Serving the approximately 20% of the US population enrolled in Medicaid is a challenge for any health plan. Some lower-income and elderly patients have communication, mobility and complex health issues – and each state has its own requirements and system, leading to increased complexity and fragmented engagement. As a result, health plans serving Medicaid members need advanced healthcare Medicaid plans software to deliver high-quality care and keep costs under control while ensuring compliance with changing state regulations.
Medicaid
How HealthEdge® Medicaid Software Can Benefit Your Health Plan
HealthEdge HealthRules® Payer
With HealthRules Payer, you can operate your Medicaid line of business with maximum efficiency while remaining compliant as new state-specific regulations emerge. HealthRules Payer automates critical business processes, lowers administrative costs and delivers enhanced levels of transparency and customer service.
HealthEdge SourceTM
Medicaid plans require technology that can streamline their businesses, handle complex situations, match negotiated terms exactly and use custom payment schedules. Source offers cloud-based delivery of up-to-date Medicaid policies and fee schedules, lowering administrative costs, increasing operational efficiency and mitigating compliance risks.
HealthEdge GuidingCare®
GuidingCare helps manage one out of four Medicaid members across 40+ states – and it was the first Care Management platform to integrate with leading social services search-and-referral platforms to manage SDOH. GuidingCare delivers value in maintaining compliance with state regulations and supporting innovation in partnership with government programs.
HealthEdge WellframeTM
Gain insights between clinical encounters and provide more consistent support to people on your Medicaid plan. Wellframe Digital Care Management extends the reach of your staff to engage more fully with your high-risk members.
HealthEdge SourceTM
Medicaid plans require technology that can streamline their businesses, handle complex situations, match negotiated terms exactly and use custom payment schedules. Source offers cloud-based delivery of up-to-date Medicaid policies and fee schedules, lowering administrative costs, increasing operational efficiency and mitigating compliance risks.
HealthEdge GuidingCare®
GuidingCare helps manage one out of four Medicaid members across 40+ states – and it was the first Care Management platform to integrate with leading social services search-and-referral platforms to manage SDOH. GuidingCare delivers value in maintaining compliance with state regulations and supporting innovation in partnership with government programs.
HealthEdge WellframeTM
Gain insights between clinical encounters and provide more consistent support to people on your Medicaid plan. Wellframe Digital Care Management extends the reach of your staff to engage more fully with your high-risk members.
HealthEdge HealthRules® Payer
With HealthRules Payer, you can operate your Medicaid line of business with maximum efficiency while remaining compliant as new state-specific regulations emerge. HealthRules Payer automates critical business processes, lowers administrative costs and delivers enhanced levels of transparency and customer service.