Advantasure
UST HealthProof, operating as Advantasure, delivers an integrated BPaaS ecosystem — Core Administration, Risk Adjustment, and Quality/Stars solutions — to 55 Medicare Advantage, Medicaid, and commercial health plans covering 9M+ members, now part of a combined platform with HealthEdge under Bain Capital.
- Company typePrivate
- Founded2016
- HeadquartersGlen Allen, United States
- Headcount501–1,000
- GTM typeB2B
- OfferingSoftware
Advantasure firmographics
Firmographics- Name
- Advantasure
- Legal name
- UST HealthProof
- Website
- https://advantasure.com
- Company type
- Private
- Founded year
- 2016
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- UST HealthProof, operating as Advantasure, delivers an integrated BPaaS ecosystem — Core Administration, Risk Adjustment, and Quality/Stars solutions — to 55 Medicare Advantage, Medicaid, and commercial health plans covering 9M+ members, now part of a combined platform with HealthEdge under Bain Capital.
- Ownership category
- akta.pro rank
Advantasure industry classification
Industry- Product category
- Healthcare BPaaS (Business Process as a Service)
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Computer Systems Design and Related Services (54151)
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Eligibility, Coverage Verification & Policy Administration Support (BPAAAFAC)
Keywords
Where Advantasure is headquartered
LocationHeadquarters
- HQ city
- Glen Allen
- HQ country
- United States
- HQ region
- North America
Markets served
Advantasure business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure
Revenue model
- BPaaS Subscription and Managed Services: The company operates on a BPaaS (Business Process as a Service) model providing integrated solutions as recurring services to health plans. This includes Core Administration, Risk Adjustment, and Quality/Stars solutions delivered as managed services with predictable operating costs. The model emphasizes outcome-based value with cost efficiency through streamlined processes.
- Advisory and Consulting Services: Expert advisory services that help optimize core health plan operations, reduce costs, enhance compliance, and drive improved member satisfaction and scalability. These professional services complement the technology platform.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Multi-year contract | Enterprise health plan solutions - custom pricing based on plan size and requirements |
Go-to-market motion2 records
Distribution channels1 record
Marketing channels9 records
Advantasure product offering
Product offeringCore offering
Advantasure (operating as UST HealthProof) delivers a BPaaS (Business Process as a Service) ecosystem of integrated healthcare operations, processes, and solutions for U.S. health plans. Its product portfolio covers Core Administration (enrollment, engagement, integration, workflow, and operational insights), Risk Adjustment (retrospective and prospective), Quality Improvement and Stars (HEDIS-based measurement and consulting), and Advisory Services. The platform is sold to Medicare Advantage, Medicaid, and commercial health plan operators on a managed-services basis, with 120 prebuilt integrations and outcome-based pricing.
Product overview
UST HealthProof offers a unified BPaaS (Business Process as a Service) Ecosystem that integrates Core Administration, Risk Adjustment, Quality Improvement and Stars, and Advisory Services into a single scalable platform. The core platform provides an integrated ecosystem of healthcare operations with 120 prebuilt integrations. Key products include Enrollment Plus™, Engagement Plus®, Integration Plus®, Workflow Plus®, and Insitz Plus under Core Administration; Retrospective and Prospective Risk Adjustment Solutions; Stars Consulting Services and Quality360® HEDIS® Engine for quality management. The portfolio serves government-sponsored and commercial health plans across all lines of business.
Differentiator
Problem solved
Functional benefit
Brands
- BPaaS Ecosystem: Business Process as a Service ecosystem providing integrated healthcare operations, processes, and solutions with scalability, efficiency, and predictable outcomes.
- Enrollment Plus™
- Engagement Plus®
- Integration Plus®
- Workflow Plus®
- Insitz Plus
- Quality360® HEDIS® Engine
- Retrospective Risk Adjustment Solutions
- Prospective Risk Adjustment Solutions
- Stars Consulting Services
Products and services
- BPaaS Ecosystem Integrated ecosystem of best-in-class, scalable, turnkey solutions for health plans across all lines of business, designed to replace fragmented legacy systems with scalability, efficiency, and predictable outcomes.
- Core Administration Suite of leading-edge core admin solutions that deliver outcomes with reduced costs across multiple lines of business, covering enrollment, engagement, integration, workflow, and operational insights for health plans.
- Risk Adjustment Technology and services solutions that improve reimbursement accuracy, optimize gap and chase, and streamline submissions for Medicare Advantage and other government healthcare businesses through retrospective and prospective risk adjustment.
- Quality Improvement and Stars Tailored programs combined with industry expertise that help health plans measure, analyze, and implement quality and Stars strategies with impact, anchored by the Quality360® HEDIS® Engine and Stars Consulting Services.
- Advisory Services Expert advisory services that help optimize core health plan operations, reduce costs, enhance compliance, and improve member satisfaction and scalability, complementing the Core Administration and Risk Adjustment platforms.
Quantifiable outcome
- 30% average operational cost savings for health plan clients
- +3 more outcomes
Companies that use Advantasure
Customer profileNamed customers3 records
Segments3 records
Ideal customer profiles2 records
Advantasure technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature10 records
Advantasure partnerships and signals
Strategic signalScale indicators5 records
Recent moves7 records
Expansion highlights6 records
Advantasure competitors and assessment
Company assessmentDirect peers
- Cognizant: Global IT services and digital transformation provider with a sizable healthcare payer practice offering BPaaS, core administration, and risk/quality services to Medicare Advantage and commercial health plans — directly comparable to Advantasure's BPaaS delivery model.
- Tata Consultancy Services (TCS): Large IT and business process services firm with deep healthcare payer engagements, providing core administration, claims, and analytics BPO/BPaaS to US health plans — competing for the same enterprise RFPs as Advantasure.
- Conduent: Business process services company with a healthcare payer solutions portfolio covering member management, claims administration, and quality programs — a direct competitor in health plan BPaaS.
- NTT DATA: Global IT services provider with a strong healthcare payer practice, offering core administration platforms, risk adjustment, and payer-side managed services that overlap with Advantasure's offering.
- SS&C Technologies: Through its DST Health Solutions business, SS&C provides core administration and health plan technology services, directly overlapping with Advantasure's core admin and BPaaS positioning for payers.
- Infosys: Global IT and BPM services firm with a dedicated US healthcare payer practice delivering core admin modernization, risk adjustment support, and managed services — comparable in delivery model and customer profile to Advantasure.
Broad incumbents
- Optum (UnitedHealth Group): Healthcare technology and services arm of UnitedHealth Group that operates one of the largest payer-tech and BPaaS footprints, bundling claims, risk, quality, and analytics — a much larger incumbent that competes for the same health plan wallet share.
Emerging players
- Edifecs: Healthcare data integration and interoperability vendor with solutions in payer-provider connectivity, risk adjustment, and quality — an adjacent/emerging competitor addressing parts of Advantasure's integration and quality stack.
- CitiusTech: Healthcare technology services and analytics firm focused on payers, providers, and life sciences, offering risk, quality, and data platform services that overlap with segments of Advantasure's portfolio.
- Mphasis: IT services company with a healthcare-focused practice serving US payers and providers, offering application development, analytics, and BPaaS-adjacent services — an emerging competitor pursuing similar mid-to-large health plan clients.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Advantasure social profiles
Digital presenceAdvantasure financial estimates
Financial estimateRevenue estimate
Valuation estimate
Advantasure leadership team
Management profileNumber of profiles
Profiles1 record
Advantasure funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Advantasure M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Advantasure
What does Advantasure do?
Advantasure (operating as UST HealthProof) delivers a BPaaS (Business Process as a Service) ecosystem of integrated healthcare operations, processes, and solutions for U.S. health plans. Its product portfolio covers Core Administration (enrollment, engagement, integration, workflow, and operational insights), Risk Adjustment (retrospective and prospective), Quality Improvement and Stars (HEDIS-based measurement and consulting), and Advisory Services. The platform is sold to Medicare Advantage, Medicaid, and commercial health plan operators on a managed-services basis, with 120 prebuilt integrations and outcome-based pricing.
Is Advantasure a public or private company?
Advantasure is a private company. It is classified as private equity controlled and is currently operating.
When was Advantasure founded?
Advantasure was founded in 2016. It employs 501 to 1,000 people.
Where is Advantasure based?
Advantasure is headquartered in Glen Allen, United States, in the North America region.
How does Advantasure make money?
Two revenue lines are on record. BPaaS Subscription and Managed Services are the primary driver. The others are advisory and Consulting Services.
Who are Advantasure's main competitors?
Direct peers on record are Cognizant, Tata Consultancy Services (TCS), Conduent, NTT DATA, SS&C Technologies and Infosys. Optum (UnitedHealth Group) is listed as a broad incumbent. Emerging players are Edifecs, CitiusTech and Mphasis.
Does Advantasure have an API?
No public API is recorded for Advantasure.
What industry is Advantasure in?
Advantasure's product category is Healthcare BPaaS (Business Process as a Service). Its primary akta.pro industry code is BPAAAFAC, Eligibility, Coverage Verification & Policy Administration Support. Its NAICS code is 524292 and its SIC code is 7370.