Building Regulatory Compliance Agility: Lessons from Nascentia Health’s Success Story  

Implementing new care management technology is about more than just meeting a go-live date. For Medicaid and Long-Term Services and Supports (LTSS) plans navigating evolving state mandates, success hinges on achieving regulatory compliance agility—the ability to adapt swiftly and confidently to continuous change.

This theme was the focus of a recent webinar hosted by the Association for Community Affiliated Plans (ACAP), hosted by implementation and regulatory leaders from HealthEdge® and Nascentia Health. They shared how Nascentia completed a nine-month, compliance-focused implementation of HealthEdge GuidingCare® that strengthened care management operations, reduced risk, and empowered its care management teams.

In the webinar, speakers also highlighted five key lessons the Nascentia team learned from their experience, and how HealthEdge implementation best practices helped embed regulatory compliance agility into every stage of the process.

Five Key Implementation Lessons from Nascentia Health

1. Start with compliance as a priority on day one

Nascentia made regulatory compliance the foundation of its implementation. The plan’s compliance team was involved from the first assessment through post-go-live evaluation, ensuring every workflow, form, and report aligned with state and federal requirements.

“Start with compliance as a priority on day one,” said Brian Davey, Vice President of Health Plan Operations at Nascentia. “One of the main reasons we achieved a nine-month timeline was because there was not much rework. Compliance was involved every step of the way.”

Implementation Best Practices

• Integrated compliance and regulatory leaders into each phase, from discovery through testing.
• Mapped all regulatory touchpoints early and defined measurable compliance outcomes.
• Used the proprietary HealthEdge Transform Framework to connect compliance requirements directly to solution delivery.

The most successful health plans treat compliance as an enterprise-wide foundation rather than a separate workstream. Compliance serves as a governing focus that spans the entire program and supports the organization’s broader goals.

2. Build shared accountability between your health plan and technology partner

Nascentia and HealthEdge adopted a “one-team” model, fostering transparency and mutual accountability through daily communication, shared milestones, and joint decision-making—key elements for a rapid and compliant rollout.

Implementation Best Practices:

• Established shared project dashboards and escalation paths to track progress.
• Embedded compliance checkpoints into project governance for joint approval at each stage.
• Maintained open communication through regular stand-ups and weekly syncs.
• Treated implementation as a collaborative transformation, not a handoff.

This model helped Nascentia stay on schedule and ensure compliance remained central. “It was a true partnership from the beginning,” said Davey. “We trusted each other and problem-solved in real time.”

3. Strengthen internal capacity early

From the outset, Nascentia prioritized sustainability by employing a “train-the-trainer” approach. This strategy empowered internal champions to manage configuration, updates, and training well beyond go-live. This focus included the following results:

• 20 internal champions trained
• 90% of configuration changes now handled in-house
• Approximately 7 full-time equivalents (FTEs) saved through automation and efficiency gains

Implementation Best Practices:

• Provided hands-on training and documentation during implementation to build lasting in-house expertise.
• GuidingCare’s configurable technology enabled quick workflow and form updates without HealthEdge support, supporting internal capability rather than vendor dependence.
• Paired plan leaders with HealthEdge subject matter experts to ensure smooth knowledge transfer.

4. Select a partner with proven regulatory experience

Nascentia needed a technology partner that understood New York’s Medicaid and LTSS environment, including Department of Health (DOH) requirements for Uniform Assessment System (UAS) assessments, Person-Centered Service Plan (PCSP) workflows, and SmartComm letters. HealthEdge brought deep experience in state-specific mandates and a proven record of compliance-ready implementations.

Implementation Best Practices:

• Used pre-built, audit-tested assets aligned to the Centers for Medicare & Medicaid Services (CMS), the National Committee for Quality Assurance (NCQA), and state requirements.
• Leveraged HealthEdge’s Regulatory Change Management Model, which tracks mandates and crosswalks them to product capabilities.
• Offered transparency through the HealthEdge Trust Portal, with SOC2, HITRUST, and HIPAA documentation accessible to the health plan and auditors.
• HealthEdge maintains a regulatory pipeline incorporating learnings from emerging changes and customer advisory boards.

Choosing a partner with deep regulatory expertise allowed Nascentia to reduce implementation risk and accelerate go-live—achieving a timeline “about 40% faster than the industry average,” according to Davey.

5. Track early wins and share them across the organization

Nascentia measured and shared progress from day one, building internal momentum. Early wins—like improved audit readiness and faster updates—reinforced the platform’s value across teams. Outcomes achieved include:

• 15% increase in nurse capacity
• Reduced burnout and manual workload
• Real-time adaptability to DOH guidance changes
• Seamless integration across lines of business

Implementation Best Practices:

• Defined early success metrics tied to compliance, efficiency, and user adoption.
• Shared dashboards and reports with leadership to maintain visibility and confidence.
• Continued optimization after go-live to build on early gains.

Nascentia’s success demonstrates how measurement and transparency foster engagement, ensuring that compliance improvement becomes an integral part of daily operations rather than just a project milestone.

A Model for Compliant Care Management Implementations

The partnership between HealthEdge and Nascentia showcases the transformative potential of embedding compliance into every layer of technology and teamwork. Starting with compliance, shared accountability, and measuring shared outcomes provide a clear blueprint for health plans who want to modernize their care management systems.

The lessons proven through this partnership validate HealthEdge’s best practices for implementation success, including:

• Embed compliance into design and testing.
• Operate under a one-team model.
• Empower health plan staff with configurable tools.
• Leverage regulatory expertise and prebuilt assets for rapid, compliant and effective implementation.
• Measure, communicate, and sustain improvement for material business improvement.

Compliance agility extends far beyond audit readiness. It serves as a protective foundation for the organization, strengthens teams, and enables better care delivery.

Want to watch the full discussion between leaders from Nascentia and HealthEdge? Watch the webinar on-demand: “Care Management Software Implementation Best Practices.”