SS&C Partners with Humana, Anthem on API-Driven Claims Adjudication Platform
SS&C Technologies Holdings Inc. (Nasdaq: SSNC) has entered into a joint venture with Humana and Anthem to create a cloud-native, application programming interface-driven claims adjudication platform.
SS&C, a Connecticut-based provider of services and software for the financial services and healthcare industries, said that upon completion, the joint venture, named DomaniRx LLC “will shape the future of pharmacy benefit management (PBM) and harmonize the payer and provider management user experience.
As reported by Healthcare Finance News, the announcement of the joint venture was made in an SEC filing on July 15. The filing noted that SS&C holds an 80.2 percent interest in the joint venture and Humana and Anthem each hold a minority interest.
The parties have committed up to an aggregate of approximately $925 million in the form of cash, property and/or services, to support the development project. This amount includes $138.3 million in initial cash contributions and other considerations.
"SS&C is creating DomaniRx and we are excited to be working with two world-class founding minority co-investors. We are committed to building a next-generation claim adjudication and PBM platform," said Bill Stone, chairman and CEO of SS&C, in a press release.
SS&C said healthcare organizations need end-to-end transparency and data analytics while adhering to ever-changing government regulations. To better address the complexity of the claims adjudication industry-wide as healthcare organizations compete and grow, DomaniRx will build a unified best-in-class user experience leveraging plug-and-play technology to provide the industry's most affordable, transparent solution, the company added.
"This is a milestone partnership for the healthcare technology industry, and we are pleased that Humana will be our partner and first customer. DomaniRx will focus on disrupting the industry through open source technology to interface with other systems quickly," said Danny Delmastro, DomaniRx's general manager, in a statement. “The insights we will draw from hundreds of millions of claims transactions, powered by DomaniRx's advanced processing platform, will provide participating members flexible tools, advanced analytics, and customizable programs, all while increasing transparency, accessibility and service quality for members and pharmacies."