Explore additional content on the GuidingCare Solution Suite
Health plans today face multifaceted challenges, particularly when managing care for individuals navigating significant barriers to health equity. These populations, including dual-eligible...
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Read the paper!VillageCareMAX transformed its operations, improved care coordination, & enhanced reporting efficiency by implementing HealthEdge’s GuidingCare, unifying workflows & driving better member outcomes.
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GuidingCare Letters is an integrated feature within GuidingCare that streamlines the creation of personalized, compliant member communications, including real-time and batch correspondence.
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Modernizing technology solutions and adjusting digital strategies are key priorities for health plan executives. Advancements in integrated care management solutions are enabling payers to...
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Effective care management begins with getting members onboarded. For health plans, the onboarding process sets the tone for the member’s experience while also building the foundation for long-term...
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Medicaid programs nationwide are increasingly requiring and incentivizing health plans to incorporate whole-person care and the social determinants of health (SDOH) into their service models....
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A payer’s ecosystem is large, complex, and constantly evolving. HealthEdge’s goal is to develop a thriving platform-based ecosystem that allows payers to flexibly weave...
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Burlington, MA – [Feb. 4, 2025] – HealthEdge®, a leading provider of next-generation core administrative processing systems (CAPS) and care management solutions, and Unite Us, the nation’s leading...
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Burlington, MA – [Jan. 22, 2025] – HealthEdge®, a leader in next-generation health management solutions, achieved its 5th consecutive NCQA HEDIS® Allowable Adjustment (AA) certification for a...
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The Centers for Medicare & Medicaid Services (CMS) has raised performance benchmarks for Medicare Advantage (MA) and Part D plans, raising the bar for achieving high Star Ratings. By excluding the...
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Managing pediatric health within today’s healthcare landscape requires precision, innovation, and unwavering dedication to excellence. Health plans face the dual imperative of delivering tailored,...
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Health plan executives are pursuing integrated platform solutions that provide better access to data, leading to better member outcomes.
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Navigating healthcare regulations and compliance is an intricate challenge. To optimize the use of healthcare dollars and more effectively address population health, The Office of the National...
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To streamline its administrative systems, Medica partners with HealthEdge through the use of HRP and GuidingCare
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Lessons in Effective Change Management from an Innovative Medicaid Managed Care Organization
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The U.S. maternal health system faces a troubling crisis: Disparities in maternal health outcomes disproportionately affect Black, American Indian/Alaska Native (AIAN), and Native Hawaiian/Pacific...
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In a recent webinar hosted by the Association for Community Affiliated Plans, Anna Dunn, the president of Health Services for Children with Special Needs (HSCSN), shared her experience...
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Maternal morbidity rates in the U.S. are in the spotlight—particularly the disparities many Black women face compared to their white counterparts. Despite advances in medical technology and...
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