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The implementation of the Interoperability and Prior Authorization Final Rule mandate (CMS-0057-F) in early 2024 is more than just a compliance requirement—it’s an opportunity for health plans to...
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See what 3,500 consumers say about their healthcare experiences
Read the report!A strategy to comply with the final rule issued by the U.S. Centers for Medicare & Medicaid Services suggests that payers should unify systems around their core claims and care management platforms...
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Prioritizing member satisfaction is vital for health plans to succeed in today’s highly competitive and rapidly changing landscape.
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HealthEdge recently completed a nationwide research study of nearly 3,000 health care consumers to help payers better understand what members care most about today. With consumer expectations shifting
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Over the past several years, health plans have been hit by a tsunami of regulatory changes, and two primary themes have emerged: transparency and interoperability. From the Transparency in...
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Creating an Interoperability Strategy that Delivers Results: How to Prioritize Integrations within Care Management and Across the Healthcare Ecosystem To achieve seamless care coordination, reduce...
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Managing members’ utilization of benefits is a complex and time-consuming, yet necessary task that often requires extensive human resources.
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Healthcare today is increasingly dynamic. Health plans must be able to quickly and effectively adjust to multiple sources of change such as regulatory shifts, competitive pressures...
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