How Waystar Delivers a Unified Postgres Data Platform to Simplify Healthcare Payments at National Scale

Waystar exists to solve a problem most people never see but everybody pays for. Behind every medical visit is a complex web of administrative and payment processes that determine whether healthcare providers are paid accurately and on time. When those systems break down, the cost shows up in wasted dollars, delayed care, and strain across the healthcare system.

“There are hundreds of billions of dollars of administrative waste in the healthcare marketplace in the United States,” explains Joshua Dove, Vice President of Technology Operations at Waystar. “Those are dollars that come out of people’s paychecks and detract providers from being able to care for their patients and communities.”

Waystar focuses exclusively on addressing that problem. The company provides a unified, cloud-based platform that helps healthcare providers manage and simplify payments across the complete revenue cycle. “Our mission, our goal, is to help those providers get paid,” says Dove.

Supporting the data infrastructure healthcare providers depend on

Dove’s teams are responsible for operating and supporting the environments Waystar’s products run on, from cloud and data center infrastructure to databases and networks.

“Our tech ops teams provision and maintain the environments on which our products run,” he explains. “We also act as the bridge between client support and product engineering, making sure changes are implemented safely and clients are supported with white-glove service.”

In healthcare, payment disruptions directly affect provider cash flow, staffing, and patient care. At Waystar’s scale, even small failures can ripple quickly across providers and patients. Platform discipline and data sovereignty is foundational to the business itself.

Designing for national scale and high availability with Postgres

Waystar maintains data on more than half of the U.S. population and processes billions of transactions each year. At that level, performance and resilience are table stakes.

“Our systems have to be highly available and highly responsive,” Dove says. “So we use Postgres to ensure our systems can scale to meet the growing needs of the healthcare market.” That architectural consistency matters as Waystar continues to expand its platform.

AI reshapes how Waystar builds and operates

AI has added urgency to platform decisions across the organization. “I don’t think I’ve been in a vendor, partner, or client conversation in the last two years that didn’t center around AI,” Dove notes.

At Waystar, AI shows up in two places. First, in client-facing capabilities that reduce manual work, improve accuracy, and help providers get paid more reliably. Second, in how teams operate internally. “How do we get better at getting better?” Dove asks. From automating routine tasks to enabling non-technical team members to build and adapt their own workflows, AI is expanding who can participate in transformation across the organization.

Consolidating on EDB Postgres AI

As Waystar grew organically and through acquisitions, Postgres usage varied across products and teams. Over time, that fragmentation became unsustainable.

“We wanted to consolidate on a consistent Postgres platform, and we needed a partner that had both the technical expertise and the organizational maturity to support us at scale,” explains Dove. “We looked at five or six different Postgres support options, and what ultimately stood out was EnterpriseDB.”

For Dove, the decision came down to trust built through that evaluation process. “We found a team that inspired a lot of confidence,” he says. “They cared about our success, were flexible in how they worked with us, and had the depth of expertise to support us at scale.”