Bedminster, NJ – Zelis, a leading healthcare payments and pricing company, announced today it entered into a definitive agreement to acquire Payer Compass, one of the healthcare industry’s leading providers of reimbursement and claims pricing, administration, and processing solutions. Navigating the rising costs and ever-changing healthcare regulations in the United States is extremely complex and challenging for all participants. Like Zelis, Payer Compass has proudly and effectively developed innovative solutions to help price, explain, and mitigate healthcare costs, helping members better navigate the often-complex financial journey without sacrificing quality of care.
For more than 20 years, Payer Compass has been dedicated to restoring rationality to the cost of healthcare, focused on solving spiraling costs and the lack of price transparency. Payer Compass has helped organizations control the cost of care by combining its multi-faceted pricing platform Visium™ with an emphasis on client success. Working with health plans and self-funded organizations, Payer Compass has provided data and insights to reprice more than $200 billion in claims, generate more than $1.5 billion in annual savings and serve more than 10 million lives.
Together, Zelis and Payer Compass will leverage advanced technology and best-of-breed approaches to create reference-based pricing solutions to manage rising healthcare claims cost for clients and their members.
“We’re committed to our mission of making care more affordable and transparent for all. Combining Payer Compass’ innovative platform with our existing network solutions and payment integrity offerings will do just that,“ said Amanda Eisel, CEO of Zelis. “Through our combined assets, we’ll have the people, technology, and shared energy to generate more savings for our clients and continue to positively impact healthcare’s rising costs and complexity.”
Jay Deady, President of Claims Cost Solutions at Zelis, added, “Healthcare costs continue to increase without an end in sight. The burden on consumers to understand, navigate, and address these expenses is overwhelming. The combination of these outstanding companies will drive technical and service innovation to make a difference.”
Greg Everett, CEO of Payer Compass couldn’t agree more, stating, “We’ve been at the forefront of tackling rising costs and healthcare spend for more than two decades. We’re thrilled to join an organization who has shared this vision for just as long. With our assets combined, we stand well-positioned for an even greater impact in the next chapter.”
The transaction is expected to close in the third quarter. Specific terms of the transaction were not disclosed. Spectrum Equity, a leading growth equity firm, and Health Enterprise Partners, a healthcare-focused investment firm, have been investors in Payer Compass since 2019. Triple Tree, LLC. served as the exclusive financial advisor for this transaction. Payer Compass was represented by Latham & Watkins, LLP and Zelis was represented by Kirkland & Ellis.
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re committed in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top- 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers and millions of providers and members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
Payer Compass is dedicated to restoring rationality to the cost of care. We focus squarely on tackling the most elusive problems in today’s healthcare landscape: spiraling costs and associated lack of price transparency. For health plans, we are minimizing overall spend on claims pricing, administration, and processing. And for self-insured organizations, our innovations and services are driving down the costs of healthcare claims reimbursement. Our multi-faceted, SaaS platform, VisiumTM, yields 99.9% pricing accuracy on more than $200 Billion in repriced claims and is the cornerstone of our comprehensive suite of solutions that address the need for cost control while bridging the gap between payer and provider. Payer Compass does this with reference-based pricing, patient advocacy, balance billing, and appeals services, value-based payments, care management, predictive modeling and analytics, and tools for provider search and price transparency. Combining our next-gen technology with an emphasis on client success, Payer Compass is dramatically reducing overall healthcare spend.