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13 partnerships were given a 2024 SDOH Points of Light recognition, and their strategies and outcomes are shared in this report to highlight what is possible with deep collaboration. This Executive Insights section provides a high-level summary of the challenges the honorees tackled, the outcomes they achieved, and key lessons learned on the journey (see last page); the full report provides an in-depth case study of each collaboration.

Note: Overall, interviewed customers in this market are satisfied, but since this is a developing market, the customer bases for measured solutions are fairly small. KLAS will continue to monitor customer experiences as new vendor solutions are adopted by the market.

22 partnerships were awarded a 2024 Points of Light award, and their strategies and outcomes are shared in this report to illustrate the art of the possible. To help payer and provider organizations and vendors more effectively collaborate to resolve major points of friction, this Executive Insights section provides a high-level summary of the challenges the award winners tackled, the outcomes they achieved, and key lessons learned on the journey; the full report provides an in-depth case study of each collaboration.

† KLAS specifically asked interviewed organizations about their shared smart device programs. Some respondents may also utilize corporate-issued personal-use devices.

Note: While there are many regional debt collection firms, this report focuses on firms with a national presence.

Note: The next report on payer IT consulting services will further dive into customer validations of specific engagement types and outcomes.

Health care payers face many challenges that are shaping strategic priorities — from cost containment to IT spending to member engagement. They have experienced higher than expected medical costs over the last two years, driven by rising demand for health care services that were deferred during the COVID-19 pandemic. Commercial payers see their business model affected as an increasing number of employers move to a self-funded model. Meanwhile, increased health care utilization has been a double whammy for Medicare payers, as the Center for Medicare and Medicaid Services (CMS) announced a lower rate increase compared to prior years (~3% in 2024 vs. ~5% in the prior three years). Likewise, Managed Medicaid plans face about a 15 million drop in member enrollment with the end of the redetermination waiver period.

At the same time, payer business models are being disrupted by provider incumbents that are taking on risk and typical payer health care. Combined, these macroeconomic forces and industry trends are putting pressures on payer margins, forcing them to reevaluate their cost models and growth options.

With these trends in mind, EY-Parthenon professionals and KLAS Research interviewed and surveyed executives across a diverse mix of payer types, sizes and line of business (LoB) coverage to understand their overall strategic priorities, the impact on spend for HCIT variety of players in the health care ecosystem.

• Investors: What are the key trends in payer HCIT? Which areas are ripe for increased investment? What are key investment considerations in the payer tech and tech-enabled services market?
• HCIT vendors: What do payers want from their HCIT vendors? How do payers make decisions? What could be potential solutions to cross-sell (or not)?
• Payers: How are your competitors dealing with market forces? Where are your competitors making investments? How can you up your HCIT game?

† Roche navify POC Operations is formally registered today in most countries as Roche cobas infinity POC solution and will be rebranded to Roche navify POC Operations.

† Roche navify Lab Operations is formally registered today in most countries as Roche cobas infinity lab and will be rebranded to Roche navify Lab Operations.

Note: Research in this report is based on feedback from interviewed payer customers. This report is not intended to compare measured vendors’ technological capabilities.

Note: In this market, vendors that serve only certain types of health plans are designated as component solutions and marked with a [C]. For a complete view of all vendors and their target clients, please see Vendors at a Glance.