Explore additional content on the GuidingCare Solution Suite
Discover practical insights and innovative strategies shared during our exclusive roundtable, where health plan leaders collaborated on advancing health equity through technology and partnership. This
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See what 3,500 consumers say about their healthcare experiences
Read the report!Discover how HealthEdge GuidingCare® uses AI, streamlined workflows, and seamless engagement to deliver personalized care while boosting efficiency and outcomes. Download the brochure to learn more.
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GuidingCare® offers health plans and providers easy-to-use, next-generation data integration and workflow management tools.
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Member populations have escalating needs. Meanwhile, digital healthcare and care management solutions have created an opportunity for big returns on care management dollars.
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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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Healthcare is undergoing a transformation, and artificial intelligence (AI) is a major part of this evolution. From improving diagnostic accuracy to transforming care coordination workflows, AI...
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Are you ready to transform compliance into a strategic advantage?
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Strategies for Health Plans Navigating Change, Compliance and Innovation
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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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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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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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