BURLINGTON, Mass.--(BUSINESS WIRE)--HealthEdge®, provider of the only integrated financial, administrative and clinical platform for health insurers, and Remedy Partners, the nation’s leading bundled payment company, today announced a collaboration to deliver a transformational platform to the market, capable of administering an entirely new category of health insurance benefit plan based on episodes of care and bundled payments.
This innovative offering provides a turnkey opportunity for payers, large self-funded employers and third party administrators to underwrite, sell, and/or administer episodes of care-based commercial products. The platform may be offered as a part of a comprehensive business process outsourcing (BPO) package or as a standalone platform for customers to independently manage the administration of episode of care plans.
“Bundled payments and episodes of care are part of the new reality of value-based reimbursements today,” said Steve Krupa, CEO of HealthEdge. “They will become even more important in the future and we are pleased to partner with the leader in the field, Remedy Partners, on this innovative offering.”
“Remedy Partners and HealthEdge are putting our combined domain expertise together for the benefit of health plans, TPA’s and large self-funded plans,” said Carolyn Magill, CEO of Remedy Partners. “We are jointly empowering our customers to offer innovative benefit plans that achieve the price points of narrow network products, while preserving a wide range of provider options and choice.”
This program offers a highly configurable, best-in-class technical platform for end-to-end administration of episode of care benefit plan designs, including group/member enrollment and eligibility maintenance; medical claims processing (both episode and non-episode claims); prior authorization and medical review; customer support for employers, providers and members; provider network maintenance and reimbursement and premium billing.
About HealthEdge
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. Our next-generation enterprise solution suite, HealthRules®, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. An award-winning company, HealthEdge empowers health insurers to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit http://www.healthedge.com.
About Remedy Partners
Remedy Partners delivers software and services that enable payers, employers and at-risk providers to organize and finance health care delivery around a patient's episode of care. For healthcare providers, Remedy’s software, analytics and administrative services support bundled payment contracts with Medicare and Commercial Insurers, often through shared-risk partnerships. For payers, Remedy empowers the development of bundled payment contracting programs and guides development of bundled payment networks. Remedy presently delivers its services to partners at more than 1,000 health care locations nationwide.
