This potential acquisition underscores Edifecs’ growth strategy to become an industry leader in risk adjustment. Health Fidelity offers risk-bearing organizations clear visibility for critical decision-making, and control over the process. Health Fidelity’s technology uncovers insights that enable better care planning and more complete revenue capture; giving health plans and providers the ability to succeed in risk-sharing arrangements across MA, ACA, Medicaid, and ACO programs.
“I recently shared the news that we acquired Talix, another risk adjustment-focused solution provider,” said Venkat Kavarthapu, CEO of Edifecs. “Each has unique and distinct capabilities which, when combined with our industry-leading workflows, will create a much stronger offering for all of our customers.”
Edifecs’ goal is to offer its customers the industry’s best natural language processing, workflow, and submissions solution, while rapidly expanding suspecting and financial analytics capabilities. The powerful combination of these technologies will enable Edifecs to provide a seamless risk adjustment solution without requiring its customers to pay for costly integrations and multi-vendor management overhead.
“In our analysis and diligence, it became clear that by combining the best of Edifecs’ existing risk adjustment portfolio with Talix, and potentially the complementary capabilities of Health Fidelity, we would be able to provide one of the most complete risk adjustment solutions in the market,” Sunny Singh, Edifecs founder and chairman of the board. “Through the prospective acquisition of Health Fidelity, we are hoping to strategically integrate the unique and distinct capabilities of all three organizations to create an unrivaled risk adjustment portfolio that will be able to deliver value at every stage in the risk adjustment process.”
Edifecs plans to integrate Health Fidelity and Talix technology into its signature Encounter Management solution to provide customers the opportunity to operate risk adjustment processes more efficiently for Medicare Advantage, Managed Medicaid, and Affordable Care Act (ACA) products. When the acquisition is complete, joint customers will have access to up-to-date claim and member information via Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs), highly scalable workflows, and mass actions that reduce the operational staff required to manage exceptions.
“This potential acquisition marks the beginning of a new, exciting chapter for Health Fidelity. Edifecs’ execution, service resources, and process strength, coupled with our innovative solution portfolio will be a powerful combination,” said Steve Whitehurst, CEO of Health Fidelity. “We evaluated dozens of potential partners and it quickly became clear that our respective expertise and combined resources will propel clients to realize new levels of excellence in their risk adjustment programs,” he added.
Edifecs is a premier technology company in the US Healthcare market with solutions focused on interoperability, workflows, value-based care payments, and analytics. With innovative technology and solutions, Edifecs helps its customers by optimizing the secure exchange and processing of administrative and clinical data, reducing the cost of meeting various regulations, and automating workflows involved in multiple core processes within the healthcare ecosystem. Edifecs is a frontrunner in bringing new technology for B2B data exchange in healthcare streamlining business processes from “card to care,” and reducing the industry burden associated with data provisioning at the points of enrollment, care, payment, and reporting. With the advent of FHIR and new regulatory guidance from HHS, Edifecs has emerged as a leader in easing the effort associated with achieving compliance with new federal rules and in making the healthcare consumer the primary stakeholder. The company is headquartered in Bellevue, Washington, with additional offices in Atlanta, Georgia, and Mohali, India, an engineering center in Moldova, and has more than 750 employees globally. For more information about Edifecs, please visit www.edifecs.com.
About Health Fidelity
Health Fidelity simplifies risk adjustment, offering risk-bearing organizations clear visibility into and control over the process. Through their NLP-powered solutions and expert advisory services, they uncover insights that enable better care plans and more complete revenue capture. The Lumanent® suite gives Health Fidelity partners the confidence to pursue and ability to succeed in risk-sharing arrangements across MA, ACA, Medicaid, and ACO programs.
Cain Brothers served as exclusive financial advisor to Health Fidelity in connection with the transaction.
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