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Blue Cross Blue Shield of AZ Case Study - Digital Solutions for a Modern Health Plan

Blue Cross Blue Shield of AZ Case Study - Digital Solutions for a Modern Health Plan

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GuidingCare® Business Rules Designer
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GuidingCare® Business Rules Designer

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GuidingCare Clinical Expertise Infographic

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Effective Care Management for a Complex Market

How GuidingCare for Government Lines of Business and D-SNPs is a Game-Changer

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The Many Dimensions of Value-Based Care

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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Empowering Health Plans to Advance Care Management with GuidingCare

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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Advancing Care Management Through Digital Transformation

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 Care Management

GuidingCare® offers health plans and providers easy-to-use, next-generation data integration and workflow management tools.

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Effective Care Management for D-SNPs

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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‘Gold Card’ Approach to Prior Authorization No Hurdle for HealthEdge

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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Impacts of COVID-19 on Care Management in the Dual-Eligible Population

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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Why Using Modern Technology is Critical to Serving the D-SNP Population

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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State of the D-SNP Market

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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What does composability mean for care management… and why should I care?

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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3 Interoperability Must-Haves for Modern Care Management Systems

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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The True Meaning of Interoperability for Care Management

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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New CAQH Reports Offers Pandemic Perspective On Adoption Of Electronic Processes

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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Improving member health with predictive risk modeling

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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GuidingCare Continuum of Care

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Top 9 Reasons More Payers Choose GuidingCare Than Any Other Care Management System

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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Leading with Clinical Expertise

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