GuidingCare® Business Rules Designer
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How GuidingCare for Government Lines of Business and D-SNPs is a Game-Changer
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Value-based care aims to improve the quality and outcome for patients by linking provider reimbursement to the quality of care provided. Under this system, providers are rewarded for helping...
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When care teams are empowered with next-gen solutions, they can improve coordination and communication, increase member engagement, and ultimately help patients better manage their chronic conditions.
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Stuart Myer, Chief Information Officer, VillageCare, a community-based, not-for-profit organization in New York, recently joined HealthEdge leaders Christine Davis, Vice President, Product...
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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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In today’s world, health plans are challenged with improving care, reducing costs, and remaining compliant with ever-changing regulations. This is especially true when it comes to providing care...
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States have been passing legislation in recent years to address the complaints of providers that they are subject to too many prior authorization requirements in advance of patient treatment. This...
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COVID-19 has highlighted weaknesses in our healthcare system and shone a spotlight on fault lines, especially for the most clinically and socially vulnerable like the dual-eligible special needs...
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As the dual eligible population grows, Dual Eligible Special Needs Plans (D-SNPs) are also experiencing tremendous growth across the country. CMS reports that as of February 2022, D-SNPs are...
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Within Medicare Advantage (MA), there are Special Needs Plans (SNP) with specialty cohorts that provide coverage for members who qualify for both Medicare and Medicaid. The membership for these...
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The term composability has emerged as a popular topic among healthcare industry analysts and CIOs. But what does composability really mean and why should care management leaders care if they have...
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Historically, health plans were forced to choose between care management systems that offered best-of-breed functionality but required heavy involvement from IT and those that were missing key...
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Interoperability may be one of the most over-used words in healthcare. Everyone has their own definition of the term, and everyone says they do it. But when it comes to the role interoperability...
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The non-profit organization CAQH® has been issuing a steady drumbeat of reports over the years about how much money and time could be saved across the healthcare industry by switching transactions...
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Smokers, on average, die 10 years younger than nonsmokers. But that’s just one data point. What happens when you consider all the data that composes the fabric of a member’s health? When you...
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This infographic sheds a light on the key benefits GuidingCare has to offer- and what makes us different; from clinical expertise and operational efficiency to ease
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