HealthEdge and UST HealthProof have officially merged, creating a leading next-generation healthcare payer technology and services company under the ownership of Bain Capital. The combined entity will operate as HealthEdge, bringing together award-winning technology, deep industry expertise, and a broad suite of AI-powered solutions to transform how health plans manage claims, payments, care and utilization, payment integrity, and member engagement. Headquartered in Boston, the new HealthEdge serves over 115 health plans and touches more than 110 million lives across the U.S. healthcare system. The merger unites HealthEdge’s AI-driven payer applications with UST HealthProof’s advanced interoperability platform, delivering a comprehensive, end-to-end claims operating system designed to modernize legacy infrastructure, reduce administrative costs, and improve both operational efficiency and patient outcomes. Health plans face mounting pressure from rising costs, complex regulations, and increasing member expectations, all while relying on outdated systems that hinder innovation. The new platform addresses these challenges by offering seamless integration, cloud-ready migration support, and powerful AI capabilities that streamline workflows and enhance decision-making. UST HealthProof’s proprietary technology significantly reduces the risks associated with cloud transitions, enabling safer, faster digital transformation. Kevin Adams, former CEO of UST HealthProof, will lead the combined company as CEO, bringing a strong vision for innovation and execution. Steve Krupa, former CEO of HealthEdge, will remain on the board, contributing strategic guidance and deep industry experience. The new leadership team is poised to drive growth, foster collaboration, and unlock new opportunities for employees across both organizations. “We’re at a pivotal moment in healthcare technology,” said Kevin Adams. “Health plans need solutions that are not only powerful but also easy to implement and scale. This merger combines best-in-class technology with proven operational excellence, giving payers the tools they need to lower costs, improve member experiences, and thrive in a rapidly evolving landscape.” Steve Krupa emphasized the strategic value of the partnership. “For nearly a decade, HealthEdge and UST HealthProof have worked together to deliver real results for health plans. Now, by joining forces, we’re creating the first true end-to-end, next-generation claims platform—built for the future of healthcare.” Bain Capital, which acquired UST HealthProof from UST, highlighted the transformative potential of the merger. “This combination brings together two innovators with complementary strengths—proven technology, deep customer relationships, and a shared commitment to advancing healthcare delivery,” said Devin O’Reilly, a Partner at Bain Capital. “With AI at the core and a focus on frictionless operations, the new HealthEdge is uniquely positioned to lead the next wave of payer innovation.” Paul Moskowitz, another Bain Capital Partner, added, “At a time when healthcare is facing unprecedented challenges, this merger delivers a scalable, intelligent platform that can lower costs, improve outcomes, and help build a more efficient, equitable system for everyone.” TripleTree served as financial advisor to the combined company, while Kirkland & Ellis LLP provided legal counsel. Ares Management was the lead financing partner for Bain Capital. Evercore advised HealthEdge, and Goldman Sachs and JPMorgan advised UST HealthProof, with Davis Polk & Wardell LLP providing legal support. The merger marks a major step forward in modernizing the U.S. healthcare payer ecosystem, combining cutting-edge technology with proven operational excellence to deliver a smarter, more efficient future for health plans and the patients they serve.