UST acquires Advantasure to service surge in government health plans

An aging population and post-COVID economic challenges have boosted demand for US healthcare delivery models such as Medicare, Medicaid, and self-insured.

The surge in demand for government health plans (see Exhibit 1) creates new opportunities for providers, insurers, and related businesses to develop products and services to meet emerging needs. In response to this rising demand, UST HealthProof has closed a deal to acquire Advantasure, a leading provider of technology-enabled solutions for government-sponsored health plans.

Exhibit 1: Rising enrollment numbers and expected continued growth indicate a growing demand for Medicaid and Medicare health plans

Sample and data: CMS, US Department of Labor, CBO, Kaiser Family Foundation
Source: HFS Research, 2023

UST HealthProof helps health plans streamline their operations through its innovative BPaaS Solutions

UST HealthProof, a UST company, provides core administrative solutions and business-process-as-a-Service (BPaaS) for health plans. Founded in 2016 as a division of UST and later spun off into a different entity in 2020, UST HealthProof currently has 4,000 employees and 60 customers. Focusing predominantly on regional and community health plans, UST HealthProof helps clients solve business challenges through technology-enabled solutions. It offers a per-member-per-month (PMPM) pricing model and helps customers configure their back-office systems using its proprietary platform built on deep industry knowledge. The company has established strong relationships with its clients by making long-term commitments to guaranteed operational improvements.

UST HealthProof strengthens its value proposition with the acquisition of Advantasure

The acquisition of Advantasure builds on UST’s business process and healthcare tech creds. Advantasure specializes in providing services to health plans and provider organizations to improve the delivery of government healthcare programs with solutions and services across administration, risk adjustment, quality management, and health management.

Health plans must prioritize risk management to identify high-risk beneficiaries and predict and provide necessary interventions to avoid high-cost health complications further down the line. UST has prioritized its risk and quality services, particularly with Medicare and Medicaid. The deal adds Advantasure’s customer-centric platform to UST’s portfolio, enabling UST to scale risk and quality services.

The Bottom Line: Deal brings the potential of single-solution simplicity to health plan providers if merged cultures can click.

With this acquisition, UST HealthProof will help health plan providers utilize a single solution to address most of the value chain rather than multiple solutions requiring integration and risk performance.

However, achieving seamless solution integration and successfully merging the organizational cultures will be complex and challenging. UST must work diligently to ensure it addresses these challenges effectively. If UST can do that, this acquisition and the expanded value chain coverage will enable it to compete with Tier 1 providers and offer commercial models to capitated ones.