Core Administrative
Processing System

You already know what your health plan needs to maintain a competitive advantage and grow:

Strategic investments in improving the member experience, strengthening care coordination, and launching new lines of business and other innovations. But increasing administrative costs, tighter margins and regulatory changes limit your ability to act.

An advanced Core Administrative Processing System (CAPS) can provide you with the efficiency, flexibility, insights and agility necessary to control costs, embrace change and move quickly to take advantage of new opportunities.

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The HealthRules® Solution Suite

HealthRules Payer

HealthRules Payer provides transformational capabilities to health plans of all types and sizes with features that align with your business processes and functional areas.


Our HealthRules Answers business intelligence solution transforms the way you see and use data in real time, helping to reduce costs, identify market opportunities, validate new product offerings, and support next-generation business models.

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HealthRules Connector

HealthRules Connector is a robust integration layer that links HealthRules seamlessly with other systems, partner networks and exchanges so you can share critical healthcare information quickly, easily and securely.

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Additional Offerings

HealthRules Promote

Our Configuration and Promotion application enables your organization to benefit from increased automation, greater accuracy, a simplified process and lower costs.

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HealthRules Home & Host Processing

HealthRules Payer offers built-in capabilities to support all aspects of the home and host program, reducing complexity and eliminating unnecessary duplication of provider data.

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“We wouldn’t be in business if we didn’t make a change. Not only was our legacy solution extremely clunky and hard to configure, but only a couple of people understood it, as it was not user-friendly, and it certainly wasn’t scalable.”

Sara Mavredes, Vice President of Business Information and Operations at McLaren Health Plan
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