HealthEdge Corporate

The Transformation Tipping Point: Why Health Plans Are Rethinking Operations

Health plans are heading into 2026 under a level of pressure that feels fundamentally different from just a few years ago. Findings from the HealthEdge® 2026 Healthcare Payer Survey Report, “The...

29 days ago

Executive Strategies for Balancing Costs and Quality for Health Plans

At HealthEdge®, we strive to understand the key challenges health plans face so we can help anticipate and address new market opportunities. Recently, HealthEdge Chief Strategy Officer, Raj...

about 1 month ago

Core System Modernization: Innovative Solutions for Cost Management and Member Health

Recently, the HealthEdge® Chief Solutions Officer hosted a discussion with four health plan executives to discuss how they’re using advanced, integrated technology solutions to enhance claims...

about 1 month ago

How AI-Powered Document Processing Transforms Provider Data Management

At HealthEdge®, our team understands that efficient provider data management is fundamental to delivering quality healthcare. Yet, the reality for many health plans is that maintaining accurate...

about 1 month ago

Unlocking the Future of Healthcare Technology: Interoperability, Transparency, and AI

At a recent executive roundtable, HealthEdge® brought together health plan leaders from across the U.S. to share their experiences and see how other organizations are addressing key challenges....

2 months ago

New Research: How Rising Costs and Regulatory Pressures Are Reshaping Health Plan Priorities

Rising costs. Relentless regulation. For health plans, the question isn’t whether these pressures are intensifying. It’s how to respond. According to new research from HealthEdge®, these twin...

2 months ago

From Petabytes to Practicality: Navigating the New CMS Transparency Rule

The Transparency in Coverage (TiC) final rules of 2020 promised a revolution in healthcare price transparency. The vision was bold: empower consumers with data to drive competition and lower...

2 months ago

How BPaaS and Technology Modernization Answer the Call for Health Plans in 2026

As health plans face mounting cost pressures and an increasingly complex regulatory landscape, one thing has become clear: incremental change is no longer enough. Today’s health plan environment...

10 days ago

Executive Summary: Payer Financial Modernization Is Real; Integrate and Interoperate Now for the Seamless Payer/Provider Future

How feasible are seamless core administration and interoperable data at the point of care, given the current provider workflows, interoperability challenges, and siloed incentives?

3 months ago

Top Challenges and Priorities in 2026 for Health Plans with Government LOB

The healthcare payer landscape is undergoing a seismic transformation, as revealed by the 2026 HealthEdge® Annual Payer Report. HealthEdge surveyed more than 550 health plan executives, including...

6 months ago

Migrating HealthEdge® Solutions to the Cloud with Amazon Web Services

At HealthEdge®, we are undertaking a structured migration of our systems to Amazon Web Services (AWS). This move reflects the ongoing evolution in healthcare, driven by the need for greater...

6 months ago

Scaling AI Thoughtfully: Behind the Scenes of the HealthEdge® GuidingCare Notes Summarizer

By Alice Zhan, AI team Part 2: Technical Implementation This is part two of a two-part blog series on HealthEdge’s AI Summarizer feature; this post focuses specifically on the feature’s technical...

7 months ago

Pivot or Fall Behind: Why OBBBA Readiness Defines the Future of Health Plans

The One Big Beautiful Bill Act (OBBBA) introduces far-reaching, fast-moving regulatory changes that demand adaptability from health plans. Some provisions are already in effect, while additional...

23 days ago

eBook: Decoding the One Big Beautiful Bill Act- A strategic Guide for Health Plans

The One Big Beautiful Bill Act (OBBBA) introduces sweeping changes to health plan eligibility and rural health care.

7 months ago

Health Plan Tactics for Medicaid Retention after the One Big Beautiful Bill Act (OBBBA)

Extensive legislative reform is shifting the healthcare landscape. The One Big Beautiful Bill Act (OBBBA) introduces significant changes to eligibility requirements across Medicaid, Medicare, and...

8 months ago

What Medicare, Medicaid, and Dual Eligible Members Want from Their Health Plan: Key Findings from the HealthEdge® 2025 Consumer Study

In today’s evolving healthcare landscape, understanding what members want and need is more important than ever. To uncover those insights, HealthEdge conducted its 2025 Healthcare Consumer Study,...

about 2 months ago

eBook: Moving to the Cloud with Confidence

8 months ago

How Health Plans Can Scale Engagement with AI (and Why It Matters)

Healthcare consumers are raising the bar for what they expect from their health plans. Members want experiences that are personalized, convenient, and responsive. Meeting these expectations across...

4 months ago

Building an AI-First SDLC: Lessons From Our Claude Pilot Program

Three months ago, I posed a question to our engineering leadership team: “What if we could use AI tools eliminate the mundane and amplify human creativity in every phase of software development?”...

10 months ago

Improve Care Coordination and Delivery with AI & HealthEdge GuidingCare®

Healthcare is undergoing a transformation, and artificial intelligence (AI) is a major part of this evolution. From improving diagnostic accuracy to transforming care coordination workflows, AI...

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HealthEdge Corporate

The Transformation Tipping Point: Why Health Plans Are Rethinking Operations

Executive Strategies for Balancing Costs and Quality for Health Plans

Core System Modernization: Innovative Solutions for Cost Management and Member Health

How AI-Powered Document Processing Transforms Provider Data Management

Unlocking the Future of Healthcare Technology: Interoperability, Transparency, and AI

New Research: How Rising Costs and Regulatory Pressures Are Reshaping Health Plan Priorities

From Petabytes to Practicality: Navigating the New CMS Transparency Rule

How BPaaS and Technology Modernization Answer the Call for Health Plans in 2026

Executive Summary: Payer Financial Modernization Is Real; Integrate and Interoperate Now for the Seamless Payer/Provider Future

Top Challenges and Priorities in 2026 for Health Plans with Government LOB

Migrating HealthEdge® Solutions to the Cloud with Amazon Web Services

Scaling AI Thoughtfully: Behind the Scenes of the HealthEdge® GuidingCare Notes Summarizer

Pivot or Fall Behind: Why OBBBA Readiness Defines the Future of Health Plans

eBook: Decoding the One Big Beautiful Bill Act- A strategic Guide for Health Plans

Health Plan Tactics for Medicaid Retention after the One Big Beautiful Bill Act (OBBBA)

What Medicare, Medicaid, and Dual Eligible Members Want from Their Health Plan: Key Findings from the HealthEdge® 2025 Consumer Study

eBook: Moving to the Cloud with Confidence

How Health Plans Can Scale Engagement with AI (and Why It Matters)

Building an AI-First SDLC: Lessons From Our Claude Pilot Program

Improve Care Coordination and Delivery with AI & HealthEdge GuidingCare®