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SOFTWARE (NON-INTERNET/MOBILE) | Healthcare Software
altruistahealth.com

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Founded Year

2007

Stage

Acquired | Acquired

Total Raised

$41.6M

About Altruista Health

Altruista Health provides customizable, patient-centric total population care management technologies and solutions. The company's services are used to streamline clinical and administrative processes, improve patient outcomes, and reduce avoidable healthcare costs.On December 29th, 2020, Altruista Health was acquired by HealthEdge. The terms of the transaction were not disclosed.

Altruista Health Headquarter Location

11800 Sunrise Valley Drive Suite 1100

Reston, Virginia, 20191,

United States

703-707-8890

Latest Altruista Health News

HealthEdge Brings Colorado Access Into a Modern, Integrated Core/Clinical Ecosystem to Streamline Key Health Plan Operations

Nov 16, 2021

November 16, 2021 01:29 PM Eastern Standard Time BURLINGTON, Mass.--( BUSINESS WIRE )--HealthEdge Software today said it is excited to upgrade long-time Altruista Health customer Colorado Access to a fully integrated ecosystem with the addition of HealthRules Payor® (HRP) to its operations via HealthEdge’s complementary Business Process as a Service (BPaaS) partner, UST HealthProof, a UST company. Colorado Access has relied on Altruista’s GuidingCare® care management platform to manage plan members for more than a decade, and is now poised for a major transformational effort to integrate the HealthEdge solution in core administrative processing. It will be one of the first health plans to adopt all three HealthEdge solution suites as it adopts Burgess Source® payment integrity software in 2022. “Colorado Access is one of the first of many health plans we expect to recognize the value of our fully integrated core/clinical solution going forward,” said Steve Krupa, HealthEdge Chief Executive Officer. “The unique value proposition that comes with integrating a health plan’s three most important value streams is becoming more apparent every day as plans push forward with value-based care.” HealthRules is the leading modern core administrative system for health plans driving more agility, efficiencies, compliance and innovation than any other solution on the market. The vision for an integrated payer “digital nervous system” became possible with the HealthEdge acquisitions last year of SaaS innovators, The Burgess Group and Altruista Health. Burgess offers a leading payment integrity solution for editing, pricing and modeling. Altruista leads the industry in utilization management, care management, population health, social determinants of health, provider collaboration, member engagement and predictive analytics. The new opportunity for Colorado Access came at contract renewal time for their incumbent provider of a core administrative processing system. The health plan found the prospect of moving to an integrated ecosystem intriguing. “When we learned about the acquisition of Altruista Health by HealthEdge at the end of 2020, we were excited,” said Paula Kautzmann, Chief Information Officer at Colorado Access. “This presented a great opportunity to explore what an integrated ecosystem could deliver for us, our members and providers.” “We serve our regional health plans with high quality, and our connected technology with the HealthEdge solution suite is a comprehensive yet cost-effective solution that reduces the need for customization and is proven to increase customer engagement and provider satisfaction,” said Raj Sundar, President, UST HealthProof. Colorado Access has used GuidingCare to close gaps in care, enhance quality and compliance, and automate clinical workflows on behalf of its 545,000 members since 2010. After a review, Colorado Access concluded they could achieve cost savings, better performance, streamlined operations and a better member experience in moving to an integrated model with HealthEdge. “We are really excited about the integration because it makes us more nimble,” said Kautzmann. “It gives us a way to leverage a 360-degree view of the member to more completely understand their needs and support them to optimal health. When our care management team see claims data in the care management environment, it gives them a chance to make preventive interventions that can improve a member’s health.” Kautzmann noted that there are cost savings and overall efficiencies with integration, including not having to maintain separate membership, provider and benefit systems. The payment integrity solution from Burgess also reduces the administrative burden associated with recovering provider overpayments. In an environment of rigorous public budgets, the new arrangement is a better deployment of resources. Colorado Access also opted to implement the new GuidingCare® Authorization Portal, which electronically streamlines the prior authorization process and eases the paper work burden between providers and the plan. Altruista introduced the Authorization Portal last year, generating sufficient utilization review data for one plan to actually reduce its list of services requiring preauthorization, reducing administrative burden and cost. Some 80 percent of services are auto-approved with the electronic tool, dramatically streamlining the process at the same time it aligns care with the world’s leading clinical guidelines. About Colorado Access As the largest and most experienced public sector health plan in the state, Colorado Access is a nonprofit organization that works beyond just navigating health services. The company focuses on meeting members’ unique needs by partnering with providers and community organizations to provide better personalized care through measurable results. Their broad and deep view of regional and local systems allows them to stay focused on our members’ care while collaborating on measurable and economically sustainable systems that serve them better. Learn more at coaccess.com . About HealthEdge HealthEdge ® offers the health insurance industry’s leading next-gen solution suit providing automation and seamless connectivity between all parts of a payer’s administrative and clinical systems. 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 is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. In 2020, funds managed by Blackstone became the majority owner. HealthEdge and its portfolio of mission-critical technology assets for payers, including Source ® and GuidingCare ®, are collectively driving a digital transformation in healthcare. Follow HealthEdge on Twitter or LinkedIn . About UST HealthProof UST HealthProof, a UST company, is on a mission to reduce administrative cost and play a role in shaping how the future of healthcare is delivered through consumer centricity. Our proven core admin solutions and business process-as-a-service (BPaaS) provide transparency, improve operational efficiency, break down operational barriers to scale and drive strategic growth. Contacts

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Expert Collections containing Altruista Health

Expert Collections are analyst-curated lists that highlight the companies you need to know in the most important technology spaces.

Altruista Health is included in 3 Expert Collections, including Value-Based Care & Population Health.

V

Value-Based Care & Population Health

649 items

The VBC & Population Health collection includes companies that enable and deliver care models that address the health needs for defining populations along the continuum of care, including in the community setting, through participation, engagement, and targeted interventions.

C

Conference Exhibitors

5,302 items

D

Digital Health

11,292 items

Technologies, platforms, and systems that engage consumers for lifestyle, wellness, or health-related purposes; capture, store, or transmit health data; and/or support life science and clinical operations. (DiME, DTA, HealthXL, & NODE.Health)

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