Anthem, Humana team with SS&C on new claims management joint venture

Anthem and Humana have signed on for a minority stake in a new joint venture that aims to reshape the claims management experience.

DomaniRx, pending regulatory approval, will feature a cloud-native, API-driven claims adjudication platform, according to an announcement. SS&C Technologies, which provides services and software to the financial and healthcare industries, will have a majority stake in the venture.

SS&C will hold an 80.2% interest in the new company, documents filed with the Securities and Exchange Commission show. The parties have committed $925 million in cash and services to the venture, according to the filing.

“SS&C is creating DomaniRx and we are excited to be working with two world-class founding minority co-investors. We are committed to building a next-generation claim adjudication and PBM platform,” said Bill Stone, chairman and CEO of SS&C, in a statement.

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The investment includes $138.3 million in initial cash. Both Anthem and Humana have avenues to exit the venture, including failure to implement the platform, according to the SEC filing.

The goal of the venture, according to the announcement, is to arm healthcare organizations with “end-to-end transparency and data analytics” to help them keep up with an ever-changing regulatory environment.

DomaniRx also aims to support up-and-coming companies deal with the highly complex claims adjudication process, according to the announcement. It will take advantage of SS&C’s technology capabilities and live on its private cloud.

“This is a milestone partnership for the healthcare technology industry, and we are pleased that Humana will be our partner and first customer. DomaniRx will focus on disrupting the industry through open source technology to interface with other systems quickly,” said Danny Delmastro, DomaniRx’s general manager, in a statement.

“The insights we will draw from hundreds of millions of claims transactions, powered by DomaniRx’s advanced processing platform, will provide participating members flexible tools, advanced analytics and customizable programs. All while increasing transparency, accessibility and service quality for members and pharmacies,” Delmastro said.

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