HealthEdge, a leading provider of next-generation core administrative processing systems (CAPS) and care management solutions, has announced its strategic move to Amazon Web Services (AWS) to accelerate its transformation into an AI-native enterprise. In collaboration with Loka, AWS’s 2024 Partner of the Year, HealthEdge will integrate generative AI and agentic systems into the fabric of its operations, infrastructure, and product suite.

Leveraging Amazon Bedrock, Loka will help HealthEdge build and scale AI applications that streamline internal workflows and enhance value delivery across the healthcare landscape. This initiative is designed to modernize HealthEdge’s digital capabilities and unlock efficiencies for both employees and customers.

Three Pillars of AI-Driven Transformation

  • Workforce Efficiency: HealthEdge is deploying AI tools across teams—engineering, finance, marketing, and more—with a target of automating 15% of current workloads within 12–18 months. The goal is to free up staff for higher-value activities, promoting AI literacy and laying the groundwork for future investment in AI-enabled tools.
  • Product Enhancements: AI will be embedded into the HealthEdge platform to empower health payer customers with intelligent tools. Enhancements include faster, more accurate, and touchless claims processing, and the use of large language models (LLMs) for improved user interaction and data accessibility.
  • AI and Agentic Platform: By building an AI-first infrastructure on AWS, HealthEdge ensures that its AI systems are scalable, secure, and high-performing. This backbone will support both internal efficiencies and the delivery of advanced features to customers through platforms like the HealthEdge Agent Lab, delivering agent-led workflows on a two-week sprint cycle.

“AI is unlocking opportunities we couldn’t have imagined just a few years ago, especially in a complex industry like healthcare,” said Robert Duffy, Chief Technology Officer at HealthEdge. “This collaboration with AWS and Loka positions us to lead the healthcare industry’s shift toward smarter, data-driven systems.”

Emily Kruger, CIO at Loka, emphasized the transformative potential of agentic AI, stating, “It’s not just automation—it’s adaptive intelligence that continuously learns and evolves, redefining how healthcare work gets done.”

Ben Schreiner, Head of AI and Modern Data Strategy Business Development at AWS, noted, “Amazon Bedrock empowers HealthEdge to unlock real-time healthcare insights, lower costs, and deliver more personalized experiences, all while adhering to strict security and compliance standards.”

This initiative is set to redefine how technology supports healthcare administration, providing scalable, AI-powered solutions that drive speed, precision, and patient-centered outcomes across the entire payer ecosystem.