The Rawlings Group, Apixio Payment Integrity, and VARIS Merge to Form Next-Generation Payment Accuracy and Integrity Platform
The comprehensive, technology-enabled platform will leverage data and artificial intelligence to reduce healthcare costs for health plan clients
Together, the new company will have an expansive set of capabilities, including subrogation, coordination of benefits, pharmacy payment integrity, and complex claim solutions, to ensure payment integrity and will serve many of the largest health plans in
Administrative complexity is the top driver of excess spending in the US healthcare system, with this type of waste accounting for an estimated
With its capabilities, scale, proprietary technology, and artificial intelligence (AI) enablement, the company is uniquely positioned to meet payers’ growing demand for improved financial performance and quality. The combined entity’s differentiators include:
- Flexible delivery model: Only company in the market that allows clients to configure the platform to enable their internal payment integrity teams or work with a bench of clinical experts on a fully outsourced basis.
- Market leadership: Impacts over 160 million lives across more than 60 health plan clients, including many of the top 20 plans.
-
Meaningful financial outcomes: Over
$3 billion in total annual savings and cost avoidance generated through commitment to client service and quality. - Analytics-powered innovation: Over 500K proprietary algorithms, concepts, and analytic models to drive higher accuracy and efficiency.
- Deep subject matter expertise: Combined organization of over 1,900 technology, coding, legal, and clinical experts.
“This combination of payment integrity leaders will create value across the entire healthcare ecosystem,” said
“We are excited for the growth and innovation that this merger will enable, and the world-class talent ready to unlock value in new ways across the enterprise,” said Pierre. “We share a customer-first approach and are bringing together what we believe are the industry's best individual capabilities into one, data-rich platform, with the power of analytics to intervene earlier in the claims cycle to drive maximum ROI for our clients.”
As part of the transaction, Apixio’s Connected Care platform and value-based care solutions were acquired by Datavant.
About
About Rawlings
Rawlings, founded in 1977 and based in
About
About VARIS
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