2022 Best In KLAS Risk Adjustment

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.

Vatica Health provides dedicated clinical support and technology to payers’ contracted physicians to improve diagnostic coding, documentation, and quality of care for members. Vatica Health’s team works on-site to lend providers support, enabling payers to manage members and their care while also increasing financial impact and reducing compliance risk.

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

Company/solution	Overall score	Total evaluations	Trend (2021-2022)	Culture	Loyalty	Operations	Product	Relationship	Value	Censinet assessment

EXL Clarity™	93.2	n=15	0%	A	A	A-	A	A+	A

Apixio HCC Identifier	91.2	n=23	-3%	A	A-	A	B+	A	A+

Pareto Intelligence Risk Solutions	90.5	n=16	N/A	A	A	B+	B+	A	A

MedInsight Risk Analytics	89.6	n=23	+11%	A	A	B+	B+	A-	A-

Episource Risk Adjustment and Analytics	87	n=20	N/A	B	A-	B+	B	B+	A-

Ciox Health Risk Adjustment Solution	81.8	n=19	-4%	B-	B	B-	B-	B	B

Change Healthcare Risk View (Risk Analytics)	78.6	n=12	N/A	C+	C+	B	C	B	B

Inovalon ONE Platform Risk	60	n=16	N/A	F	D	D	D	D+	F
	50.0	100.0		*Limited Data

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

EXL Clarity™ 93.2 n=15 COMMENTS	0%	A	A	A-	A	A+	A
Apixio HCC Identifier 91.2 n=23 COMMENTS	-3%	A	A-	A	B+	A	A+
Pareto Intelligence Risk Solutions 90.5 n=16 COMMENTS	N/A	A	A	B+	B+	A	A
MedInsight Risk Analytics 89.6 n=23 COMMENTS	+11%	A	A	B+	B+	A-	A-
Episource Risk Adjustment and Analytics 87 n=20 COMMENTS	N/A	B	A-	B+	B	B+	A-
Ciox Health Risk Adjustment Solution 81.8 n=19 COMMENTS	-4%	B-	B	B-	B-	B	B
Change Healthcare Risk View (Risk Analytics) 78.6 n=12 COMMENTS	N/A	C+	C+	B	C	B	B
Inovalon ONE Platform Risk 60 n=16 COMMENTS	N/A	F	D	D	D	D+	F

Company/solution	Overall performance score	Total evaluations	Culture	Loyalty	Operations	Product	Relationship	Value	Censinet assessment

Advantmed ELEVATE Risk Adjustment Insights * L	77.3	n=6	C+	C	C	B-	B-	B+

Arcadia Arcadia.io Arcadia Risk Navigator Plus * L	84.5	n=6	B	A-	C+	B	B	B+

Cotiviti Risk Adjustment Solutions * L	70.4	n=8	D+	C-	D+	D+	C-	B+

Health Fidelity Lumanent * L	79	n=11	C-	B-	B-	C+	B	B

Optum Risk Adjustment Solutions * L	65.9	n=6	D+	D	D	D	C+	C-

Talix Risk Adjustment and Analytics Solutions * L	89.8	n=10	A-	A	B+	B+	A	A

Vatica Health Risk Adjustment and Quality of Care Solution * L	89.2	n=6	A	A	B	B-	A+	A

Veradigm (formerly Allscripts) Pulse8 Illumin8 Risk Analytics * L	72.9	n=7	C+	D+	C+	C+	B-	C

Company/solution	Overall performance score	Total evaluations

Advantmed ELEVATE Risk Adjustment Insights * L culture C+ loyalty C operations C product B- relationship B- value B+	77.3	n=6

Arcadia Arcadia.io Arcadia Risk Navigator Plus * L culture B loyalty A- operations C+ product B relationship B value B+	84.5	n=6

Cotiviti Risk Adjustment Solutions * L culture D+ loyalty C- operations D+ product D+ relationship C- value B+	70.4	n=8

Health Fidelity Lumanent * L culture C- loyalty B- operations B- product C+ relationship B value B	79	n=11

Optum Risk Adjustment Solutions * L culture D+ loyalty D operations D product D relationship C+ value C-	65.9	n=6

Talix Risk Adjustment and Analytics Solutions * L culture A- loyalty A operations B+ product B+ relationship A value A	89.8	n=10

Vatica Health Risk Adjustment and Quality of Care Solution * L culture A loyalty A operations B product B- relationship A+ value A	89.2	n=6

Veradigm (formerly Allscripts) Pulse8 Illumin8 Risk Analytics * L culture C+ loyalty D+ operations C+ product C+ relationship B- value C	72.9	n=7

Risk Adjustment

Past Risk Adjustment Awards

Contact KLAS

Tell us about your organization

How can we help you?