HealthEdge, Rising from the Ashes of DeNovis, Reaps Benefits from Healthcare Reform

People who paid close attention to the healthcare reform debate know that it was really about bringing sweeping changes to health insurance in the United States. It includes all kinds of new laws about who is eligible for coverage and other health benefits. For Burlington, MA-based HealthEdge, the legislation has created a new reason for health insurance firms and other outfits that pay for care to adopt its technology, according to Rob Gillette, the firm’s co-founder and CEO.

Even before healthcare reform passed this year, HealthEdge was gaining new business from health insurers who were trying to keep up with demand for customized health plans for employers. Long gone are the days when the only differences between health plans were the amounts of co-pays required of subscribers at the doctor’s office and the pharmacy. Today, it’s not uncommon for a health plans to come with a special savings account (also called a health savings account, or HSA), varying deductibles, and incentives for staying fit, among other things. HealthEdge provides the software and technology for the insurance companies to rapidly design such health plans to the specifications of the employers they serve.

What healthcare reform has done in the past several months is dial up the need for insurers to quickly adjust their offerings to comply with the new laws. For example, insurance firms will need to reconfigure their plans to comply with a new reform that allows young adults to stay on their parents’ insurance until they turn 26 years old. To hear Gillette describe it, this one provision alone could keep an insurer’s programmers busy for months to reconfigure their core systems. Yet HealthEdge reduces the time to make such adjustments from months to hours because of its unique programming rules that are designed to let programmers make changes easily.

“There was a bit of a quiet time while people were waiting to see what was going to happen in the [healthcare] reform legislation,” Gillette says. “Since its passage, business has gone … Next Page »

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