Payer
Blog
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Core Platforms
Payer
Optimizing Claims Workflows: Are Inefficiencies Costing Your Health Plan Money?
Oct 29th, 2024How Well Do You Know Your Data? Is It Costing You Money? Health plans operate in a complex environment where every claim tells a story. But how well do you truly understand that story? The reality is that inefficiencies in claims processing could be costing you more than you realize. Start by evaluating key metrics: […]
eBook
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Payer
Strategy
Sustainable Cost Optimization for Payers: Unlocking Efficiency and Growth in Healthcare
Oct 25th, 2024Healthcare payers face mounting challenges balancing rising costs, regulatory demands, and member expectations. Learn how to optimize Medical Loss Ratios (MLR), modernize outdated systems, and consolidate data for smarter decision-making. Packed with insights from Emids’ 30+ years of healthcare transformation expertise, this eBook provides the tools to future-proof your organization and drive sustainable growth.
eBook
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Core Platforms
Payer
Healthcare Payers at Risk: Fixing Broken Core Administrative Systems for Future Growth
Oct 12th, 2024Discover how healthcare payers can overcome outdated CAS challenges, streamline operations, and turn integration gaps into growth opportunities. This exclusive eBook by Emids offers actionable strategies for market expansion, claims optimization, and system upgrades to drive efficiency and ensure compliance.
Case Studies
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Cloud
Payer
From On-Prem to Google Cloud for a leading US Healthcare Player
Jul 11th, 2024Challenge A prominent healthcare organization in the USA, managing diverse business lines including retail, pharmacy, health insurance, managed healthcare, and population health management, sought to modernize its data ecosystem. The goal was to transition from on-prem systems to the Google Cloud Platform (GCP) to leverage the full potential of their data, enhance scalability, and streamline […]
Case Studies
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Cloud
Payer
Cloud Migration and CMS Interoperability for a Leading HMO
Jul 11th, 2024Challenge A non-profit Health Maintenance Organization (HMO), wanted to modernize its IT ecosystem. This included a crucial migration to the cloud, constructing next-generation data platforms, and upskilling their workforce to support their growth trajectory. They were also driven by the need to comply with the Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient […]
Case Studies
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Data Engineering
Featured
Payer
Transforming IT Infrastructure for a Top-Tier Healthcare Company
Jun 5th, 2023One of the largest healthcare companies in the Fortune 500 approached Emids with a vision for a modern IT ecosystem. They found themselves in a situation where their IT infrastructure and capabilities were not scalable to support their rapid growth. These infrastructural shortcomings were not merely internal roadblocks. They directly impacted the customer experience and […]
Case Studies
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Data Engineering
Payer
Enterprise Data Platform Implementation for Leading Payer
Mar 17th, 2023The Emids customer is a leading payer—with nearly 47 million members operating across the commercial, Medicare, and Medicaid markets—focusing on whole-person health for improving outcomes. The customer had developed and acquired applications across their business, primarily leveraged for internal use with a few external clients. They saw a market opportunity to commercialize these apps for […]
Case Studies
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Featured
Insights
Payer
Humana’s Low-Code Partnership Approach to Rapid Digital Innovation
Jul 15th, 2022In an era of rapid digital healthcare innovation, Humana, the third largest health insurance company in the U.S. faced several challenges within its digital channels unit to rapidly bring new solutions to market. It was laden with complex architecture, which meant IT had to tread carefully, given the importance of safeguarding personal health information for […]
Case Studies
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Design-Led Engineering
Payer
Experience Design of a Direct-to-Consumer Care Portal
May 11th, 2022Emids worked with a top Fortune 500 payer organization, which aims to empower their over 100m members to live healthier lives. The organization wanted to complement its care advisors with a high touch, digital concierge experience for families experiencing complex care needs regardless of their health plans. The objective was to free up space for […]