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Payer Quality and Risk Analytics 2018

Payer Quality and Risk Analytics 2018
Different Options for Different Needs

Authored by: Peter Van Mondfrans and Chris Ptak June 14, 2018 | Read Time: 3  minutes

Ever-evolving HEDIS metrics continue to demand payer attention, but annual quality reporting alone is not an effective way to close care gaps or reduce costs. Health plans have repeatedly expressed a need for more frequent HEDIS reporting and deeper analytics capabilities that enable them to empower proactive care interventions and improve outcomes for their members. KLAS asked 84 health plans which vendors go beyond the required HEDIS check boxes to help clients forecast risk and improve quality.

Key Findings

  1. Industry Insight & Context
  2. Client-Reported Vendor Performance: Change Healthcare Rises to the Top, Inovalon Falls to the Bottom
  3. MedInsight and Verscend Technologies Seen as Progressive in Analytics; General Dynamics IT Falls Behind
  4. Verscend Technologies and General Dynamics IT, Now a Single Offering, Show Progress toward On-Demand Regulatory Reporting
  5. Among the Niche Risk Adjustment Vendors, Talix, Cognisight, Health Fidelity Offer Full or Near-Full Capabilities

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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. © 2020 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.