Burgess Listed as a Sample Vendor for Prospective Payment Integrity Solutions in Gartner’s Hype Cycle for U.S. Healthcare Payers, 2020

ALEXANDRIA, Va. – The Burgess Group, LLC (“Burgess”), an innovator in healthcare payment operations for more than 20 years, today announced that the company has been identified as a Sample Vendor in Gartner’s annual report: Hype Cycle for U.S. Healthcare Payers, 2020 (August 2020). Gartner identified Burgess as a Sample Vendor in the Prospective Payment Integrity Solutions category.

According to the report, “prospective payment integrity solutions enable payers to proactively avoid paying claims improperly, versus focusing on the pay-and-chase activities that define retrospective payment integrity solutions. These technologies facilitate accurate claims processing with minimal payment leakage, addressing contracts and services, eligibility, and payment accountability, along with fraud, waste, and abuse (FWA). These solutions incorporate tools that include claims editing, data mining and complex clinical review, as well as advanced analytics and AI.”1

Burgess was recently acquired by HealthEdge Software, Inc.® (“HealthEdge”), a provider of the industry’s leading financial, administrative, and clinical platform for health insurers. HealthEdge has also been identified as a Sample Vendor in Gartner’s annual report: Hype Cycle for U.S. Healthcare Payers, 2020, in the Next Generation Core Administrative Processing Solutions category.

“Our company has tremendous respect for Gartner and we are thrilled to be recognized in this report for another year,” said Jared Lorinsky, Chief Strategy Officer, Burgess. “Our coming together with HealthEdge reflects our commitment to addressing the estimated $1 trillion in wasteful spending in the U.S. healthcare system and to developing best-in-class, unified solutions to improve payment integrity.”

Burgess Source® is the first solution to natively bring together claim payment automation with business intelligence. The platform enables payers with Medicare, Medicaid, and commercial lines of business to have better relationships with providers, reduce waste, and improve their financial performance.

1 Gartner, Hype Cycle for U.S. Healthcare Payers, 2020, Mandi Bishop, Jeff Cribbs, Bryan Cole, 5 August 2020.

Gartner Disclaimer

Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

About Burgess

Burgess operates at the intersection of healthcare, finance, and technology. The company helps leading American health insurers and ACOs set a new standard: Payment Accountability®. The company’s cloud-based platform, Burgess Source, is the only solution that natively brings together up-to-date regulatory data, claims pricing and editing, and real-time analytics tools. This unified approach allows clients to make payments with total confidence and make business decisions with real intelligence. The company is headquartered in Alexandria, VA, with an office in West Hartford, CT, and online at burgessgroup.com.

For interviews and general press inquiries, please contact:

Matt Brady
matt.brady@burgessgroup.com
703-894-1800


HealthEdge Completes Acquisition of The Burgess Group

Burlington, Ma., and Alexandria, Va. – HealthEdge Software, Inc.® (“HealthEdge”), provider of the industry’s leading integrated financial, administrative and clinical platform for health insurers, HealthRules® Payor, today announced it has completed the acquisition of The Burgess Group, LLC (“Burgess”), an innovative payment integrity software company focused on improving healthcare payment operations through technology. Health plan customers will now benefit from claims cost savings via the Burgess Source® platform’s ability to identify and reduce wasteful spending in the U.S. healthcare system, leading the way to on-time, accurate payments for millions of their covered lives.

“We are really excited about the future of HealthEdge,” said Steve Krupa, CEO of HealthEdge. “Our company’s growth and maturation, coupled with strategic and capital support from our investors, have enabled us to take a significant step toward creating a fully automated cloud-based transactional system for health plans by partnering with Greg Burgess and his team.”

“The Burgess Group team is hitting the ground running with HealthEdge,” said Greg Burgess, Founder and President. “Driving solutions in the payment integrity arena has been our heart and soul for nearly 25 years. Together with HealthEdge, we will maximize efficiencies through our collective experience and ultimately create win-win scenarios for health plans, patients and participating providers.”

The Burgess acquisition follows the purchase of a majority stake in HealthEdge by funds managed by Blackstone in April 2020.

Ram Jagannath, Global Head of Healthcare for Blackstone Growth and Chairman of HealthEdge said, “We are excited to back HealthEdge as a leading next-generation payor software company and we see HealthEdge as a platform for further strategic acquisitions. HealthEdge’s acquisition of Burgess provides a critical adjacency in payment integrity software to further strengthen our value proposition to health plan customers.”

TripleTree, LLC served as financial advisor and Debevoise & Plimpton LLP was legal advisor to HealthEdge and Blackstone. Seabrook Partners, LLC served as financial advisor and Vedder Price was legal advisor to Burgess. Terms of the transaction were not disclosed.

About HealthEdge
HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite, HealthRules, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. An award-winning company, HealthEdge empowers health insurers to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit www.healthedge.com.

About The Burgess Group
Burgess operates at the intersection of healthcare, finance, and technology. The company helps leading American health insurers and ACOs set a new standard: Payment Accountability. The company’s cloud-based platform, Burgess Source, is the only solution that natively brings together up-to-date regulatory data, claims pricing and editing, and real-time analytics tools. This unified approach allows clients to make payments with total confidence and make business decisions with real intelligence. The company is headquartered in Alexandria, VA, with an office in West Hartford, CT, and online at www.burgessgroup.com.

About Blackstone
Blackstone is one of the world’s leading investment firms. We seek to create positive economic impact and long-term value for our investors, the companies we invest in, and the communities in which we work. We do this by using extraordinary people and flexible capital to help companies solve problems. Our asset management businesses, with $538 billion in assets under management, include investment vehicles focused on private equity, real estate, public debt and equity, growth equity, opportunistic, non-investment grade credit, real assets, and secondary funds, all on a global basis. Further information is available at www.blackstone.com. Follow Blackstone on Twitter @Blackstone.

For interviews and general press inquiries, please contact:

Gail Winslow
HealthEdge
978-482-6237
gwinslow@healthedge.com

Matt Brady
Burgess
703-682-0986
matt.brady@burgessgroup.com

Matt Anderson
Blackstone
212-390-2472
matthew.anderson@blackstone.com


Burgess Source® Achieves HITRUST CSF® Certification in Azure to Further Mitigate Risk in Third-Party Privacy, Security, and Compliance

ALEXANDRIA, Va. – Burgess, an innovator in healthcare payment operations for over 20 years, today announced that Burgess Source® has earned Certified status for information security by HITRUST® in its Microsoft Azure environment.

HITRUST CSF Certified status demonstrates that Burgess Source has met key regulations and industry-defined requirements and is appropriately managing risk. This achievement places Burgess among the top tier of organizations worldwide that have earned this certification. By including federal and state regulations, standards and frameworks, and incorporating a risk-based approach, the HITRUST CSF helps organizations address these challenges through a comprehensive and flexible framework of prescriptive and scalable security controls.

“HITRUST is continually innovating to help streamline and simplify how organizations assess information risk and manage compliance in a cloud environment,” said Jeremy Huval, Chief Compliance Officer, HITRUST. “We are happy that Burgess has taken the steps needed to achieve HITRUST CSF Certification in its Azure environment—a designation which provides added confidence to their customers.”

Burgess’ latest innovation, Burgess Source, enables a unified approach to ensure higher payment accuracy. The unique design of Burgess Source provides a cohesive approach to claims payment with a single integration point for multiple aspects of claims processing, unified configuration and customization of rules, automated processing in the cloud, and editing, pricing, auditing, reporting and modeling in one transaction. It also provides extensibility to incorporate third-party solutions and their data into a simplified workflow.

For more information on Burgess Source and to discover how its unified approach can streamline payment operations in your organization, visit burgessgroup.com.

About Burgess
Burgess is dedicated to improving healthcare payment operations through technology. We bring technology innovation and real-time data to an overlooked and critical part of the American healthcare system. The company is located in Alexandria, Va., with a satellite office in West Hartford, Conn., and online at burgessgroup.com.

For interviews and general press inquiries, please contact:

Matt Brady
matt.brady@burgessgroup.com
703-894-1800


COVID-19: Burgess Donations Support Those Impacted

During this uncertain time for all of us, Burgess has made donations to local organizations that provide help to those in need during the COVID-19 (Coronavirus) pandemic. Donations will be made in Virginia to Carpenter’s Shelter and Alive, and in Connecticut to Healing Meals and the CT Food Bank.

Here is information on the charities we are supporting, including links for more information and to donate:

ALIVE: alive-inc.org
Alive’s mission is to alleviate the suffering caused by poverty and to dramatically improve the lives of those in need in the city of Alexandria. Through faith and love, Alive seeks to help people faced with emergency situations or long-term needs become capable of assuming self-reliant roles in the community.

CARPENTER’S SHELTER: carpentersshelter.org
Carpenter’s Shelter supports the homeless in achieving sustainable independence through shelter, guidance, education and advocacy. It serves more than 650 homeless and formerly homeless children and adults each year.

HEALING MEALS: healingmealsproject.org
Healing Meals provides nourishing, healing meals to clients at their most vulnerable time, in particular those who are immunocompromised. The company prepares and delivers delicious, organic meals for families dealing with a serious health crisis for 12 weeks.

CONNECTICUT FOOD BANK: ctfoodbank.org
Connecticut Food Bank is committed to alleviating hunger in Connecticut by providing food resources, raising awareness of the challenges of hunger, and advocating for people who need help meeting basic needs. Connecticut Food Bank partners with the food industry, food growers, donors, and volunteers to distribute nutritious food to people in need.

Thank you to all the healthcare workers, first responders, and community leaders who continue to heroically serve our communities during the Coronavirus pandemic.


Burgess Acquired by HealthEdge Software

Burlington, Ma., and Alexandria, Va. – HealthEdge Software, Inc.® (“HealthEdge”), a provider of the industry’s leading integrated financial, administrative and clinical platform for health insurers, HealthRules® Payor, today announced the acquisition of The Burgess Group, LLC (“Burgess”), an innovative payment integrity software company focused on improving healthcare payment operations through technology.

Complementary Products Result in a Leading Solutions Combination
Steve Krupa, HealthEdge Chief Executive Officer, and Greg Burgess, Founder and President of The Burgess Group, built a strong relationship around their mutual passion to automate the transactional systems for health plan claims processing and payments through a cloud-computing infrastructure.

“Greg and I realized our like-minded mission to enhance operational efficiency for health plans through our next-generation platforms would create momentum in the healthcare payor marketplace,” said Steve Krupa. “We both spearhead entrepreneurial and innovation-driven organizations, and our shared desire to impact healthcare by overcoming the limitations of current solutions, have resulted in our coming together to create a robust, thriving, growth-oriented company built on disruptive healthcare payor technology.”

“After 23 years, I’ve discovered a partner in Steve and the HealthEdge team, who understand our passion in designing and delivering the industry’s first cloud-native payment integrity ecosystem,” said Greg Burgess. “Working together we will accelerate our shared vision to challenge the inefficient status quo in claims administration. As one combined company, we can offer our existing complementary solutions while we collaborate to introduce another industry first: an end-to-end unified claims processing, payment integrity, and adjudication platform capable of delivering first pass payment accuracy to providers. By harnessing cloud technologies, we will bring data integration, reimbursement accuracy and accountability, to an elevated level of precision, empowering the industry to realize point of service payments.”

Future Benefits for the Health Insurance Industry
“The acquisition of Burgess is a great strategic fit for HealthEdge to enter the large, high-growth market of payment integrity, helping address the estimated $1 trillion in wasteful spending in the U.S. healthcare system. This partnership will extend HealthEdge’s best-in-class claims processing to include software-driven payment integrity, actioned before a claim is paid, delivering significant value to health plans beyond what is available in the market today,” said Ram Jagannath, Global Head of Healthcare for Blackstone Growth and Chairman of HealthEdge.  “We are excited to invest further in HealthEdge to continue building a market-leading software platform for health insurers.”

HealthEdge’s acquisition of Burgess follows the acquisition of a majority stake in HealthEdge by funds managed by Blackstone (“Blackstone”) in April 2020.

Next-Generation Payor Technology Companies
HealthEdge provides mission-critical next-generation Core Administrative Processing Systems solutions to healthcare payors, enabling them to administer benefits, configure plans, manage providers, and enroll participants seamlessly and efficiently. The company’s products offer a modern, simple user interface, greater flexibility, and a cloud-compliant solution well suited to the increasingly complex and data-rich healthcare environment.

Burgess operates at the intersection of healthcare, finance, and technology, helping leading national, regional, and local health insurers set a new standard of Payment Accountability®. Its platform enables payors with Medicare, Medicaid, and Commercial lines of business to have better relationships with providers, reduce waste, and improve their financial performance. Burgess’ product, Burgess Source®, is the first solution to natively bring together claim payment automation with business intelligence and enables a unified approach to ensure payment accuracy.

TripleTree, LLC served as financial advisor and Debevoise & Plimpton LLP was legal advisor to HealthEdge and Blackstone. Seabrook Partners, LLC served as financial advisor and Vedder Price was legal advisor to Burgess. Terms of the transaction were not disclosed.

About HealthEdge
HealthEdge provides modern, disruptive healthcare IT solutions that health insurers use to leverage new business models, improve outcomes, drastically reduce administrative costs, and connect everyone in the healthcare delivery cycle. Its next-generation enterprise solution suite, HealthRules, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or onsite deployment. An award-winning company, HealthEdge empowers health insurers to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit www.healthedge.com.

About The Burgess Group
Burgess operates at the intersection of healthcare, finance, and technology. The company helps leading American health insurers and ACOs set a new standard: Payment Accountability. The company’s cloud-based platform, Burgess Source, is the only solution that natively brings together up-to-date regulatory data, claims pricing and editing, and real-time analytics tools. This unified approach allows clients to make payments with total confidence and make business decisions with real intelligence. The company is headquartered in Alexandria, VA, with an office in West Hartford, CT, and online at www.burgessgroup.com.

About Blackstone
Blackstone is one of the world’s leading investment firms. We seek to create positive economic impact and long-term value for our investors, the companies we invest in, and the communities in which we work. We do this by using extraordinary people and flexible capital to help companies solve problems. Our asset management businesses, with $538 billion in assets under management, include investment vehicles focused on private equity, real estate, public debt and equity, growth equity, opportunistic, non-investment grade credit, real assets, and secondary funds, all on a global basis. Further information is available at www.blackstone.com. Follow Blackstone on Twitter @Blackstone.


COVID-19: We Are Prepared and in This Together

The spread of the coronavirus (COVID-19) is impacting countless individuals, businesses, and increasingly, our daily routines. During this time, we have implemented measures to ensure that we provide continuous, uninterrupted service and, as part of our Business Continuity Plan, we are prepared to provide our services on a remote basis.

As we support your evolving business needs, we recognize our moral and social responsibility to keep our people healthy and avoid straining the healthcare system. We are following the guidance provided by the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and local authorities in areas where we operate. We are also reducing business travel, holding meetings by teleconference whenever possible, postponing certain meetings and events, and asking members of our Burgess family to take whatever additional cautionary measures they need to maintain their health. We want our team to be available to serve your needs whenever those needs arise.

We extend our gratitude to healthcare professionals and government officials for their care and dedication to our communities during this global health crisis. Our thoughts remain with those impacted by the coronavirus. We hope you, your coworkers, and your loved ones remain in good health during this evolving health situation.


Accelerate on the Path to Point-of-Service Payments with Smart Workflows and Automation

President and Chief Product Officer Greg Burgess presented “The Path to Point-of-Service Payment Success” during the 2019 AHIP Institute & Expo in Nashville. This session provided a look at how to move the healthcare industry toward a future point-of-service payment structure that providers and beneficiaries seek. Real-time technology and long-term collaboration with providers and partners were discussed to begin this necessary transformation of the payment process.

A series of insights have been created that elaborate on this speaking session. Readers can dive deeper into the advancements in technology that will bring us closer to accurate point-of-care payments.

Download our insight, The Path to Point-of-Service Payment Success: Process Automation and Intelligent Workflow

To receive future insights from Burgess, subscribe today:

Subscribe: 

To learn more about ways we help payers achieve payment accountability, please contact us or request a demo today.

Burgess is dedicated to improving healthcare payment operations through technology. We bring technology innovation and real-time data to an overlooked and critical part of the American healthcare system. Our scalable Payment Accountability® platform, Burgess Source®, integrates payer systems to transform payment workflows and provide powerful business intelligence to lift payer performance. The company is located in Alexandria, Va., with a satellite office in West Hartford, Conn., and online at burgessgroup.com.


Burgess Mentioned in Gartner Report on the Hype Cycle for U.S. Healthcare Payers, 2019

ALEXANDRIA, Va. – Burgess, an innovator in healthcare payment operations for over 20 years, announced that the company has been identified as a sample vendor in Gartner’s annual report: Hype Cycle for U.S. Healthcare Payers, 2019 (July 2019). 

Written by healthcare analysts Bryan Cole, Jeff Cribbs, and Mandi Bishop, this report focuses on strategic planning for U.S. healthcare payer CIOs who are considering investments to optimize and transform their organizationsSpecifically, the report tracks maturity levels and adoption rates of emerging payer technologies. 

The report mentions Burgess in a section termed “Prospective Payment Integrity Solutions. This is defined as solutions that “enable payers to proactively avoid paying claims improperly, rather than focusing on the pay-and-chase activities that define retrospective payment integrity solutions. These technologies facilitate accurate claims processing with minimal payment leakage, addressing contracts and services, eligibility, and payment accountability along with fraud, waste and abuse (FWA). These solutions incorporate tools such as claims editing, data mining and complex clinical review as well as advanced analytics and AI.1

Gartner goes on to outline the financial savings for healthcare payers with Prospective Payment Integrity Solutions. “Payers can reliably expect a 1% to 2% savings on claim expense for implementing a full-cycle payment integrity solution (with some vendors claiming 10% savings or more).”1 

Burgess expands upon the challenges and solutions in payment operations in a new series called “The Path to Point-of-Service Payment Success,” based on a speaking session hosted by President and CEO, Greg Burgess, at the 2019 AHIP Institute & Expo. For details on this series, visit burgessgroup.com/insights. 

Our company has tremendous respect for Gartner and its expertise in healthcare payer operations,” Chief Strategy Officer Jared Lorinsky said. “We believe being recognized in this year’s Hype Cycle reflects the commitment we have made to developing solutions that help payers achieve accuracy and efficiency. This shift to distinguishing Prospective Payment Integrity Solutions is in line with what Burgess Source® enables for payers in the healthcare industry. 

For more information on Burgess Source and how to streamline payment operations in your organization, visit burgessgroup.com. 

1 Gartner, Hype Cycle for U.S. Healthcare Payers, 2019, Analyst(s): Bryan Cole, Jeff Cribbs, Mandi Bishop, Published: 18 July 2019 ID: G00369514.

Gartner Disclaimer 

Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose. 

About Burgess 

Burgess is dedicated to improving healthcare payment operations through technology. We bring technology innovation and real-time data to an overlooked and critical part of the American healthcare system. Our scalable Payment Accountability® platform, Burgess Source®, provides payers with a forward-thinking enterprise platform to manage payment rules and workflow. The company is located in Alexandria, Va., with a satellite office in West Hartford, Conn., and online at burgessgroup.com. 

For interviews and general press inquiries, please contact:

Matt Brady
matt.brady@burgessgroup.com
703-894-1800

 


Integrated Ecosystems are Vital on the Path to Point-of-Service Payments

President and Chief Product Officer Greg Burgess presented “The Path to Point-of-Service Payment Success” during the 2019 AHIP Institute & Expo in Nashville. This session provided a look at how to move the healthcare industry toward a future point-of-service payment structure that providers and beneficiaries seek. Real-time technology and long-term collaboration with providers and partners were discussed to begin this necessary transformation of the payment process.

A series of insights have been created that elaborate on this speaking session. Readers can dive deeper into the advancements in technology that will bring us closer to accurate point-of-care payments.

Download our insight, The Path to Point-of-Service Payment Success: Integrated Ecosystems

To receive future insights, including the next in the series “The Path to Point-of-Service Payment Success: Process Automation and Intelligence,” subscribe today:

Subscribe: 

To learn more about ways we help payers achieve payment accountability, please contact us or request a demo today.

Burgess is dedicated to improving healthcare payment operations through technology. We bring technology innovation and real-time data to an overlooked and critical part of the American healthcare system. Our scalable Payment Accountability® platform, Burgess Source®, integrates payer systems to transform payment workflows and provide powerful business intelligence to lift payer performance. The company is located in Alexandria, Va., with a satellite office in West Hartford, Conn., and online at burgessgroup.com.


New Insight Illuminates the Path to Point-of-Service Payments

President and Chief Product Officer Greg Burgess presented “The Path to Point-of-Service Payment Success” during the 2019 AHIP Institute & Expo in Nashville. This session provided a look at how to move the healthcare industry toward a future point-of-service payment structure that providers and beneficiaries seek. Real-time technology and long-term collaboration with providers and partners were discussed to begin this necessary transformation of the payment process.

A series of insights have been created that elaborate on this speaking session. Readers can dive deeper into the advancements in technology that will bring us closer to accurate point-of-care payments.

Download our insight, The Path to Point-of-Service Payment Success: Cloud-based Data Delivery

To receive future insights, including the next in the series “The Path to Point-of-Service Payment Success: Integrated Ecosystems,” subscribe today:

Subscribe: 

 

To learn more about ways we help payers achieve payment accountability, please contact us or request a demo today.

Burgess is dedicated to improving healthcare payment operations through technology. We bring technology innovation and real-time data to an overlooked and critical part of the American healthcare system. Our scalable Payment Accountability® platform, Burgess Source®, integrates payer systems to transform payment workflows and provide powerful business intelligence to lift payer performance. The company is located in Alexandria, Va., with a satellite office in West Hartford, Conn., and online at burgessgroup.com.