Commercial
The commercial health plan market is marked by high member turnover, with nearly 20%1 disenrolling each year. This creates intense pressure for health plans to minimize churn, invest in new enrollment strategies, and balance affordability with business growth in an increasingly competitive environment.
HealthEdge® offers a next-generation integrated solution suite tailored specifically for commercial lines of business. Designed for scalability and flexibility, our advanced platform empowers you to adapt swiftly to changing market conditions. With HealthEdge, you can introduce innovative products, reduce administrative costs, and enhance operational efficiency. Most importantly, our solutions help you deliver exceptional value and a superior member experience, keeping enrollment strong and driving sustainable business growth.
How HealthEdge
Can Help
HealthRules® Payer
Gain the ability to expand into new markets and quickly stand up and grow all lines of business. Our next-generation core administrative platform provides industry-leading flexibility for contract configurations so you can reduce IT and administrative overhead and improve operational efficiencies.
HealthEdge Source
Transform your business with the market-leading prospective payment accuracy and integrity solution designed specifically to enable health plans to pay claims accurately, quickly and comprehensively the first time, while radically reducing contract maintenance by 90%.
GuidingCare®
Turn to the nation's largest and most widely adopted solution for care management and population health to address care coordination, medical management workflow, and regulatory compliance to serve all members.
Wellframe
Gain insights between clinical encounters and provide more consistent support. Wellframe Digital Care Management extends the reach of your staff to engage more fully with high-risk members.
Provider Data Management
Streamline data ingestion and enrichment using a Generitive AI-powered framework that enables real-time accurate provider data to flow across the HealthEdge solution suite and the broader heath plan ecosystem.
HealthEdge Source
Transform your business with the market-leading prospective payment accuracy and integrity solution designed specifically to enable health plans to pay claims accurately, quickly and comprehensively the first time, while radically reducing contract maintenance by 90%.
GuidingCare®
Turn to the nation's largest and most widely adopted solution for care management and population health to address care coordination, medical management workflow, and regulatory compliance to serve all members.
Wellframe
Gain insights between clinical encounters and provide more consistent support. Wellframe Digital Care Management extends the reach of your staff to engage more fully with high-risk members.
Provider Data Management
Streamline data ingestion and enrichment using a Generitive AI-powered framework that enables real-time accurate provider data to flow across the HealthEdge solution suite and the broader heath plan ecosystem.
HealthRules® Payer
Gain the ability to expand into new markets and quickly stand up and grow all lines of business. Our next-generation core administrative platform provides industry-leading flexibility for contract configurations so you can reduce IT and administrative overhead and improve operational efficiencies.