PHILADELPHIA, PA — Lyric acquired Concert to expand its healthcare payment-accuracy platform as health plans face rising costs and increasingly complex coverage decisions tied to genetic testing, specialty medicines and new therapies.
The transaction will integrate Concert’s machine-readable clinical policy technology with Lyric42, Lyric’s healthcare decision intelligence platform. Lyric did not disclose financial terms.
Concert develops technology that converts clinical and administrative policies into automated decisions that can be applied within health plan and provider workflows.
The companies have worked together since 2023. Lyric stated that the scope and use of their joint offering has grown nearly tenfold during that period.
Their existing Diagnostics Module provides policy and claim-editing capabilities for outpatient laboratory testing. Lyric plans to expand the technology across additional services and its broader client base.
Health plans are under pressure to control medical spending while updating coverage and payment policies as clinical evidence changes. The acquisition is intended to move those policies into the systems used to process claims and make coverage decisions.
“Concert’s ground-up approach to synchronize human- and machine-readable policy will plug into health plan workflows through the Lyric42 platform,” Lyric President and Chief Financial Officer Ravi Umarji stated.
Umarji described the combination as a shift from enforcement at separate claims-processing checkpoints toward shared standards used by health plans and providers.
Concert Chief Executive Officer Rob Metcalf stated that the company was built around the premise that clinical and administrative policies should be transparent, evidence-based and computable.
“Combining with Lyric allows us to deliver at scale through the Lyric42 platform,” Metcalf stated.
Lyric provides payment-accuracy and decision-support technology to health plans. Concert has spent more than a decade developing clinical policy capabilities for precision health and diagnostic services.
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