Built for Provider-Sponsored Plans. Backed by Proven Results
We help payviders (aka. provider-sponsored organizations):
And we do this without losing what makes them mission-driven.
Provider-Sponsored Organizations are Facing More Pressure Than Ever
Rising costs, staffing constraints, regulatory complexity, and the need to grow membership sustainably – it’s a lot. At the end of the day, you’re not just a payer – You’re a care provider, a mission-driven community anchor, and a team under constant strain. Below are some of the ways we can help:
Keep them in check with automation
Increase efficiency with our suite of built-in tools
Plug the hole with our retention technology
Expand into new LOBs (ACA, ICHRA, Medicare Advantage and more), with one tool!
Major Market Changes are Coming. Is your Payvider Plan Ready?
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FREE DOWNLOAD
This useful playbook covers everything from the latest market shifts to ways provider-sponsored plans can gain an advantage in 2027. Interested? Click the link below.
You’re not just a payer – You’re a care provider, a mission-driven community anchor, and a team under constant strain.
See Why 15+ Payviders Are Choosing Softheon
“Softheon’s expert knowledge of the ACA marketplace coupled with their leading enrollment and billing technology has made them the perfect partner during Hometown Health’s first open enrollment period on the exchange.”
David Hansen | CEO, Hometown Health
“The Third Party Payment program is a way for the hospital system, the federal government, and health plans to make sure that funding for healthcare is going to the people that truly need it.”
Daverick Isaac | Senior Vice President & Chief Financial Officer at Community First Health Plan
“The sustainability and technology within the Softheon platform has allowed us to align with what providers need and improve overall coordination – overall improving member experience and leading to a 200% growth upon our re-entry into the ACA.”
Liz Lopez Cepero | SVP Chief Growth Officer, Baylor Scott & White Health Plan
Modern Challenges Demand Modern Solutions
Technology built for payviders – by a team who actually understands them. Expand the sections below to learn more.
Problem: Your health plan isn’t like the others. So why use tech that treats you like it is?
We know that payviders walk a unique tightrope: balancing clinical excellence with financial performance, while navigating internal politics, limited resources, and a growing list of regulatory demands. You’re expected to scale like a national carrier — with the budget and flexibility of a local safety-net plan.
Our Solution? One Partner. One Platform. Built for Provider-Led Growth.
Softheon is the only health tech partner purpose-built for the unique needs of Payviders and PSOs. Whether you’re expanding into new lines of business like ICHRA or just trying to get through AEP without burning out your team, we simplify the backend — so you can focus on the frontlines.
Problem: Business diversification sounds great — until you realize your team is already stretched thin.
Launching new products or entering new markets takes time, buy-in, and system-wide coordination. For most payvider organizations, that feels out of reach.
Our Solution? Growth Without the Growing Pains
Softheon helps provider-sponsored organizations diversify without disruption. We integrate with your existing ecosystem (EMR, claims, population health, etc.) and give your team the tools to succeed without learning a dozen new systems.
You don’t need to rip and replace. You need a vendor that knows how PSOs grow.
Problem: You can’t afford to wait two years to prove this was the right move.
New initiatives require quick wins and measurable outcomes. CFOs want to see ROI. Boards want to see results. Your members want a better experience — yesterday.
Our Solution? Measurable Impact in Months – Not Years
Softheon is already powering over 15 provider-sponsored plans and 38% of ACA enrollment nationwide. Our partners see faster effectuation, improved reconciliation, and smarter automation from the start.
Problem: You’re not just trying to reduce costs — You’re trying to improve care.
As a PSO, your mission goes beyond the margins. But administrative complexity, siloed data, and compliance hurdles can distract from what matters most: your members.
Our Solution? Technology that Supports Your Mission — Without Sacrificing Performance.
We believe operational excellence and community health can — and should — go hand in hand.
Softheon is an ACAP and ACHP Strategic Ally
Making healthcare more affordable, accessible, and plentiful for all Americans.
Insights to Move You Forward
Third-Party Payment Program Generates Annualized 2.2X ROI
UCare faced significant challenges due to manual processes in shopping, enrollment, and billing, which
