Health Technology, Digital Healthcare

Innovative New Tool Empowers Unprecedented Health Plan Efficiency

Innovative New Tool Empowers

Next-generation healthcare SaaS company HealthEdge® today announced the release of a first-of-its-kind application that makes running a health plan faster and easier than ever. The web-based configuration management tool HealthRules® Promote is available to all HealthRules Payer customers.

Born from a unique collaboration between HealthEdge and Minnesota-based nonprofit health plan Medica, HealthRules Promote answers the need for a more efficient, accurate and worry-free way to manage complex health plan offerings across multiple lines of business.

In the midst of rapid expansion into eight new states, Medica turned to HealthEdge for help with an increasingly elaborate infrastructure. Together, they developed a powerful solution that gives plans the configuration agility to handle today’s dynamic healthcare demands. In its first year at Medica, HealthRules Promote supported more than 400 configuration projects and yielded an estimated $750,000 cost savings.

“For us, HealthRules Promote has been a game changer,” said Robb Tushie-Lessard, manager of configuration architecture, quality and business analysts at Medica. “We are able to empower our multi-user environments with the tools they need to implement new configurations with greater confidence and fewer issues. When we recently rolled our commercial plans onto the HealthRules Payer platform, we experienced zero configuration issues.”

Paired with HealthEdge’s next-generation core administrative processing solution, HealthRules Payer, HealthRules Promote enables health plan business analysts to promote and test configuration changes in minutes through a user-friendly interface. Leveraging automation, the application’s controlled workflow saves thousands of hours in manual effort and simplifies the process of updating validation policies, modifying fee schedules, restructuring benefit plans and launching new lines of business. A self-service design alleviates administrative burden and technical resources, empowering analysts to move configurations from testing to production environments without the need for Information Technology (IT) support. A comprehensive audit trail tracks changes automatically, increasing transparency and facilitating build review. Dependency and compare features reduce errors and allow analysts to identify issues with ease.

“HealthRules Promote makes health plans nimble and resilient to member, provider, regulatory and competitive pressures in the ever-changing healthcare landscape,” said Alan Stein, chief commercial officer of HealthEdge. “The solution provides unprecedented configuration and promotion integrity that helps HealthRules Payer customers grow, compete and realize maximum value from their core system at an accelerated pace.”

About HealthEdge

Innovating a world where healthcare can focus on people, HealthEdge® is driving a digital transformation through transaction automation and real-time business and clinical engagement among payers, providers and patients. The next-generation healthcare SaaS company provides an integrated ecosystem of advanced solutions for core administration (HealthRules® Payer), payment integrity (Source), care management (GuidingCare®) and member experience (Wellframe) that empower health plans to accelerate business, reduce costs and improve outcomes.

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