Simplify Healthcare

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Founded in 2008, Simplify Healthcare is a technology and services provider in the Healthcare Payer space connecting payers, providers, and patients in the U.S. healthcare system. It was founded by a visionary technologist, Mohammed Vaid, to focus on improving the state of the healthcare outcomes and not only support the businesses, but also advance it.

On August 2020, Simplify Healthcare said that the revenue growth of the company had surpassed 729% in the last three years 2016-2019. The company is headquartered in Chicago, United States, and has Software Engineering Center in Pune, India.  

Market Segments

As of September 2020, the company’s health information network reached over 30 Health Plans with approximately 300% YoY growth, and the company tripled its CMS PBP bid submissions for 2021 Medicare Advantage Plans and accounted for 25% of US MA PBP Filings.

Healthcare Payers / Health Plans:

• Commercial and Government
• Standard and Custom
• Value-based purchasing
• Ancillary (Dental, Vision, Pharmacy, STD, LTD, Life etc.)

Company History

Simplify Healthcare was established in 2008 by the visionary technologist, Mohammed Vaid, to provide technology consulting services to the health insurance market. Earlier it was registered as ‘The Most Group,’ which was rebranded to Simplify Healthcare in 2017.

In 2010, the company started investing heavily in cloud embedded solutions and platforms to help health plans create a single source of truth for critical business functions like benefit plan management, provider data & contract management, and value-based reimbursement.

In 2015, the company launched its first product with its first client. In 2016, IDC MarketScape identified eBenefitSync™, benefit plan management solution as the sole product leader.

In 2018, the company launched its second automated solution, eMedicareSync™, the industry’s first automated CMS PBP Medicare Product Configuration and Document Generation solution. The same year the company was awarded rankings on the Inc 5000 and Deloitte Fast 500 lists.

In 2019, the company launched two new solutions eACASync™ , an automated solution to manage the end-to-end needs of ACA compliant Qualified Health Plans (QHP), and eContractSync™ , an automated solution to manage the end-to-end needs of Customer and Provider Contract Lifecycle Management.

For two consecutive years, 2018 and 2020, the company was recognized by Gartner as one of the few vendors for payer value-based payment reconciliation. In 2020, the company was cited in three Gartner’s recent reports, including ‘Hype Cycle for U.S. Healthcare Payers, 2020’, ‘How U.S. Healthcare Payer CIOs Can Best Deploy Health Benefits Product Configuration’, and ‘Adopt Value-Based Payment Reconciliation Systems Soon to Meet Expanding Healthcare Payer Needs.’ The company opened a new center in Aurora, IL, in 2020.

In 2020, the company achieved No. 645 rank in the Inc. 5000 annual list of Americas’ Fastest-Growing Private Companies . The company also announced its support to Maker’s Merci, a non-profit organization focused on empowering communities and support those in need . The same year the company also launched two new products in the market, eGroupEnroll™ , an automated client lifecycle management solution, eMedicaidSync™ , a single source of truth for Medicaid Benefit Plan management.

Solutions and platform

Simplify Healthcare develops an intelligent suite of end-to-end enterprise solutions enabling Health Plans to address critical pain points and improve quality, costs, speed-to-market, and eventually bend the healthcare cost curve.

The company offers nine solutions as of September 2020, including:

• eBenefitSync™ - A single source of truth for benefit plans data and auto-generation of benefits documents.
• eMedicareSync™ - An end-to-end Medicare plan configuration (CMS PBP) and document generation (ANOC/EOC, SB) solution.
• eMedicaidSync™ - A single source of truth for Medicaid benefit plan management for Medicaid Managed Care and Medicaid Fee-For-Service plans.
• eACASync™ - An end-to-end single source of truth to manage and automate the varied needs of Individual and Small Group ACA compliant benefit plans.  
• eContractSync™ - Contract Management solution for Providers and Customers to manage and automate various aspects of a contract lifecycle.
• eProviderSync™ - An end-to-end single source of truth for Provider and Provider contract management.
• eGroupEnroll™ - An automated client setup, on-boarding, and enrollment solution including ASO setup, ASO fees, performance guarantees, group setup, PBMs, and vendors.
• AP2™ - An automated value-based payment reconciliation solution to improve FFV payment accuracy, timeliness, and compliance.
• Simplify9 - A digital business process transformation suite of tools to automate and transform any manual or semi-automated business processes.

Key Personal

As of September 2020, the leadership team includes:

• Mohammed Vaid - CEO and Chief Solution Architect
• Mark Manning - Chief Growth Officer
• Harry Jordan - Chief Operating Officer
• Ashish Desai - Chief Strategy Officer & EVP
• Sushrut Joshi - VP, Chief Technology Officer, Delivery

Awards and Recognitions

• Ranked 645 in the 2020 Inc. 5000 list of Americas’ Fastest-Growing Private Companies.
• Deloitte 2018 Technology Fast 500 Award.
• Recognized in the 2018 Inc. 5000 list of Americas’ fastest-growing private companies.
• Listed as a sample vendor in 2018 Gartner Hype Cycle for value-based reconciliation solutions.
• Won the 2018 Corp! Magazine Michigan’s Bright Spot award and Corp! 2016 Technology Innovation award.
• Recognized as the sole leader in IDC’s Health Plan Product/Plan Benefit Configuration Solutions Vendor MarketScape in 2016.
• Voted the Best Newcomer for 2014 at the Healthcare IT Summit.
  

References

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