Hudson Health Plan Selects HealthEdge to Bring a New Level of Agility to Its Core Claims and Administration Platform

New York Medicaid plan to leverage the HealthRules® Product Suite to drive product and service innovation

BURLINGTON, Mass.--(BUSINESS WIRE)--HealthEdge®, provider of the only modern, enterprise-class software platform for healthcare payors, today announced that Hudson Health Plan (Hudson) of Tarrytown, N.Y. has selected the HealthRules software suite as its new core claims and administration platform. Hudson chose HealthRules, after a rigorous review process, to drive new levels of agility, compliance and transparency throughout its organization.

“HealthRules provides us with a next-generation software platform that gives us the speed, flexibility and ease-of-use that will enable us to help our providers by processing claims efficiently”

The healthcare payor market is currently undergoing a period of unprecedented change, and payors must navigate among various market forces and government regulations as they adapt to the rapidly evolving health insurance landscape. After struggling with legacy systems that were negatively impacting its ability to meet its goals, Hudson decided to transform its core administrative platform to enable the not-for-profit organization to continue its mission of providing access to innovative, high-quality health services to its members while continuously adapting to changing New York Medicaid regulations. Hudson also recognized the need to automate manual operations, a move that would save the health insurance industry billions of dollars that are currently wasted on administrative costs every year.

“HealthRules provides us with a next-generation software platform that gives us the speed, flexibility and ease-of-use that will enable us to help our providers by processing claims efficiently,” said Georganne Chapin, President and CEO of Hudson Health Plan. “Our use of HealthRules will allow us to lower administrative costs and reduce manual operations, so that we can redirect resources to fund the innovative quality-improvement programs for which we are known.”

Hudson is a community-based health care organization providing state-sponsored Medicaid Managed Care, Child Health Plus and Family Health Plus insurance coverage to more than 115,000 members in New York’s Hudson Valley Region. In addition to selecting HealthEdge and the HealthRules Platform, Hudson also chose Click-4-Care, a highly configurable, member-centric care management system for physicians, payors and their members. Combined, HealthEdge and Click4Care provide a comprehensive product suite designed to help organizations streamline interactions with members, analyze health information and link everyone involved in the healthcare delivery cycle.

“Hudson Health Plan has recognized the need to adopt new technology in order to successfully operate in the 21^st century healthcare system,” said HealthEdge CEO Rob Gillette. "We are confident that its implementation of HealthRules will enable the organization to dramatically enhance operational efficiencies and significantly increase its agility.”

About Hudson Health Plan

Hudson Health Plan is a community-based not-for-profit health care organization that provides state-sponsored Medicaid Managed Care, Child Health Plus, and Family Health Plus insurance coverage to over 115,000 members in New York’s Hudson Valley. Hudson uses every government dollar it receives to fulfill its mission, which is “to promote and provide access to excellent health services for all people.” Hudson improves the health of its members and the communities in which they live through its innovations in care coordination, and by supporting over 5,000 local health providers. Hudson received the national 2012 Medicaid Health Plan Innovation Award for its Westchester Cares Action Program, an innovative integrated care management project. In both 2009 and 2010, Hudson achieved the highest quality incentive scores of any Medicaid plan in New York State, and in 2010, it received the highest overall performance rating of any Medicaid plan in the Hudson Valley. It also has earned the highest ratings in overall satisfaction among Medicaid Managed Care members in the Hudson Valley region every year since 2003. Hudson Health Plan is based in Tarrytown, N.Y. Visit Hudson on the Web at www.hudsonhealthplan.org, and follow us on Facebook and Twitter.

About HealthEdge

HealthEdge® provides the only modern, enterprise-class software platform for healthcare payors. Using the patented HealthRules® software suite, health plans, health insurance companies, and other payors can finally respond to new business opportunities and market changes in hours, not months or years, while drastically reducing both IT and operational costs. Leveraging an investment of over $125 million, HealthRules is the most modern, scalable, and cost-effective technology in the industry. HealthEdge is the only choice for payors to survive and thrive in the emerging healthcare economy. For more information, visit www.healthedge.com.