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Artificial Intelligence
Data
Payer
Payers: Is Your Data Ready for AI?
Payers are handling massive volumes of data, but few are truly prepared to harness its power for AI transformation. This eBook offers a comprehensive look into how payer organizations are navigating the challenges of AI adoption and what it takes to establish a strong data foundation. Unlock expert insights from Emids and start building a trusted foundation for AI in your organization.
Blog
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Member Engagement
Payer
Digital for All: Why Accessibility Is the Missing Link in Member Engagement
It’s no secret amongst payer executives that digitally engaged members are more likely to schedule preventive care appointments, adhere to prescribed treatments, and are more likely to avoid costly emergency interventions and experience better health outcomes, overall. This enables payers to also reap substantial benefits – particularly in efficiency, cost management, and long-term profitability. As […]
eBook
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Payer
Healthcare Payer Trends Outlook 2025
The healthcare payer landscape is evolving rapidly, shaped by technological advancements, regulatory shifts, and changing consumer expectations. In our 2025 Healthcare Payer Trends & Outlook, we cover actionable insights to navigate these transformations, enhance member experiences, and drive operational excellence. Whether you’re strategizing for the year ahead or looking to stay competitive, this report provides the intelligence you need.
eBook
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Payer
Strategy
Reducing Medical Loss Ratio and Enhancing Member Care
Discover how BCBS organizations can reduce Medical Loss Ratio and enhance member care while managing rising healthcare costs and growing regulatory demands. This exclusive eBook by Emids offers actionable strategies across five key pillars—operational efficiency, MLR optimization, interoperability, member engagement, and compliance. Learn how to optimize costs, improve member satisfaction, and drive sustainable growth.
Blog
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Artificial Intelligence
Low-Code
Payer
Bridging Cost Optimization and Innovation with Low-Code and AI
Healthcare payers face the dual challenge of enhancing member services while reducing operational costs in an ever-evolving tech landscape. While many turn to digital solutions, such transformations can be costly and time-consuming. At Emids, we help you leverage low-code platforms to unlock AI’s potential, streamlining operations and improving care delivery—faster and at a fraction of […]
Blog
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Digital Transformation
Low-Code
Payer
Low-Code, High Impact: Transforming Payer Operations and Member Engagement
For payers, the balance between operational efficiency and rapid innovation has always been a delicate one. Traditional development approaches can be slow, costly, and inflexible, creating a gap between what payers aspire to deliver and what current processes allow. Low-code platforms, however, offer a transformative solution—an approach that promises not only to close this gap […]
Blog
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Generative AI
Payer
Generative AI in Payer Operations: Reshaping Efficiency and Member Satisfaction
As health plans look to implement, optimize, or modernize their core administrative platforms and integrated systems, Generative AI presents a compelling opportunity to drive efficiency and elevate customer satisfaction. But what exactly is Generative AI, and how can payers harness its capabilities to enhance their operations? Once considered a cautious tech adopter, healthcare today is […]
Blog
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Automation
Payer
Transforming Healthcare Payer Operations with Intelligent Automation
Healthcare payers face mounting challenges as they strive to meet regulatory requirements, manage costs, and maintain quality service. Regulatory changes and the recalibration of Star ratings by CMS directly impact revenue streams and reputational standings. Meanwhile, healthcare costs continue to rise due to medical inflation and increased service demand, putting further strain on operational budgets. […]
Case Studies
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Automation
Payer
Quality Assurance
Accelerating Quality and Efficiency: A QA Transformation Journey for a Leading Health Plan
Challenge A prominent health plan serving millions of members faced multiple, interrelated challenges that were impacting its efficiency and profitability. Key among these was a lengthy end-to-end (E2E) and user acceptance testing (UAT) cycle that extended up to eight weeks per release. This drawn-out testing period meant the health plan could only manage three production […]
Case Studies
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Automation
Payer
Transforming Operations with Intelligent Automation for a Leading Health Plan
Challenge A leading health plan with millions of members faced significant operational inefficiencies due to manual processes across multiple departments. These inefficiencies were time-consuming, hindered service quality, and negatively impacted the organization’s bottom line. Key areas such as Claims, Care Management, Enrollment & Billing, and Pharmacy Benefit Management were experiencing bottlenecks, leading to delays, higher […]
Blog
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Core Platforms
Payer
Optimizing Claims Workflows: Are Inefficiencies Costing Your Health Plan Money?
How 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
Healthcare 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.