Part 1 of a 2-part series, where HealthEdge® Vice President of Product Development Bobby Sherwood discusses how a new operating model can transform care operations for health plans. In this...
Read Blog
Health plans are heading into 2026 under a level of pressure that feels fundamentally different from just a few years ago. Findings from the HealthEdge® 2026 Healthcare Payer Survey Report, “The...
Read Blog
For the second consecutive year, 52% of health plan executives named “managing rising costs” as the top challenge, according to the 2026 HealthEdge® Annual Payer Report. In the same survey, 85% of...
Read Blog
Error - something went wrong!
Enjoying the content? Sign up to our weekly blog email recap!
Thank you!
When a health plan undertakes a major technology change, whether implementing a new platform, modernizing a legacy system, or rolling out new functionality, the promise is compelling: streamlined...
Read Blog
Artificial intelligence (AI) is fundamentally changing how healthcare software is built. From automated test case generation to intelligent documentation and decision support, large language...
Read Blog
Payment integrity has always played a critical role in payer operations, but in 2026, it has become a strategic imperative. According to the HealthEdge® 2026 Annual Payer Survey, health plan...
Read Blog
At a recent roundtable, the HealthEdge® Chief Medical Officer led executives from three leading health plans in a discussion centered around optimizing care delivery and...
Read Blog
At HealthEdge®, we strive to understand the key challenges health plans face so we can help anticipate and address new market opportunities. Recently, HealthEdge Chief Strategy Officer, Raj...
Read Blog
When health plans implement new software, upgrade existing platforms, or roll out new features, one factor is key to achieving success is effective testing.` While testing may not always...
Read Blog
Recently, the HealthEdge® Chief Solutions Officer hosted a discussion with four health plan executives to discuss how they’re using advanced, integrated technology solutions to enhance claims...
Read Blog
Health plans are racing ahead with artificial intelligence (AI). Members are moving more cautiously. In 2026, the question is no longer whether AI will shape healthcare. It’s whether payers and...
Read Blog
In today’s rapidly evolving healthcare landscape, standing still isn’t an option. Health plans relying on legacy care management platforms, whether vendor-supported, homegrown, or heavily...
Read Blog
At HealthEdge®, our team understands that efficient provider data management is fundamental to delivering quality healthcare. Yet, the reality for many health plans is that maintaining accurate...
Read Blog
At a recent executive roundtable, HealthEdge® brought together health plan leaders from across the U.S. to share their experiences and see how other organizations are addressing key challenges....
Read Blog
Managing payments for a health plan is not as simple as it was a few decades ago. Updated billing models, new compliance mandates, and complex provider networks can make it challenging for payers...
Read Blog
HealthEdge Source™ earned the 2026 Best in KLAS Awards: Software and Services as the leader in “Pre-Payment Accuracy & Integrity Solutions (Payer)”—with an overall score 8% higher than its...
Read Blog
Industry pressures like regulatory complexity and the shift toward value-based care demand that health plans take an integrated, strategic approach to care management. Whether payers are...
Read Blog
Care teams, product managers, and operations leaders across healthcare live inside documents: contracts, benefit summaries, clinical policies, internal runbooks, and email threads. These artifacts...
Read Blog
Rising costs. Relentless regulation. For health plans, the question isn’t whether these pressures are intensifying. It’s how to respond. According to new research from HealthEdge®, these twin...
Read Blog
The Transparency in Coverage (TiC) final rules of 2020 promised a revolution in healthcare price transparency. The vision was bold: empower consumers with data to drive competition and lower...
Read Blog
Loading More...
HealthEdge Software, Inc. | HealthEdge®, HealthRules®, The HealthRules Language™, GuidingCare®, and the Wellframe logo are registered trademarks of HealthEdge Software, Inc. All Rights Reserved.
