Home chevron icon Payer Solutions chevron icon Payer Software chevron icon Claims & Administration Platforms (Payer)
2018 Best In KLAS Payer Claims & Administration Platforms

2018 Best in KLAS Payer Claims & Administration Platforms

2023 BEST IN KLAS

Who is Best in KLAS?



How do they score? In five key performance categories

Market Segment Average   Conduent


Sales & Contracting

Implementation & Training

Functionality & Upgrades

Service & Support

General

50
100

Solutions Not Ranked

Limited Data Products

Score

Aldera Healthcare Payer and Administrator System*

81.9

Component [C], Not Primary [NP], Regional [R] or Limited Market Share [MS]

GE Healthcare Centricity Financial Risk Manager (Payvider market only)* [C]*

77.2

Tapestry (Payvider market only) [C]*

83.4

*Does not meet minimum KLAS Konfidence level.

Trend does not include the Best KLAS score

See the latest BEST IN KLAS 2018

2023 Best in KLAS Awards - Global Software
2023 GLOBAL
2023 Best in KLAS Awards - Software and Services
2023 BEST IN KLAS

How do Payer Claims & Administration Platforms solutions compare?


How do the top three solutions trend?


Conduent-Health Solutions Plus (HSP) MediTrac
Cognizant-Cognizant Trizetto Core Claims/Administration Solutions
Cedar Gate Technologies-Citra Health Solutions EZ-CAP

Past Payer Claims & Administration Platforms Awards

2023
Claims & Administration Platforms (Payer) 2023 Claims & Administration Platforms (Payer)
2022
Payer Claims & Administration Platforms 2022 Payer Claims & Administration Platforms
2021
Payer Claims & Administration Platforms 2021 Payer Claims & Administration Platforms
2020
Payer Claims & Administration Platforms 2020 Payer Claims & Administration Platforms
2019
Payer Claims & Administration Platforms 2019 Payer Claims & Administration Platforms
2018
Payer Claims & Administration Platforms 2018 Payer Claims & Administration Platforms
2017
Payer Claims and Administration Platforms 2017 Payer Claims and Administration Platforms
Related ReportsView All Reports
White Paper
KLAS article icon
Payer Claims & Administration Platforms
08 September 22    |   Joe VanDeGraaff and Ruirui Sun
Value-based care models have created widespread recognition among health plans that flexible technology is a must, while the need to be more member-centric and digitally focused is driving a desire for better integration between claims platforms and other payer HIT applications. This vendor guide is intended as a simple starting point for health plans and TPAs investigating payer claims and administration platforms. The guide is limited only to vendors with commercial software solutions (services firms are not covered) and includes all vendors known to KLAS as of July 2022.
Performance
KLAS article icon
HealthEdge Core Payer Administration Platform 2021
26 October 21    |   Jennifer Hickenlooper and Joe VanDeGraaff
Though core administration platforms are essential for payer organizations, many of the products in the market are perceived as outdated, complex, and low performing (the market has one of the lowest average performance scores of any KLAS measures). However, HealthEdge has recently seen increased attention from both small and large health plans, who view the vendor’s technology as innovative and who have been asking KLAS for vendor insights. This report examines the experience of HealthEdge customers and how the HealthEdge technology stands out from competitors’.
Best in KLAS
KLAS article icon
2021 Best in KLAS Awards - Software and Professional Services
02 February 21    |   Mark Allphin and Sam Eaquinto
The Best in KLAS report recognizes software and services companies who excel in helping healthcare professionals improve patient care. All rankings are a direct result of the feedback of thousands of providers over the last year. A Best in KLAS award signifies to the healthcare IT industry the commitment and partnership that the top vendors should provide. Read the report to see the top-rated medical software and services for 2021. Watch sessions from our first-ever virtual Best In KLAS Award Show to hear from the winning vendors in each segment. View Awards Show Recordings
Decision Insights
KLAS article icon
Payer Core Administration Platforms 2020
20 May 20    |   Joe VanDeGraaff and Sam Eaquinto
A core administration platform is the transactional heart of a payer organization—it is used to enroll new members, process and pay claims, and manage product lines and benefits. Many of the products in this market, while needed and typically stable, have been around for decades and are highly customized, hosted on-premises, and often seen as old and complex. Many payers are therefore reluctant to replace these systems because the risks and required effort are so high. But recent buying activity suggests the payer core administration platform market is seeing revitalization. Triggered by the opportunities and challenges of payment reform and value-based care, payers are looking ahead and starting to bid for new vendor partners.  KLAS spoke with 30 payer organizations who are making or have recently made purchase decisions, and they shared their candid feedback and insights regarding what vendors they have considered, selected, and/or replaced. These interviews reveal new energy and life in a market long overdue for change—in terms of both product and service delivery.

Konfidence

Konfidence level
Konfidence Level Description
Products must have at least 30 live organizations participating for software and at least 15 live organizations for professional services. Exception to this is Transcription Services (30).
Products must have at least 20 live organizations participating for software and at least 10 live organizations for professional services. Exception to this is Transcription Services (20).
Products must have at least 15 live organizations participating for software and at least 6 live organizations for professional services. Exception to this is Transcription Services
-
The Konfidence level on this product rating is low. These results are for early trend detection. As more performance data is received, the result is likely to have a wide variance.
We use cookies! We use essential and basic aggregated, depersonalized Google Analytics cookies to provide the type of content which our visitors are most interested in.  Cookie Policy    
​