incredibly fortunate that our employees were able to move remotely overnight and our open positions remain active; in fact we are growing and adding new positions For the second time in less than two months, we welcomed our second full new hire class of five; the first having eight.

While we would all agree it is not ideal, it’ s certainly hopeful that we continue to grow and thrive even under such circumstances. We know this story of ‘business as usual’ makes us incredibly lucky and we are grateful to be resilient in these times.   If you or others have been impacted by job loss during COVID-19, we encourage you to connect and check out our healthedge.com/careers page.

Katie Conti is a senior talent acquisition professional with 20 years of experience with resource management and recruiting. She is currently focused on building a diverse, robust five-star healthcare IT talent pool at HealthEdge. Katie’ passion for building teams and impacting culture with every hire is evident.

With constant change in the healthcare sector, our customers have always relied on us to follow through, help them with opportunities and challenges, and deliver value and results. Building trust with our customers is our number one priority.

The impact of the COVID-19 pandemic is far-reaching. The federal and state officials’ guidance and regulations related to COVID-19 testing and treatment had many health plans adapting while operating in a new work environment. Health plans also needed to quickly enact policies and procedures that transformed payment models, authorization requirements, and state-specific waivers, while also paying providers who were treating patients in unique ways and with new coding requirements.

HealthEdge customers can rapidly implement configuration changes—which was paramount during the global pandemic. We quickly provided guidance on how best to address shifting governmental regulations using the capabilities our customers already had. HealthEdge partnered with our customers to ensure that their operations could continue smoothly amidst all the changes impacting members and providers.

The ability to respond to the myriad of operational and clinical changes caused by the pandemic is allowing our customers to stay focused on and the critical mission of providing vital, quality care for their members.

At HealthEdge, we are fortunate to have the capabilities and resources in our remote work environment to help keep our customers’ businesses running, no matter the circumstances.

In my 25-year career, I have found that strong customer relationships, built on transparency and trust, are crucial to success in healthcare. And this is just one example of how we have proven that our customers can trust us in a time of crisis. In many ways, HealthEdge is at the core of a health plan and how it serves its members. For our HealthEdge customers, we are their partners in success, and here to help overcome challenging times.

Want to know more about HealthEdge, email me or follow HealthEdge on LinkedIn.

This edition of ‘the Edge Report is authored by Chris Conte, Chief Revenue Officer. Chris is an accomplished healthcare sales leader and is responsible for ensuring the successful growth of the company. Chris has over 20 years of Industry and Sales Management experience in progressive and varying leadership roles. He began his career in Federal Law Enforcement.

The international COVID-19 outbreak has introduced unforeseen changes and uncertainty to all parts of our lives. HealthEdge is taking the health of our employees, customers and communities seriously and like many other businesses across the country, we’ve told our staff to work from home exclusively and replace travel with virtual meetings to help reduce the spread of COVID-19. During this time, we’re committed to helping our customers run their business, and we are ready to assist in resolving real-time, business-critical challenges.

HealthEdge’s Commitment to Customers 

The international COVID-19 outbreak has introduced unforeseen changes and uncertainty to all parts of our lives. During this time, HealthEdge wants you to know that we are here for you and committed to helping you continue running your business as you work with your providers and members.  We understand your business may be unusually impacted, for example by the increased need for healthcare services, putting additional strain on your resources. We are ready to assist you. Every day, customers rely on us to help them rapidly resolve real-time, business-critical challenges and COVID-19 does not change our ability to provide those critical capabilities.

Employee Focus

We take the health of the community and our employees seriously and are following the advice of medical experts and local authorities regarding steps we can take to help reduce the spread of the virus, such as social distancing. We have told our staff to work from home exclusively, and this policy will continue to be evaluated. We’ve also directed our employees to replace travel with virtual meetings during this time.

Agility and collaboration have been the focus at HealthEdge in our culture and how we approach our day to day support commitments.  Our staff are all deployed with equipment and toolsets that enable them to work effectively remotely.  Employees are trained in the use of video conferencing tools for virtual meetings to ensure our collaborative work focus for our customers continues.  Our internal support teams continue to support our customers 24x7x365, managing and monitoring any critical events that may occur.

We believe it’s our duty to play a role in reducing the spread of COVID-19, and precautions like these are in the best interest of our employees, their families, and the communities in which they live.

Crisis Management

The senior management team at HealthEdge is meeting daily to assess all aspects of the crisis and ensure that our resources are deployed to help you continue managing your business.  Please address any concerns to your Account Executive as we work through this unprecedented situation.