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Payer Care Management 2023
How Do Vendors Perform as Use Cases Expand?

author - Joe VanDeGraaff
Joe VanDeGraaff
author - Jennifer Hickenlooper
Jennifer Hickenlooper
author - Ruirui Sun
Ruirui Sun
May 9, 2023 | Read Time: 20  minutes

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.

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Key Findings:

  1. InfoMC, ZeOmega, and MHK (Limited Data) Drive Strong Customer Relationships
  2. Medecision and UpHealth (Limited Data) Struggle to Meet Customers’ Product & Relationship Needs
  3. ZeOmega and HealthEdge Support Broad Emerging Use Cases—Still, Some Functionality Challenges Persist
  4. Even with Broad Use-Case Functionality, Cognizant Customers Have Mixed Success with Integration; Zyter (Casenet) Customers Want Less Buggy Upgrades
  5. HealthEdge Leads in Considerations and Wins; EXL (Limited Data) and Gainwell Technologies Vulnerable to Replacement
author - Carlisa Cramer
Carlisa Cramer
author - Jessica Bonnett
Jessica Bonnett
author - Andrew Wright
Project Manager
Andrew Wright
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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. © 2024 KLAS Research, 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.