HealthEdge Closes Acquisition Deal With Altruista Health

Medical care management platform HealthEdge Software is acquiring the cloud-based healthcare solutions firm Altruista Health for an undisclosed amount.

HealthEdge’s HealthRules Payor solution will complement Altruista’s GuidingCare tool to streamline healthcare management functions and coordinate resources, the companies said in a press release on Tuesday (Dec. 29).

“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,” said Steve Krupa, CEO of HealthEdge. He added that Altruista “is a perfect complement” that will deliver a “complete solution” for new users and existing clients.

Altruista offers customizable software-as-a-service (SaaS) solutions that streamline healthcare management, from appeals and grievances to compliance and reporting.

Based in Massachusetts and founded in 2004 by Rob Gillette, HealthEdge strives to connect all stakeholders in the healthcare delivery cycle. HealthEdge was acquired by the global investment firm Blackstone earlier this year. The newly combined firm will service more than 90 unique health plan customers.

Headquartered in Virginia, Altruista was co-founded in 2007 by Ashish Abraham, MD, and Ashish Kachru, who serves as CEO. The company works with about 30 customers representing more than 16 million members, and has special expertise in managed Medicaid and Medicare Advantage plans.

“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 Kachru. “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.”

PYMNTS’ Deep Dive in June took a look at the pandemic’s impact on telehealth and digital healthcare payments. Telehealth use is forecasted to grow more than 64 percent by the end of this year.