Ayin Health Solutions
Ayin Health Solutions, a PSJH subsidiary, operates the cloud-hosted CIM platform for healthcare utilization management, claims, authorizations, and HRSN workflows, serving health plans, ACOs, CCOs, employers, and provider groups.
- Company typePrivate
- Founded2018
- HeadquartersSalem, United States
- Headcount5,001–10,000
- GTM typeB2B
- OfferingSoftware
What Ayin Health Solutions does
Ayin Health Solutions is a privately-held healthcare administration technology company and wholly-owned subsidiary of Providence St. Joseph Health (PSJH), headquartered in Salem, Oregon. Formed in 2018 around the acquisition of PH Tech, the company develops and operates the Community Integration Manager (CIM), a cloud-hosted proprietary platform that supports utilization management, claims processing, prior authorizations, member analytics, and Health-Related Social Needs (HRSN) workflows for health plans, ACOs, Coordinated Care Organizations (CCOs), employers, and provider groups.
At scale, the CIM platform processes approximately 1.9 million claims and authorizations per year and serves 10,800+ active platform users. Its product architecture emphasizes real-time analytics, race/ethnicity/language (REL) data handling, and compliance with CMS, Medicaid, and Medicare regulatory requirements. Recent capability additions include a BPCI-A Decision Support Service for value-based bundled payment programs and an April 2023 partnership with Lirio that integrates Precision Nudging behavioral-science personalization into member and HRSN workflows.
Ayin generates revenue through three primary streams - subscription (platform licensing), managed services (operational outsourcing of utilization management and related functions), and professional services (implementation, configuration, consulting). Its customer base is concentrated among enterprise healthcare payers and providers, with PSJH acting as both parent and anchor reference customer. The go-to-market is enterprise-direct, and the company is currently navigating an executive leadership transition under Interim CEO Dustin Strom.
Ayin Health Solutions firmographics
Firmographics- Name
- Ayin Health Solutions
- Legal name
- Ayin Health Solutions, Inc.
- Website
- https://ayin.com
- Company type
- Private
- Founded year
- 2018
- Operating status
- Operating
- Headcount range
- 5,001–10,000 employees
- Short description
- Ayin Health Solutions, a PSJH subsidiary, operates the cloud-hosted CIM platform for healthcare utilization management, claims, authorizations, and HRSN workflows, serving health plans, ACOs, CCOs, employers, and provider groups.
- Ownership category
- akta.pro rank
Ayin Health Solutions industry classification
Industry- Product category
- Population Health Management Software
- NAICS
- Custom Computer Programming Services (541511), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)
- SIC
- Services-Health Services (8000), Services-Computer Programming, Data Processing, Etc. (7370), Services-Misc Health & Allied Services, Nec (8090)
- akta.pro primary industry
- Employer/Member Engagement Platforms for Provider-Sponsored Plans (HLACAEAM)
- akta.pro secondary industries
- Data Aggregation, Interoperability & APIs for RPM (FHIR/IoMT Gateways) (HLACAFAO), EHR/EMR Integration & Interoperability Middleware (HL7/FHIR) (HLALAKAD)
Keywords
Where Ayin Health Solutions is headquartered
LocationHeadquarters
- HQ city
- Salem
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Ayin Health Solutions business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Operations, Infrastructure, Marketing or Sales
Revenue model
- Technology Platform Services: Cloud-hosted Community Integration Manager (CIM) platform providing claims processing, utilization management, population health management, and care coordination capabilities on a subscription or per-engagement basis.
- Administrative Operations Services: Hands-on administrative support including claims processing, payments, customer service, enrollment, and data reporting. Reduces administrative burden for healthcare organizations transitioning to value-based care.
- Strategic Consulting: Expert consulting services to help organizations navigate value-based care, bundled payment programs like BPCI-A, and operational optimization.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Multi-year contract | Enterprise-level pricing for Health Plans, ACOs, and Provider Groups |
Go-to-market motion1 record
Distribution channels1 record
Marketing channels4 records
Ayin Health Solutions product offering
Product offeringCore offering
Ayin Health Solutions sells its proprietary, cloud-hosted Community Integration Manager (CIM) platform that connects Providers, Administrators, Care Teams, and Customer Service in a single integrated solution for claims administration, utilization management, population health management, care management, health-related social needs management, and community collaboration. The platform is delivered with hands-on administrative operations services (claims processing, payments, customer service, enrollment, and data reporting), and complemented by specialized offerings including a BPCI-A Decision Support consulting service, pharmacy benefits management, a proprietary risk evaluation tool, and employee health benefits services for healthcare organizations navigating value-based care.
Product overview
Ayin Health Solutions offers a unified platform-plus-services model centered on its proprietary Community Integration Manager (CIM) cloud-hosted platform. CIM serves as the core technology layer, providing integrated modules for Claims Administration, Utilization Management, Community Portal, Population Health Management, Health-Related Social Needs (HRSN) Management, and Care Management. Complementing the CIM platform, Ayin delivers a suite of administrative and consulting services including Enrollments/Attribution/Encounter Data, Appeals & Grievance Support, Customer Service, and Benefit & Reimbursement Configuration. The company also offers specialized services — Pharmacy Benefits Management, a Proprietary Risk Evaluation Tool, Employee Health Benefits, and a BPCI-A Decision Support Service for bundled payment programs — extending Ayin's population health management capabilities beyond the core CIM platform. Through a partnership with Lirio, Ayin integrates Precision Nudging Solutions (for Member Enrollment, Annual Wellness Visits, and Diabetes Primary Care) directly into the CIM platform. The overall portfolio is designed to support Health Plans, ACOs, Coordinated Care Organizations, Employers, Provider Groups, and Government Programs in navigating value-based care.
Differentiator
Problem solved
Functional benefit
Brands
- Community Integration Manager (CIM): Ayin's proprietary cloud-hosted technology platform that streamlines care coordination, automates workflows, and provides administrative support for health plans, ACOs, and provider organizations.
Products and services
- Community Integration Manager (CIM) Platform Ayin's proprietary, cloud-hosted technology platform that connects Providers, Administrators, Care Teams, and Customer Service in a single solution to streamline workflows, communications, claims administration, utilization management, population health management, HRSN management, care management, and community collaboration for enterprise healthcare organizations transitioning to value-based care.
- Administrative Operations Services A managed services offering covering claims processing, payments, customer service (call centers and CRM tools), Enrollments/Attribution/Encounter Data, Appeals & Grievance Support, and Benefit & Reimbursement Configuration for healthcare organizations, including Medicaid, Medicare, PACE, and value-based arrangements.
- BPCI-A Decision Support Service A bundled payment consulting service combining advanced data analytics to assess risk and pinpoint clinical service lines with the greatest BPCI-A opportunity, covering financial ROI analysis, operational readiness assessment, post-acute network readiness evaluation, and data and informatics assessment across four key areas.
- Pharmacy Benefits Management A service partnering pharmacists and physicians across the care continuum to manage pharmacy costs without compromising patient care, supporting population health management for healthcare organizations.
- Proprietary Risk Evaluation Tool A proprietary risk evaluation tool and comprehensive reporting system that helps healthcare organizations manage healthcare costs and improve patient outcomes.
- Employee Health Benefits An employee health benefits program tailoring service that helps organizations reduce costs, improve employee wellness, and decrease absenteeism.
Quantifiable outcome
- 1.9 Million claims and authorizations processed per year
- +3 more outcomes
Companies that use Ayin Health Solutions
Customer profileNamed customers2 records
Segments4 records
Ideal customer profiles3 records
Ayin Health Solutions technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration1 record
Feature4 records
Ayin Health Solutions partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core.
- Lirio, LLCcoreStrategic partnership announced April 27, 2023 to address gaps in care and improve patient and member experience for populations and communities. Ayin integrates Lirio's Precision Nudging solution with its CIM platform, deploying solutions for Member Enrollment, Annual Wellness Visits, and Diabetes Primary Care to drive improved health outcomes through increased engagement, early diagnosis, and proactive chronic disease management.
- Providence St. Joseph HealthcoreProvidence St. Joseph Health (PSJH), the nation's third-largest non-profit health system, created Ayin Health Solutions in 2018 to support provider-sponsored health plans and risk-bearing entities. PSJH acquired PH Tech, a Medicaid and Medicare administrative services and technology company, as part of the formation. Ayin operates as a subsidiary focused on population health management solutions.
Scale indicators4 records
Recent moves7 records
Expansion highlights5 records
Ayin Health Solutions competitors and assessment
Company assessmentDirect peers
- Innovaccer: Innovaccer offers a health data platform unifying EHR, claims, and social determinants data for payers, providers, and ACOs — directly comparable to Ayin's data aggregation, HRSN, and care management capabilities within the CIM platform.
- Arcadia: Arcadia is a population health management platform that aggregates clinical and claims data for health plans, ACOs, and provider groups — directly comparable to Ayin's CIM platform in serving value-based care contracts with population health and care gap functionality.
- Lumeris: Lumeris is a value-based care enablement platform serving health systems and provider-sponsored plans, with population health, care management, and payer-operations capabilities — highly comparable to Ayin's CIM platform serving PSJH and similar provider-sponsored plans.
- Evolent Health: Evolent Health partners with provider-sponsored health plans and ACOs to manage value-based care populations through technology and services — directly comparable to Ayin's combination of CIM platform plus administrative operations for ACOs and CCOs.
- Cedar Gate Technologies: Cedar Gate provides value-based care analytics and bundled-payment decision support, including BPCI-A programs — directly comparable to Ayin's BPCI-A Decision Support Service and risk evaluation tooling for provider organizations.
- Lightbeam Health Solutions: Lightbeam offers a population health management platform with risk stratification, care gap identification, and value-based care analytics — directly comparable to Ayin's Population Health Management module for ACOs and provider-sponsored plans.
- Health Catalyst: Health Catalyst provides a data and analytics platform for healthcare organizations, including population health management and value-based care performance — directly comparable to Ayin's CIM Population Health Management and Real-Time Analytics modules serving health systems and ACOs.
- ZeOmega: ZeOmega provides the Jiva population health management platform for health plans and risk-bearing entities, including care management, utilization management, and HEDIS-style quality reporting — closely aligned with Ayin's CIM utilization management and care management modules.
Broad incumbents
- Optum (UnitedHealth Group): Optum operates a broad portfolio of healthcare technology and services including claims administration, population health, and analytics for payers and providers — overlapping with Ayin's CIM modules but at vastly greater scale as part of UnitedHealth Group.
Emerging players
- Salesforce Health Cloud: Salesforce Health Cloud provides a CRM and member-engagement platform for payers and providers, including care coordination workflows — adjacent competitor to Ayin's Customer Service/CRM and Community Portal capabilities within CIM.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks5 records
Key highlights6 records
Customer concentration
Ayin Health Solutions social profiles
Digital presenceAyin Health Solutions financial estimates
Financial estimateRevenue estimate
Valuation estimate
Ayin Health Solutions leadership team
Management profileNumber of profiles
Profiles4 records
Ayin Health Solutions funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Ayin Health Solutions 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 Ayin Health Solutions
What does Ayin Health Solutions do?
Ayin Health Solutions sells its proprietary, cloud-hosted Community Integration Manager (CIM) platform that connects Providers, Administrators, Care Teams, and Customer Service in a single integrated solution for claims administration, utilization management, population health management, care management, health-related social needs management, and community collaboration. The platform is delivered with hands-on administrative operations services (claims processing, payments, customer service, enrollment, and data reporting), and complemented by specialized offerings including a BPCI-A Decision Support consulting service, pharmacy benefits management, a proprietary risk evaluation tool, and employee health benefits services for healthcare organizations navigating value-based care.
Is Ayin Health Solutions a public or private company?
Ayin Health Solutions is a private company. It is classified as corporate owned and is currently operating.
When was Ayin Health Solutions founded?
Ayin Health Solutions was founded in 2018. It employs 5,001 to 10,000 people.
Where is Ayin Health Solutions based?
Ayin Health Solutions is headquartered in Salem, United States, in the North America region.
How does Ayin Health Solutions make money?
Three revenue lines are on record. Technology Platform Services are the primary driver. The others are administrative Operations Services and strategic Consulting.
Who are Ayin Health Solutions's main competitors?
Direct peers on record are Innovaccer, Arcadia, Lumeris, Evolent Health, Cedar Gate Technologies, Lightbeam Health Solutions, Health Catalyst and ZeOmega. Optum (UnitedHealth Group) is listed as a broad incumbent. Salesforce Health Cloud is listed as an emerging player.
Does Ayin Health Solutions have an API?
No public API is recorded for Ayin Health Solutions.
What industry is Ayin Health Solutions in?
Ayin Health Solutions's product category is Population Health Management Software. Its primary akta.pro industry code is HLACAEAM, Employer/Member Engagement Platforms for Provider-Sponsored Plans, with a secondary code of HLACAFAO, Data Aggregation, Interoperability & APIs for RPM (FHIR/IoMT Gateways). Its NAICS code is 541511 and its SIC code is 8000.