NASCO

What NASCO does

NASCO is a healthcare administrative technology company founded in 1987 and headquartered in Atlanta, Georgia. A wholly-owned subsidiary of Blue Cross Blue Shield of Michigan, the company provides a four-product platform (NASCO Empower, NASCO Evolve, NASCO Edge, and NASCO Engage) that handles claims processing, membership/benefits/billing administration, alternative payment model (APM) management, and CRM/engagement for Blue Cross Blue Shield plans and other regional health plans. The platform processes approximately 242 million claims transactions, 215 million APM transactions, and $73 billion in medical expenses annually, serving roughly 23 million members across more than 9,000 benefit types. The technology stack is described as cloud-native, and the Evolve product uses proprietary AI to ingest and codify provider contracts with 99% accuracy and reduce APM settlement time by 99.95%.

The company operates a B2B enterprise SaaS model with multi-year subscription contracts and quote-based pricing, selling directly through a field sales organization to health plan CIOs, CFOs, and product leaders. Its go-to-market targets two primary segments: Blue Cross Blue Shield plans and other regional health plans seeking to modernize legacy administrative systems and operationalize value-based care. NASCO holds SOC 2 Type II and HITRUST certifications for its Empower platform and employs 501–1,000 staff, the majority working remotely under a 100% remote model that has earned the company multiple workplace and culture awards.

NASCO's competitive positioning rests on four decades of Blues-specific operating knowledge, deep embedding in core administrative workflows, and the scale advantages that come with being the largest BlueCard Host processor in the country (a position held since 2002). Its growth strategy centers on productization (rebranding and repositioning core capabilities as a market-led product company), expansion into the value-based care administration market via the 2025 launch of NASCO Evolve, and adjacent expansion into Medicare Advantage and Exchange markets.

Name

NASCO

Legal name

NASCO

Website

https://nasco.com

Company type

Private

Founded year

1987

Operating status

Operating

Headcount range

501–1,000 employees

Short description

NASCO is a private, Atlanta-based healthcare administrative technology company and subsidiary of Blue Cross Blue Shield of Michigan, providing cloud-native SaaS for claims processing, membership/billing, alternative payment model administration, and CRM to Blue plans and regional health plans, processing 242 million claims and $73 billion in medical expenses annually.

Ownership category

akta.pro rank

Headquarters

HQ city

Atlanta

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Infrastructure, Marketing or Sales

Revenue model

1. Healthcare Administrative Technology Products and Services: NASCO generates revenue through a comprehensive portfolio of healthcare administrative technology products and services including SaaS-based platforms for claims processing, billing, benefits administration, and member servicing. Revenue is derived from licensing their technology platforms to health plans.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels6 records

Core offering

NASCO provides a comprehensive portfolio of cloud-native, AI-powered healthcare administrative technology platforms to Blue Cross and Blue Shield plans and regional health plans. Its four core products — NASCO Empower (claims processing), NASCO Evolve (alternative payment model administration), NASCO Edge (membership, benefits and billing) and NASCO Engage (CRM) — collectively process 242 million claims transactions, 215 million APM transactions and $73 billion in medical expenses annually, supporting 23 million members.

Product overview

NASCO offers a comprehensive portfolio of four core healthcare administrative technology products designed to help health plans innovate, grow, and provide better healthcare experiences. The platform operates as an integrated ecosystem with NASCO Empower handling powerful claims processing and reimbursement, NASCO Evolve serving as the first purpose-built system of record for Alternative Payment Model administration with AI-powered capabilities, NASCO Edge providing unified membership, benefits, and billing administration, and NASCO Engage delivering modern CRM and AI-guided customer service. Together, these products support 23 million members, process 242 million claims transactions annually, handle 215 million APM transactions, and manage $73 billion in medical expenses processed. The company has 40 years of proven health plan expertise serving Blues and regional health plans across the front, middle, and back-office including claims processing, billing, benefits, non-claims-based reimbursement, and member servicing.

Differentiator

Problem solved

Functional benefit

Brands

• NASCO Empower: Powerful claims processing solution that scales payment operations to accelerate the care-to-payment journey, with $25+ billion in paid medical expenses claims and non-claims based.
• NASCO Evolve
• NASCO Edge
• NASCO Engage

Products and services

• NASCO Empower Reimbursement and claims processing solution that scales payment operations to accelerate the care-to-payment journey. Administers the most complex claim and benefit adjudication at scale with 99.9% reliability, processing $25+ billion in paid medical expenses and 250+ million claims and encounters annually. SOC 2 Type II and HITRUST certified. Designed for Blue Cross Blue Shield plans and regional health plans.
• NASCO Evolve First purpose-built system of record for Alternative Payment Model (APM) administration. Cloud-native, AI-powered platform that handles contract ingestion, modeling, execution, analysis, traceability, governance and scaling of value-based care arrangements. Supports 2 million member lives, achieves 99% accurate contract ingestion, and reduces settlement time from weeks to minutes. Used by Blue Cross Blue Shield of Michigan to achieve 80%+ increase in operational efficiency.
• NASCO Edge Comprehensive membership, benefits, and billing solution that modernizes health plan administration by connecting eligibility & enrollment, benefits management, premium, ASO, and mixed billing into a single platform. Achieves 10x faster implementation times when onboarding new employer groups and 15x product growth over 5 years, with 25% decrease in ASO billing costs.
• NASCO Engage Modern Customer Relationship Management (CRM) and engagement platform designed for healthcare complexity. AI-guided customer service enables 200K daily member and provider support interactions through omnichannel engagement. Streamlines interactions and improves service efficiency for health plan members and providers.

Quantifiable outcome

• 80%+ increase in operational efficiency for administering value-based settlements
• +7 more outcomes

Named customers3 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability7 records

Feature6 records

Scale indicators10 records

Recent moves13 records

Expansion highlights6 records

Direct peers

• HealthEdge Software: HealthEdge provides cloud-native payer core administration, claims, and care management platforms to health plans. Like NASCO, it sells an integrated suite targeting commercial and Blues-adjacent payers, making it the closest direct competitor to the Empower/Edge stack.
• Edifecs: Edifecs provides healthcare data interoperability, value-based care administration, and compliance software used by payers and providers. Its focus on payment model management and EDI transactions is directly comparable to NASCO Evolve and Empower.

Broad incumbents

• Optum (formerly Change Healthcare): Optum operates one of the largest healthcare technology and service platforms, including claims processing, payment integrity, and payer analytics that overlap directly with NASCO's core administrative offerings across Blues and commercial markets.
• Cognizant (Healthcare): Cognizant runs a large healthcare technology services arm, including the TriZetto payer platforms, and competes for the same health plan modernization, claims, and member engagement work that NASCO serves.
• Wipro (Healthcare & Life Sciences): Wipro delivers payer technology, BPO, and digital transformation services to health plans. Its comparable scope of payer-side admin, billing, and member engagement services makes it a broad incumbent competitor.
• NTT DATA (Healthcare): NTT DATA provides payer consulting, core system modernization, and digital services to Blues and commercial health plans, directly competing with NASCO's modernization and outsourced administrative portfolio.
• DXC Technology (Healthcare): DXC operates payer technology services and BPS for health plans worldwide, including claims processing and member systems. Its incumbent contracts with major health plans place it directly alongside NASCO in Blues procurement cycles.
• Infosys BPM (Healthcare): Infosys delivers payer-side BPO, claims operations, and member lifecycle services to large US health plans. It competes with NASCO where plans look to combine outsourced operations with platform technology.

Emerging players

• Cotiviti: Cotiviti provides payment integrity, analytics, and value-based care software to health plans, with growing overlap into APM and settlement analytics adjacent to NASCO Evolve.
• Innovaccer: Innovaccer builds payer-provider data and value-based care platforms targeting the same shift to risk-based reimbursement that NASCO Evolve addresses, representing an emerging competitive threat in the APM category.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/nasco
• Xx.com/nascollc
• Facebookfacebook.com/NASCOLLC

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about NASCO