Care Management Solutions (Payer) Software Product Ranking Comparison

Over time, care management vendors have developed new functionalities that have allowed payer organizations to move beyond traditional use cases (e.g., case management and utilization management) into emerging use cases (e.g., behavioral health, automated prior authorization). Care management solutions are in an already low-performing market with persistent integration and functionality challenges, and with these emerging use cases, customers have a renewed need for strong engagement and support from vendors. This report examines which vendors are providing strong customer relationships, delivering innovative product functionality, and facilitating adoption and long-term customer loyalty.

Recent Insights

Key Findings:

InfoMC, ZeOmega, and MHK (Limited Data) Drive Strong Customer Relationships
Medecision and UpHealth (Limited Data) Struggle to Meet Customers’ Product & Relationship Needs
ZeOmega and HealthEdge Support Broad Emerging Use Cases—Still, Some Functionality Challenges Persist
Even with Broad Use-Case Functionality, Cognizant Customers Have Mixed Success with Integration; Zyter (Casenet) Customers Want Less Buggy Upgrades
HealthEdge Leads in Considerations and Wins; EXL (Limited Data) and Gainwell Technologies Vulnerable to Replacement

Performance Data

Overall Score by Product

Overall Score by Question Topic

Provider Facility Size by Product

Provider Facility Type by Product

Including payers and payer vendors in our research at KLAS has helped paint a broader picture of healthcare IT and measure healthcare more holistically.

The payer/provider relationship in healthcare is full of speed bumps and roadblocks, a fact unsurprising to even the patients. I was excited (and admittedly a little nervous) to see how both sides wou

Perception

Transitions of Care 2022

29 December 22 | Bradley Hunter and Paul Warburton

Inefficient care transitions lead to wasted time and energy, increased risk of human error, and potentially poor experiences for both patients and providers. Despite the industry’s attempts to ensure the right information is sent to the right people at the right time, healthcare organizations must often revert to manual processes for data entry, verification, and communication. Some organizations use or want to use technology to streamline their transitions of care (TOC). This report—KLAS’ first to look at TOC—draws from the perspectives of 95 healthcare leaders across multiple care settings to understand their adoption of care transition technology, the challenges they encounter in their care settings, and the vendors they are considering.

Care Management Solutions (Payer)

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