2022 Best In KLAS Patient Access

Prior authorization is mandated by payers to ensure that certain clinical procedures and medications being ordered are necessary. To alleviate the heavy administrative burden this requirement causes, healthcare organizations have adopted automated prior authorization solutions. For this report, KLAS interviewed 30 respondents from 26 unique organizations to understand their experiences using these solutions and what outcomes they have seen.

Perception

Optum/Change Healthcare Merger

16 August 22 | Boyd Stewart and Sam Eaquinto

In January 2021, Optum announced their intentions to acquire Change Healthcare. The merger remains unfinalized, however, as the US Department of Justice blocked the deal in February 2022 due to anticompetition concerns—such a merger would give UnitedHealth Group, Optum’s parent company and the nation’s largest insurer, access to rivals’ sensitive data. The legal proceeding is ongoing and scheduled to go to trial August 1, 2022. This report shares Optum and Change Healthcare customers’ reactions to the merger and their perceptions of its impact. Between March 2021 and April 2022, KLAS interviewed 48 individuals from 46 unique organizations; of these respondents, 9% are Optum customers, 56% are Change Healthcare customers, and 35% are customers of both vendors.

Company/solution	Overall performance score (100-point scale)	Total evaluations	Trend (2021-2022)	Culture	Loyalty	Operations	Product	Relationship	Value

FinThrive PELITAS iPAS®	92.6	n=27	+1%	A	A	A-	A	A	A

Waystar Patient Access	89.7	n=23	+4%	A-	A-	A-	A-	B+	A

Optum AccuReg Patient Access	88.1	n=24	-4%	B	A-	B+	B+	A	A-

Experian Health eCare NEXT	80.5	n=51	+5%	C+	B	B-	B	B-	B-

Change Healthcare Clearance Patient Access Suite	75	n=43	-12%	C	C+	C+	C	C-	C
	50.0	100.0

Company/solution	Trend (2021-2022)	Culture	Loyalty	Operations	Product	Relationship	Value

FinThrive PELITAS iPAS® 92.6 n=27 COMMENTS	+1%	A	A	A-	A	A	A
Waystar Patient Access 89.7 n=23	+4%	A-	A-	A-	A-	B+	A
Optum AccuReg Patient Access 88.1 n=24 COMMENTS	-4%	B	A-	B+	B+	A	A-
Experian Health eCare NEXT 80.5 n=51 COMMENTS	+5%	C+	B	B-	B	B-	B-
Change Healthcare Clearance Patient Access Suite 75 n=43 COMMENTS	-12%	C	C+	C+	C	C-	C

Company/solution	Overall performance score (100-point scale)	Total evaluations	Culture	Loyalty	Operations	Product	Relationship	Value

FinThrive nThrive Revenue Systems, LLC CarePricer * [C] L C	76.2	n=8	D+	B	C+	C+	C	B-

Imprivata PatientSecure * [C] L C	85.3	n=11	B+	B	B+	B	A-	B+

The SSI Group SSI Group Access Director * L	87.5	n=16	B	A-	B+	B+	A	A-

Company/solution	Overall performance score (100-point scale)	Total evaluations

FinThrive nThrive Revenue Systems, LLC CarePricer * [C] L C culture D+ loyalty B operations C+ product C+ relationship C value B-	76.2	n=8

Imprivata PatientSecure * [C] L C culture B+ loyalty B operations B+ product B relationship A- value B+	85.3	n=11

The SSI Group SSI Group Access Director * L culture B loyalty A- operations B+ product B+ relationship A value A-	87.5	n=16

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