Company profile: Verscend
1.1 - Company Overview
Company description
- Provider of healthcare data services, analytics, and advanced technologies to reduce risk and improve outcomes for health plans and employers. Offerings include payment accuracy, risk adjustment, quality intelligence for HEDIS and Star Ratings, medical intelligence, DxCG predictive risk models for clinical and financial risk, and consumer engagement via tailored multi-channel outreach.
Products and services
- Payment Accuracy: Lifecycle-spanning product that identifies and corrects billing and payment errors to save on medical and administrative costs throughout the payment lifecycle
- Quality Intelligence: HEDIS/Star Ratings-aligned system that tracks, monitors, and improves quality compliance for health plans, facilitating HEDIS, Star Ratings, and other quality measure submissions
- Risk Adjustment: Prospective-and-retrospective product that ensures appropriate reimbursement through comprehensive prospective and retrospective solutions covering the full risk adjustment process
Key contacts
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Financial details
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1.2 - Competitors and similar companies to Verscend
Renalogic
HQ: United States
Website
- Description: Provider of dialysis cost containment and chronic kidney disease management solutions for self-funded employers, offering care management to prevent CKD progression (ImpactCare), health claims advisory to manage dialysis costs (ImpactProtect), data analysis to identify CKD risks (ImpactIQ), and member advocacy for late-stage CKD and ESRD (ImpactAdvocate).
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
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- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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HMS
HQ: United States
Website
- Description: Provider of payment accuracy and population health management solutions using technology, analytics, and engagement to help healthcare payers, government programs, and at-risk organizations cut costs and improve health outcomes, saving billions of dollars annually. Offers HMS Federal Solutions for cost containment by recovering funds and avoiding unnecessary costs, and HMS 360 for a detailed view of financial savings and recovery data, including invoice details and recovery status.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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PrecisionGx
HQ: United States
Website
- Description: Provider of health insurance claims-native AI for automated claims intelligence, enabling in-house payment integrity. Includes automated claims review for additional recoveries; AstriaChat automating up to 80% of pre-payment workflows and targeting full post-payment audit automation; automated claims processing/adjudication to reduce fees; contract/provider modeling; automated medical record requests; and automated coverage validation.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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Eldorado
HQ: United States
Website
- Description: Provider of a platform for paying out and managing insurance services.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
View full Eldorado company profile →
Adaptive Software
HQ: United States
Website
- Description: Provider of software and services for pharmacy benefit plan design and health plan management, including Payer Insights Suite for centralized formulary management integrated with claims adjudication; RxFlex for creating and automating formularies and utilization edits; RxDesigner for drug lists, formularies, and compliance; Health Plan Analysis; Market Overviews; and Fingertip Formulary Suite with coverage, policy, and brand comparison tools.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
View full Adaptive Software company profile →
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2.M&A buyers
2.1 Potential strategic acquirers in the sector
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2.2 - Strategic buyer groups for Verscend
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Buyer group 2: ████████ ████████
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Buyer group 3: ████████ ████████
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3. Investors and private equity firms
3.1 - Buyout funds investing in similar companies to Verscend
2.2 - Growth funds investing in similar companies to Verscend
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4 - Top valuation comps for Verscend
4.2 - Public trading comparable groups for Verscend
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