2021 Best In KLAS Risk Adjustment and Analytics

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.

Analytics and risk adjustment are hot topics due to the expenses associated with value-based care, government regulations, and CMS programs. Pareto Intelligence’s revenue integrity solution attempts to provide organizations with actionable data to improve their risk documentation outcomes. This report examines the Pareto customer experience.

Company/solution	Overall performance score (100-point scale)	Total evaluations	Trend (2020-2021)	Culture	Loyalty	Operations	Product	Relationship	Value

Apixio HCC Identifier	94.1	n=14	N/A	A+	A+	A	B+	A	A+

EXL SCIOClarity Risk	93	n=11	N/A	A	A	A	A-	A	A+

MedInsight Risk Analytics	80.8	n=21	0%	B-	B	B-	B-	B-	B-
	50.0	100.0

Company/solution	Trend (2020-2021)	Culture	Loyalty	Operations	Product	Relationship	Value

Apixio HCC Identifier 94.1 n=14 COMMENTS	N/A	A+	A+	A	B+	A	A+
EXL SCIOClarity Risk 93 n=11 COMMENTS	N/A	A	A	A	A-	A	A+
MedInsight Risk Analytics 80.8 n=21	0%	B-	B	B-	B-	B-	B-

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

Advantasure Risk Solutions * L	67.5	n=11	D+	C	D+	D-	C	C-

Datavant (formerly Ciox Health) Ciox Health Risk Adjustment Solution * L	84.8	n=9	B+	B+	B	B-	A-	A-

Optum Risk Adjustment Solutions * L	79.6	n=7	B-	C+	C+	C+	A-	B

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

Advantasure Risk Solutions * L culture D+ loyalty C operations D+ product D- relationship C value C-	67.5	n=11

Datavant (formerly Ciox Health) Ciox Health Risk Adjustment Solution * L culture B+ loyalty B+ operations B product B- relationship A- value A-	84.8	n=9

Optum Risk Adjustment Solutions * L culture B- loyalty C+ operations C+ product C+ relationship A- value B	79.6	n=7

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