Cotiviti Completes Acquisition of Edifecs

Combined organization to facilitate transformative advancements in value-based care, interoperability, and streamlined operations across payers and providers

Cotiviti, a leader in data-driven healthcare solutions, has completed its acquisition of Edifecs, a pioneer in healthcare data interoperability. Furthering Cotiviti’s vision to enable a high-quality and viable healthcare system, the acquisition will expand and accelerate the development of innovative healthcare technologies to drive advancement in data analytics, interoperability, and value-based care solutions that ultimately improve healthcare delivery and patient outcomes.

"As an end-to-end digital data exchange leader, Edifecs has significantly advanced interoperability, enhancing collaboration between payers and providers for better care delivery," said Emad Rizk, M.D., Chairman, President, and CEO of Cotiviti. "Our new combined organization will further enable our clients to streamline healthcare operations, improve claims processing accuracy and timing, and reduce administrative costs, thereby providing greater value and efficiency for the entire ecosystem."

The transaction supports Cotiviti’s ability to provide a suite of solutions for administrative and medical cost and waste efficiencies with unparalleled breadth, depth, and track record of value delivery. The combined offerings across interoperability and data management, claims submission, eligibility and member enrollment, payment accuracy, and value-based care will facilitate unique cohesiveness and integration across workflows. Further, Cotiviti will drive the next generation of end-to-end risk adjustment by bringing together industry-leading AI-based coding software and services capabilities that allow customers to better identify risk burden and quality gap closure to drive high-quality care.

"As a partner to more than 200 healthcare payers, including the top 25 plans in the United States, Cotiviti has helped numerous healthcare organizations deliver higher-quality and more sustainable care,” said Venkat Kavarthapu, CEO of Edifecs. “By bringing together Edifecs’ industry-leading health data management platform with Cotiviti’s advanced technology, data analytics, and specialized expertise, our unified organization will deliver exceptional value to healthcare organizations as they seek to provide better care at lower cost.”

Cotiviti’s combination of highly differentiated scale, subject matter expertise, technology innovation, large national data insights, and AI enablement will open new frontiers for healthcare organizations and their constituents, with business outcomes unmatched in the industry.

Goldman Sachs & Co. LLC and TripleTree served as lead financial advisors, Evercore and Truist served as financial advisors, and Gibson Dunn provided legal counsel to Cotiviti. J.P. Morgan Securities LLC and William Blair & Company, LLC served as financial advisors and Kirkland & Ellis LLP provided legal counsel to Edifecs.

About Cotiviti:

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and consumer engagement programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.

About Edifecs:

Edifecs provides market-leading technology to its payer and health system customers, which serve nearly 300 million people in the U.S. healthcare market. For over 25 years, Edifecs has enabled customers to unlock greater value with their healthcare operations solutions and data management platform, which includes its market leading healthcare interoperability cloud solution. Edifecs healthcare SaaS solutions, available on public, private, and hybrid clouds, serve as the foundation that eliminates stakeholder friction to overcome healthcare’s biggest challenges, including accelerating value-based care adoption and obtaining more complete and accurate care funding. For more information, visit www.edifecs.com.

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The transaction supports Cotiviti’s ability to provide a suite of solutions for administrative and medical cost and waste efficiencies with unparalleled breadth, depth, and track record of value delivery.