HealthEdge Surpasses Decade Mark As A Sample Vendor For Next-Generation Core Administrative Systems In The Gartner Hype Cycle For U.S. Healthcare Payers, 2021

HealthEdge Software said it has been named a Sample Vendor for the Next-Generation Core Administrative Systems category in the Gartner “Hype Cycle for U.S. Healthcare Payers, 2021” ⁱ report for the 11th consecutive year. HealthEdge provides mission-critical HealthRules Payor® CAPS solution to healthcare payers. It enables them to seamlessly and efficiently administer benefits, configure plans, manage providers and enroll participants.

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As per the Gartner report, “Next-generation core administrative processing solutions (CAPS) enable payers to manage their enrollment, premium b******, claims processing, and payment operations more nimbly and with greater flexibility than existing legacy applications.” The Gartner report also states that, “solutions must meet the following criteria: support cloud delivery models; allow clients to configure policies and processing rules without IT intervention; decouple modular business functions and support third-party module integrations; enable value-based payment; and provide preconfigured and configurable interfaces.”

“This milestone comes at an especially significant point in our evolution as an organization,” said Steve Krupa, HealthEdge Chief Executive Officer. “We are poised for growth and innovation as we advance the first-ever, next-generation integrated solution suite for the three most important value streams within health plans. In addition, we are maximizing the strength of our CAPS solution by integrating it with the industry’s leading cloud-based technologies in payment integrity and care management with the HealthEdge acquisition of The Burgess Group and Altruista Health in 2020.”

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