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 today 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.

As per the Gartner report, “Next-generation core administrative processing solutions (CAPS) enable payers to manage their enrollment, premium billing, 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.”

Similarly, Burgess was named a Sample Vendor for the third consecutive year in the Gartner report for the Prospective Payment Integrity Solutions category for the Burgess Source® solution.

Disclaimer

ⁱGartner, Hype Cycle for U.S. Healthcare Payers, 2021, Bryan Cole, Jeff Cribbs, Mandi Bishop, 13 July 2021. Gartner and Hype Cycle are registered trademarks of Gartner, Inc. and/or its affiliates in the U.S. and internationally and are used herein with permission. All rights reserved. Gartner does not endorse any vendor, product, or service depicted in its research publications and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner’s research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

About HealthEdge

HealthEdge® is the health insurance industry’s first digital nervous system to provide automation and seamless connectivity between all parts of a payer’s administrative and clinical systems. HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. In 2020, Blackstone became the majority owner. HealthEdge and its portfolio of mission-critical technology assets for payers, including The Burgess Group and Altruista Health, are collectively driving a digital transformation in healthcare. Follow HealthEdge on Twitter or LinkedIn.

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