Case Studies

Case Study: How One Regional Health Plan Created a Member-Centric Digital Ecosystem

Health plan executives are pursuing integrated platform solutions that provide better access to data, leading to better member outcomes.

Case Study: SummaCare's Secret to Payment Integrity Success

Learn about SummaCare's journey to streamlined operations, improved payment accuracy, and enhanced provider transparency.

Case Study:Transforming Payment Accuracy and Operational Efficiency at a Large National Health Plan

Discover how one health plan enhanced efficiency, accuracy, and transparency through with HealthEdge Source.

Case Study: Medica Partners With HealthEdge To Improve Member Lives In The Moments That Matter

To streamline its administrative systems, Medica partners with HealthEdge through the use of HRP and GuidingCare

How HealthEdge®’s HealthRules® Payer Helped Medica Transform Claims Operations through Strategic Automation

Faced with growing administrative and medical cost pressures, Medica needed a solution to streamline its claims processing and improve efficiency across its operations.

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

Driving Care Management Capacity and Engagement with Wellframe Digital Health

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