Case Studies

Case Study: Modernizing with HealthEdge® to Drive Expansion

Case Study: Modernizing Care Management and Operations with HealthEdge® Solutions

The rapidly growing health plan’s strategy included expansion into a new line of business that would serve the Highly Integrated Dual Eligible (HIDE) and Fully Integrated Dual Eligible (FIDE)...

Case Study: Health Plan for Large Metropolitan Area Transforms Care and Operations with HealthEdge® Solutions

Case Study: Empowering Innovative Healthcare with Integrated HealthEdge® Solution

An innovative regional healthcare company had made numerous rapid business pivots that show remarkable agility.

Case Study: Digital Health Improves Care Transitions For Members With Multimorbidities

Demonstrating the value of digital health with a new methodology

A large Blues plan uses Wellframe Digital Health Management to Drive Care Management Capacity and Member Engagement

Report: Digital Care Management can help lower blood pressure by more than 9%

Report: Digital Care Management can help lower blood sugar by more than 25%

Case Study: Improving Maternal Health Outcomes Through Digital Engagement

The Wellframe Maternal Health program reimagines member relationship, resulting in measurable value.

HealthRules Payer Case Study with Presbyterian

HealthEdge had the opportunity to sit down with Presbyterian Health Plan leadership to learn more about why their organization decided to make the switch to HealthRules Payer as it's CAPS partner.

Case Study: VillageCare

Case Study: Managing Payment Complexity to Improve Operational Efficiency

Case Study: Regional Non-Profit - Leveraging Source for Efficient Claims Audit & Inquiry

Case Study: Denver Health Medical Plan Customer Spotlight

Member populations have escalating needs. Meanwhile, digital healthcare and care management solutions have created an opportunity for big returns on care management dollars.

Case Study: HealthRules® Promote Empowers Medica Health Plan to Streamline Processes

Large non-profit health insurance provider helps create a more efficient way to manage complex configurations and multiple instances of HealthRules Payer.

Case Study: Elderplan uses HealthRules® Payer to Lower Administrative Costs

Today’s health plans have less money to reinvest in critical areas such as innovation, member satisfaction, care coordination, and new lines of business.

Case Study: Non Profit Midwestern Health Plan

A non-profit midwestern health plan faced a unique challenge in moving its million-plus members to a single care management platform.

Case Study: Easing Healthcare Preauthorizations - Priority Health

New Authorization Portal speeds approvals and boosts provider satisfaction