BURLINGTON, Mass.—February 4, 2020 —HealthEdge®, provider of the industry’s leading integrated financial, administrative and clinical platform for health insurers, announces that Public Employees’ Health Program (PEHP) has chosen its HealthRules®Payor solution. PEHP plans to utilize HealthRules Payor to streamline current business operational processes while quickly addressing market opportunities to stay ahead of its competition. The company will also implement HealthRules®CareManager, which offers a complete 360° view of the member that allows internal and external multi-disciplinary care teams to share responsibility for coordinating member engagement across all types of programs. The combination of HealthRules Payor and HealthRules CareManager will provide PEHP with greater transparency into both operational and clinical information supporting its efforts to lower costs and improve member experience.
“We found what we wanted in HealthEdge. Superior technology built around a configurable system that allows us to innovate and create customer value at a price point that made sense for us as a public entity,” said R. Chet Loftis, Managing Director, PEHP. “We are excited about the future with what HealthEdge brings to us as a long-term, strategic partner.”
PEHP, a division of the Utah Retirement Systems, is an independent state entity, providing health benefits to Utah’s public employees and their families with approximately 160,000 members. A long-time user of an internally developed core administrative system, PEHP became convinced of the need to build or buy a new system. The organization selected HealthRules Payor and HealthRules CareManager to replace its legacy system, enabling it to maintain a high-level of control and self-efficiency through flexible business operations and plain language configuration of the platform.
“Industry changes are generating a new set of critical needs for health plans to provide the highest quality care while lowering administrative and clinical costs,” said Steve Krupa, HealthEdge Chief Executive Officer. “Implementation of HealthRules Payor and HealthRules CareManager allows health plans like PEHP to lower healthcare costs by providing capabilities for managing members and populations in the most efficient way, resulting in optimized quality metrics, member outcomes and satisfaction.”
HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs and connect everyone in the healthcare delivery cycle. Our next-generation enterprise solution suite, HealthRules, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. An award-winning company, HealthEdge empowers health insurers to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy.