PLEXIS Showcase Composable CAPS to Help Health Plans to Upgrade Legacy Core Administration with Minimal Disruption

PLEXIS Healthcare Systems announces on helping health plans modernize legacy core administration environments with a composable, API-enabled platform built for operational continuity and long-term adaptability.  

This system is the center of claims administration, enrollment, billing, provider data, and benefit management, which means every modernization decision has downstream consequences for efficiency, integration, and service delivery. 

With reference to Gartner's market guidance also underscores the need to modernize the core administrative system, address connectivity challenges between disparate systems, streamline processes, and improve claims accuracy and efficiency. 

According to Towards Healthcare, the U.S. healthcare payers core administrative processing solutions market is projected to experience significant growth, with estimates suggesting the market size will increase from USD 4.07 billion in 2026 to approximately USD 8.48 billion by 2035, representing a compound annual growth rate (CAGR) of 8.5% from 2026 to 2035. Growth is driven by cloud adoption; payers are shifting from legacy, on-premise systems to cloud-based solutions to achieve greater scalability, real-time data access, and faster claim processing. Due to the need to optimize operations and reduce administrative overhead, the market is expanding due to the integration of cloud computing and artificial intelligence. 

About PLEXIS Healthcare Systems 

It delivers enterprise-grade core administration and claims processing solutions that power modern healthcare payers and delivery organizations. It enables organisations to navigate evolving market demands around automation, integration, and benefit complexity. It supports the full spectrum of core administrative functions, including claims adjudication, enrollment, premium billing, provider data management, and benefit configuration. Built on a scalable, API-enabled architecture, the platform allows payers to streamline workflows, reduce manual intervention, and adapt to shifting regulatory and product requirements. 

It is designed to align with the market’s shift toward API-driven ecosystems and real-time data integration, empowering health plans to modernize at their own pace while maintaining operational continuity. With advanced technology and automation, configurable rules-based processing, and seamless interoperability, it also helps organizations improve efficiency, reduce administrative friction, and deliver accurate outcomes across the claims lifecycle. 

A recent report by Towards Healthcare highlights that the U.S. healthcare payers core administrative processing solutions market is witnessing growth due to the shift toward cloud-based deployments, which allow payers to efficiently scale operations, reduce reliance on outdated legacy mainframes, and improve data accessibility with automation and AI technologies to control operational costs and enable real-time adjudication.