HealthEdge Software Completes Acquisition of Altruista Health

Combination creates leading next-generation payor technology company spanning claims adjudication, payment integrity and care management

HealthEdge Software, provider of the industry’s leading integrated financial, administrative, and clinical platform for health insurers, HealthRules Payor, announced it has completed the acquisition of Altruista Health. 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.

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“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.

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“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.”

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