Combination creates leading next-generation payor technology company spanning claims adjudication, payment integrity and care management
BURLINGTON, Mass. & RESTON, Va.–(BUSINESS WIRE)–HealthEdge Software, Inc.® (“HealthEdge”), provider of the industry’s leading integrated financial, administrative, and clinical platform for health insurers, HealthRules Payor®, today announced it has completed the acquisition of Altruista Health, Inc. (“Altruista”). Since 2007, Altruista’s cloud-based enterprise care management platform, GuidingCare®, has been used by health plans to streamline care management workflows, facilitate coordination among clinical, behavioral and community resources, accelerate quality improvements, and promote engagement with their members.
Altruista marks HealthEdge’s second significant and highly synergistic acquisition in 2020, following The Burgess Group, the first solution to natively bring together claim payment automation with business intelligence, enabling a unified approach to ensure payment accuracy. Altruista offers customers a highly configurable set of comprehensive modules delivered as a SaaS solution spanning care management, utilization management, population health, appeals and grievances, medication therapy management, member engagement and reporting and compliance. HealthEdge has provided care management and utilization management software integrated with HealthRules Payor® since 2012, and acquiring Altruista amplifies the existing portfolio.
“I’m thrilled to welcome Ashish Kachru, his executive team, and the nearly 550 Altruista employees to HealthEdge,” said Steve Krupa, CEO of HealthEdge. “By adding GuidingCare® to our platform, we are able to provide our customers with a unique value proposition of claims processing enhanced with software-driven payment integrity at the point of service that feeds data to an end-to-end care management solution that can extract critical insights in near real-time to care delivery teams. I’m proud of our care management team’s accomplishments and believe that Altruista is a perfect complement to offer existing and new customers a complete solution with broad functionality.”
Altruista serves approximately 30 customers representing over 16 million members and has developed deep expertise serving complex patient populations across Managed Medicaid and Medicare Advantage plans. The combined company serves over 90 unique health plan customers across Commercial and Government lines of business.
“For nearly 15 years, Altruista has been at the forefront of providing care management software that drives significant improvements in cost savings and health outcomes for all populations,” said Ashish Kachru, CEO of Altruista. “By combining forces with HealthEdge, we can offer our customers optimal claims and utilization management matching across the network, along with a near real-time interface for updating eligibility, enrollment, and provider data. Customers will benefit from seamless out-of-the-box implementations for GuidingCare® and HealthRules Payor®, as well as future product upgrades and releases delivered in concert.”
Ram Jagannath, Chairman of HealthEdge and Global Head of Healthcare for Blackstone Growth and Tactical Opportunities, added: “The acquisition of Altruista is a great strategic fit for HealthEdge, and fortifies its position in the $1.6 billion care management software industry growing approximately 15% per year. Our continued investment in HealthEdge is a testament to our conviction in the company’s ability to build an unparalleled set of innovative and mission-critical technology assets for payors.”
TripleTree, LLC served as financial advisor and Debevoise & Plimpton LLP was legal advisor to HealthEdge and Blackstone. McDermott Will & Emery LLP served as legal advisor to Altruista and Martis Capital. Terms of the transaction were not disclosed.
HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite, HealthRules, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. In 2020, HealthEdge was acquired by Blackstone. HealthEdge’s portfolio includes HealthRules Payor®, HealthRules CareManager®, and Burgess Source®. Follow HealthEdge, on Twitter @HealthEdge or on LinkedIn.
Altruista Health delivers care management and population health management solutions that support value-based and person-centered care models. Its GuidingCare® technology platform integrates care management, care coordination and quality improvement programs through a suite of sophisticated yet easy-to-use web applications. GuidingCare® is the largest and most widely adopted platform of its kind in the United States. Founded in 2007 and headquartered in the Washington, D.C. area, Altruista Health has grown into a recognized industry leader, and was named twice as one of the Top Population Health Management Companies to Know by Becker’s Healthcare. Health plans and healthcare providers use GuidingCare® to transform their processes, reduce avoidable expenses and improve patient health outcomes.
Blackstone is one of the world’s leading investment firms. We seek to create positive economic impact and long-term value for our investors, the companies we invest in, and the communities in which we work. We do this by using extraordinary people and flexible capital to help companies solve problems. Our asset management businesses, with $584 billion in assets under management, include investment vehicles focused on private equity, real estate, public debt and equity, growth equity, opportunistic, non-investment grade credit, real assets, and secondary funds, all on a global basis. Further information is available at www.blackstone.com. Follow Blackstone on Twitter @Blackstone.