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Case Studies

Review plan benchmarks and best practices with case studies from Softheon’s partners

Find out how your health plan can benefit from industry innovation.

Provider-Sponsored Plan Enters Multiple Markets in Under 2 Years

Members demand a simpler healthcare shopping and management experience. But regional and provider-sponsored health plans are tasked with doing more with less.

Discover how one provider-sponsored plan used one platform to enter the Medicare Advantage (MA) market and expand their ACA footprint.

Navigating the FFM to SBM Transition

Change, even when it’s positive, can be intimidating. It’s crucial to have the right partners in place to make difficult transitions easier.

Discover how a national health plan shifted its shopping, enrollment, and billing processes from a FFM to SBM state while cutting down on administrative tasks.

Warp Speed ACA Entry and Expansion

Be prepared to serve members at every step of their journey, even between coverage types.

Learn how one Medicare Advantage plan was able to break into new markets in only 6-weeks with Softheon.

Achieving a Membership Growth Rate 300% Above the National Average

Industry-wide ACA growth means that plans that can’t increase their effectuation and renewal rates will soon be outclassed.

Learn how one ACA plan was able to overcome challenges through a 5+ year partnership with Softheon.

Going from Over 10K to Nearly 1M Members

One carrier avoided costly mistakes that hurt plans that were surprised by their own success in the past.

Read how they grew from tens of thousands to nearly a million members, a growth rate of over 2,400%.

Automated Marketplace Premium Billing and Payment Solution

A health plan identified that its manual approach to payments was negatively impacting growth. Inaccurate and late invoices, reconciliation delays, and a lack of oversight resulted in member abrasion.

Read how the Texas plan utilized a off-the-shelf (OTS) billing and payment solution to grow its membership exponentially.