Stay current on industry specific topics with Softheon’s in-depth reports. Find out how current events impact your insurance plan offerings.
Using Advanced Analytics to Predict Member Terminations and Inform Retention Strategies Webinar
Paul Wingle, the Vice President of Individual & Family Plans at Aetna/CVS Health, and Kevin Deutsch, General Manager and Senior Vice President of Health Plan Cloud at Softheon, share how carrier-vendor partnerships are needed for a successful transition into the ACA Marketplace.
ACA Predictive Analytics Report
Examining 2021 Billing and Enrollment Data to Accurately Predict Terminations and Inform Retention Strategies in 2022.
Marketplace Shopping, Enrollment, and Billing RFP Guide for Health Plans
In this guide, Softheon poses relevant questions that health plans must ask during the procurement process to secure robust and scalable billing and enrollment solutions.
How to Seamlessly Enter the Expanded ACA Marketplace
The Supreme Court promotes expanding the Affordable Care Act (ACA) as a priority, potentially causing a boom in ACA membership due to an increase in subsidies and overall stability.
HIX 3.0 – Sustainable Information Technology and Operations Solutions for State-Based Marketplaces
In response to most Marketplaces experiencing a raft of technical problems since their launch in 2013, several states are taking action to improve their operations and IT infrastructures and reduce operating costs by transitioning to a new class of vendors. Exchange Operators, offer robust marketplace IT solutions on a software-as-a-service (SaaS) basis. Learn how leveraging Exchange Operator solutions can benefit State-Based Marketplaces (SBM).
Enhanced Direct Enrollment: the Evolution of the Consumer Experience
In our new whitepaper written by Jane Good, Founder, JGood Advisors, we will be discussing the benefits of future of Enhanced Direct Enrollment (EDE). EDE eliminates the “double redirect” to HealthCare.gov, using a series of CMS-based APIs to process eligibility and changes behind the scenes. EDE provides consumers and health insurance brokers with alternatives to shop for and enroll in coverage, providing the data and tools needed to effectuate and maintain policies.
A Formula for Success: the Future of Technology Maturity Improvement
The United States’ Centers of Medicare & Medicaid Services (CMS) Medicaid programs are undergoing major technological shifts. With the implementation of Medicaid Information Technology Architecture (MITA), states are struggling to move forward with integrations and configurations with technology. Prepare for the future of Medicaid technology.
Take a look at Softheon’s quick breakdowns of trends and changes in the industry.
Overview the guardrails, application requirements, and state alterations the 1332 Waiver allows. Some details discussed include: state adoption and implementation, how the ACA’s basic protections will be retained, and the standards health insurance marketplaces must live up to.
Quick Facts: Section 1115 Medicaid Waivers
Learn what reforms states can implement, what constraints states are under for changing Medicaid rules, and which states have approved or pending 1115 Waivers.
For Robust Data Verification, Get Verify
Medicaid agencies prevent fraud and abuse with Softheon's Enhanced Eligibility solution. Agencies reduce costs and ensure program integrity because Softheon leverages robust data partners, risk scores, and integrations with State systems to ensure eligible individuals receive their benefits quickly.
Learn more about health savings accounts (HSAs) and gain insight into why Health Plans should begin viewing HSAs for members the same way employers view 401ks for employees; make contributions on their behalf.
Small Group Enrollment & Billing: Solutions & Challenges
Today’s administration of the small group market is burdened with cumbersome, manual processes and outdated technology. Manual processes can be replaced with cloud-based digital solutions that integrate with a carrier’s current IT infrastructure. Learn how Softheon can help address common challenges.
Connecting the Medicaid & ACA world
In today’s digital era, government agencies are not just buying software, they are investing in higher levels of technology maturity for the enterprise. Softheon’s MITA-aligned, HIPAA compliant financial management service helps state agencies achieve this high level of technological maturity.