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Claims and Clearinghouse 2016 (Large Organizations)

Claims and Clearinghouse 2016 (Large Organizations)
Who Delivers the Guidance and Tools Providers Need?

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The shift to value-based care is placing increased pressure on clearinghouse vendors to deliver enhanced tools and improved guidance for their customers. Good clearinghouse options abound, but providers still need to select the tools, technology, and relationship that best fit their organizational culture, preferences, and goals. Which vendors are providing large practices (>20 physicians) with new and useful technology for value-based reimbursements, and what lessons can these practices share with their peers?



1. NAVICURE AND GE HEALTHCARE LEAD IN PARTNERING WITH PROVIDERS FOR VERY DIFFERENT REASONS

Most providers using Navicure or GE Healthcare see them as partners who go above and beyond contractual obligations to empower customers. Providers praise Navicure for their communication, for the family-like atmosphere account managers develop, and for their willingness to go above and beyond to ensure satisfaction. GE customers feel enabled by provider-driven technology that gives them the functionality they need to succeed and makes them feel that GE is invested in their success. ZirMed and Availity customers are the most content with their vendor relationship, though many do not feel it is a partnership. TriZetto customers say that the previously customer-centric support is now more reactive.



2. GE HEALTHCARE AND ALLSCRIPTS CUSTOMERS IN NEED OF MORE OUTREACH FOR VALUE-BASED REIMBURSEMENTS

Of the customers who could respond when asked about their vendor's preparation for upcoming changes to VBC reimbursements, customers of vendors with larger average customer sizes are less satisfied than those of vendors with smaller customers. Providers using both GE and Allscripts experience the most dissatisfaction and report only limited VBC engagement from their vendor. These providers would like more proactive guidance and advice about best practices and more direct training to help them with their VBC goals.



3. IS CHANGE HEALTHCARE ABOUT TO MAKE A CHANGE?

Change Healthcare has been seen by providers as a laggard in the clearinghouse market for several years. One-quarter of large providers who recently changed vendors considered Change Healthcare's new platform but decided against it. Many providers are still leery about Change Healthcare's past. However, early users of the new platform give very positive reports concerning its integration, pricing, and overall functionality and say they get consistent updates and have little-to-no downtime or performance issues.



4. PROVIDERS LEAVING ALLSCRIPTS FOR SOLUTIONS WITH BETTER INTEGRATION

Between one-quarter and one-third of larger Allscripts respondents plan to leave the vendor; lack of integration with Allscripts' own PM and EMR systems is cited as a major factor. Multiple providers also report pricing issues and generally poor relationships that lack needed outreach from support personnel and executives. In contrast, all large ZirMed customers plan to stay with their vendor; they feel ZirMed has knowledgeable, proactive service, gives good guidance, and exceeds expectations by offering superb functionality.

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KEY TOPICS

  1. Navicure and GE Healthcare Lead in Partnering with Providers for Very Differenent Reasons
  2. GE Healthcare and Allscripts Customers in Need of More Outreach for Value-Based Reimbursements
  3. Is Change Healthcare About to Make a Change?
  4. Providers Leaving Allscripts for Solutions With Better Integration
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2018 KLAS Enterprises, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.