Why Every Healthcare IT Vendor Should Be Watching the Altera-MCAG Playbook

One week after Altera Digital Health and Managed Care Advisory Group (MCAG) announced their collaboration to streamline class action claims filing for healthcare providers, it is clear that the partnership is more than a one-off response to a $2.8 billion Blue Cross Blue Shield (BCBS) settlement. It is a directional signal, and one that other health IT vendors would be wise to study closely.

This is all about the next competitive differentiator in enterprise healthcare software: legal-financial infrastructure.

The Emergence of Litigation-Aware Platforms

Until now, health IT platforms have largely treated legal settlements, payment disputes, and enforcement actions as external noise. They build for documentation, compliance, and clinical flow, but not for the structural downstream of litigation. Altera has shifted that frame. By embedding MCAG’s class action services into its broader offering, it has effectively turned the EHR-adjacent space into a litigation-aware layer of provider operations.

This idea is not theoretical. Consider recent developments:

• In March 2025, the U.S. Department of Justice announced expanded investigations into vertical consolidation in insurance markets, including potential claims against regional payers for steering practices. Multiple health systems are now preparing to file.

• The Federal Trade Commission continues to scrutinize pharmacy benefit manager (PBM) practices—an area likely to generate future class action opportunities for providers who can prove reimbursement suppression.

• The 340B litigation landscape is evolving rapidly, with courts weighing in on manufacturer-imposed contract pharmacy restrictions. Hospitals that capture historical claims data will be in the best position to recover damages should settlements emerge.

In each case, the bottleneck is administrative readiness. Most providers simply do not track the necessary data, identify exposure windows, or dedicate time to mount a claim unless they are part of a coordinated recovery program.

Claim Positioning as a Platform Feature

What Altera has done with MCAG is to treat claim positioning as a service-line opportunity. It is not quite litigation finance, and it is not quite legal tech. It sits in the seam between compliance automation and financial optimization—a space that has been chronically underserved in the EHR marketplace.

This raises the question: why are not more vendors building in this direction?

The incentives are clear. Providers face relentless payment pressure. The compliance burden is growing. And billions of dollars in recoverable funds, across everything from data breaches to antitrust enforcement, are routinely left untapped because no platform surfaces them within the provider’s operational view.

The vendors that solve for this will not only differentiate on value—they will create new revenue alignment between platforms and providers.

Imagine:

• An RCM system that automatically flags CPT code overuse patterns linked to payer clawbacks

• A care management tool that links denied claims with pending class actions for potential restitution

• A clinical analytics dashboard that maps EHR usage history against eligibility criteria for technology-related settlements

These are not futuristic concepts. They are technically feasible with existing health IT infrastructure. What is missing is the strategic intent.

A Playbook for Health IT Vendors

Altera’s move should not be viewed as a sideline convenience. It is a model for three strategic imperatives that any serious platform vendor should consider:

1. Build proactive claims intelligence into client dashboards. Do not wait for lawsuits to conclude. Identify indicators that a provider may be entitled to future recovery.

2. Form partnerships with litigation support firms, not just legal counsel. Most hospital general counsels are reactive. Revenue recovery consultants like MCAG are execution-focused and deeply familiar with class process logistics.

3. Treat historical billing and encounter data as financial assets. That data defines eligibility across dozens of legal and regulatory pathways. Vendors that can structure and surface it effectively will control a new category of value.

The BCBS case is merely a beachhead. More are coming, and the platforms that help providers act on them will not only earn market share. They will earn trust.

The Path Forward

In the short term, Altera’s partnership may seem like a smart feature add. In the long term, it looks more like an early step toward a new category of legal-financial optimization in healthcare IT. Other vendors, particularly those with deep integrations in claims, billing, and audit, should ask themselves whether they are preparing their clients for tomorrow’s revenue environment or simply maintaining today’s workflows.

The healthcare sector is entering an era of permanent financial friction. Litigation will be a recurring instrument of redress. Providers will need tools that not only document and report, but interpret and act.

Altera and MCAG have shown what that can look like. The rest of the industry now has a choice: wait for the next billion-dollar settlement, or build the infrastructure that ensures providers are ready for it.