Healthcare Payor Services*

Industry Niche Description

Technology solutions and services for health plans, providers and other healthcare payors.

Investment Thesis

Healthcare payors are responding to the increasing cost of medical care by more closely managing episodes of care and chronic conditions. In addition, the expansion of government coverage and increased access to commercial healthcare insurance is further highlighting the need to manage costs, improve outcomes and optimize healthcare delivery.

Representative Targets

Attractive target companies within this niche may have the following attributes:

  • “SaaS-like” revenue models (PMPM, PEPM) or percentage-of-savings revenue models.
  • Business models that leverage technology and avoid large groups of employees either onshore or offshore.
  • Leading technology and service solutions that enable outsourcing of administrative and other back office functions such as eligibility verification, code authentication, and claims processing solutions.
  • Solutions that ensure compliance and manage risk within the complex healthcare regulatory environment.
  • Providers of cost containment solutions such as fraud, waste and abuse or subrogation.
  • Administrators that facilitate the movement or adoption of more cost-effective models for direct and indirect payors.

Contact

Ray Wagner
Director
(314) 446-3315
rwagner@tscp.com