New Mountain merges Rawlings, Varis, Apixio assets to form payment accuracy firm

Dive Transient:

New Mountain Capital is combining three of its portfolio corporations to create a brand new fee accuracy agency for well being plans, the non-public fairness agency mentioned Thursday.
The deal will merge The Rawlings Group, an analytics agency that finds third events accountable for paying medical claims, the fee integrity platform of well being tech supplier Apixio and overpayment identification agency Varis. 
David Pierre, beforehand the chief working officer of residence healthcare firm Signify Well being, will head up the newly mixed firm.

Dive Perception:

New Mountain’s new agency will use information and synthetic intelligence to coordinate advantages, test pharmacy claims and pursue reimbursement from third events accountable for medical claims, which may lower prices for payers, based on a Thursday press launch.

The corporate, which doesn’t but have a proper title, will embody over 1,900 workers and serve greater than 60 well being plan purchasers, New Mountain mentioned.

The PE agency bought Apixio from insurer Centene final yr, and purchased a majority stake in Rawlings this spring.

Nevertheless, the merger doesn’t embody all of Apixio. Its related care platform and value-based care merchandise have been acquired by Datavant, one other New Mountain portfolio firm that focuses on information trade, as a part of the transaction.

Cost integrity is enjoying a bigger position within the healthcare sector as medical spending continues to rise and billing turns into extra advanced. It’s presently a $9 billion trade, based on consultancy McKinsey.

In the meantime, PE companies are preferring to put money into healthcare IT companies or pharmaceutical providers over suppliers, a report by market information analysis agency PitchBook famous earlier this summer time. 

In Might, PE agency KKR invested in Cotiviti, an information analytics firm that gives fee accuracy, danger adjustment and high quality enchancment providers for well being plans.

New Mountain additionally tried to purchase out income cycle administration agency R1 RCM early this yr. Nevertheless, the deal didn’t undergo. As a substitute, non-public fairness companies TowerBrook Capital Companions and Clayton, Dubilier and Rice entered right into a definitive settlement this summer time to accumulate R1 for about $8.9 billion and take the corporate non-public.