HealthEdge and UST HealthProof Merge to Form AI-Powered Healthcare Payer Technology and Services Leader Backed by Bain Capital
The merger establishes a next-generation claims operating system for payers, offering end-to-end AI capabilities across claims, payments, care and utilization management, payment integrity, and member engagement, and serving more than 115 health plans.
BOSTON, September 4, 2025 – HealthEdge and UST HealthProof announced today the completion of their merger, following Bain Capital’s purchase of UST HealthProof from UST. Terms of the deal were not disclosed.
Headquartered in Boston, the combined company will operate under the HealthEdge name. Reaching more than 110 million lives across the U.S. healthcare system, HealthEdge is positioned to equip health plans with modern, AI-enabled technology and services that reduce costs and boost operational efficiency. The company will also benefit from Bain Capital’s four decades of experience investing in and scaling healthcare businesses globally, driving innovation and advancing patient outcomes and experiences.
Health plans today face rising administrative expenses, increasing regulatory complexity, and growing member expectations—challenges that outdated legacy systems are unable to meet. The merger of HealthEdge and UST HealthProof delivers a unified, end-to-end platform designed to modernize payer operations. By combining HealthEdge’s AI-powered payer applications with UST HealthProof’s interoperability solutions, the platform streamlines administrative workflows, cuts costs, and enhances the member experience. In addition, UST HealthProof’s proprietary technology reduces the risks associated with cloud migration, giving payers a safer path to digital transformation while supporting improved clinical outcomes for both plans and patients.
The merger unites award-winning technology, a comprehensive product portfolio, and deep industry expertise to accelerate the modernization of payer technology. Specifically, the combined company will:
- Deliver greater value for payers through integrated software and technology-enabled services designed to reduce costs and enhance clinical outcomes
- Open new opportunities for product development and market expansion in a rapidly growing industry
- Accelerate innovation with an AI-native operating system that supports the entire payer value chain—from claims automation and payment integrity to personalized member engagement
- Strengthen and unify go-to-market capabilities to better address the most pressing customer needs
HealthEdge will be led by a management team that combines the leadership, vision, and expertise of both organizations, creating new opportunities for employees to grow and develop. Kevin Adams, former CEO of UST HealthProof, will take on the role of CEO of the combined company. Steve Krupa, former CEO of HealthEdge, will continue to play an active role as a member of the board of directors.
“I’m honored to lead HealthEdge at such a pivotal time in healthcare technology,” said Kevin Adams, CEO of HealthEdge. “Health plans are under pressure to manage rising costs and complex regulations while meeting higher member expectations. This merger unites leading payer technology with seamless integration capabilities and experienced operational teams. Together, we’re simplifying the administrative burdens health plans face every day and providing an integrated solution that’s easier to adopt and more effective in delivering the value they need.”
“HealthEdge has long partnered with health plans to drive ongoing innovation in healthcare IT,” said Steve Krupa, member of HealthEdge’s Board of Directors. “Now, we have the opportunity to combine modern technology with proprietary interoperability and proven operational expertise—helping health plans deliver more seamless, cost-effective healthcare experiences. We’re excited to join forces with UST HealthProof to provide even greater value to our customers and teams.”
“HealthEdge and UST HealthProof are two innovative organizations with complementary customers, product portfolios, and go-to-market strategies. Together, they are creating the first fully integrated, next-generation claims platform of its kind for payers,” said Devin O’Reilly, Partner at Bain Capital. “The companies also bring a decade-long track record of collaboration in delivering meaningful value to health plans.”
“By bringing these two leaders together, we are establishing the definitive next-generation, cloud-based claims platform for payers—with the scale, expertise, and technology to reshape the industry,” added Paul Moskowitz, Partner at Bain Capital. “At a time when healthcare is at a critical turning point and payers face unprecedented financial pressures, the combined company is uniquely positioned to reduce costs, accelerate AI-driven innovation, and deliver the streamlined U.S. healthcare experience of the future.”
TripleTree served as financial advisor, Kirkland & Ellis LLP as legal counsel, and Ares Management as lead financing partner to Bain Capital. Evercore advised HealthEdge, while Goldman Sachs and JPMorgan acted as financial advisors and Davis Polk & Wardwell LLP served as legal counsel to UST HealthProof.
Company Overview: HealthEdge
HealthEdge® delivers the technology and services that power the core value streams of health plans. Its integrated platform spans claims administration, quality improvement, payment accuracy, provider network management, care management, member engagement, and risk adjustment—enabling health plans to unify their data, leverage automation, and unlock the potential of AI. By combining next-generation technology with deep expertise and services, HealthEdge equips health plans with the tools to deliver seamless, cost-effective healthcare experiences. To learn more, visit www.HealthEdge.com
Company Overview: Bain Capital
Founded in 1984, Bain Capital is a leading global private investment firm dedicated to creating lasting value for investors, businesses, teams, and the communities it serves. Operating as a private partnership, the firm fosters a culture of conviction and collaboration—strengths that drive innovative investment strategies, unlock opportunities, and deliver exceptional results. Bain Capital invests across five core areas: Private Equity, Growth & Venture, Capital Solutions, Credit & Capital Markets, and Real Assets. With deep sector expertise and broad capabilities, the firm manages approximately $185 billion in assets, supported by more than 1,850 employees across 24 offices on four continents. For more information, visit www.baincapital.com and follow @BainCapital on LinkedIn and X (Twitter).
