KLAS scores payer IT consulting firms

Change Healthcare topped the 2019 payer IT consulting performance report  released by KLAS.

Change received the highest overall score followed, in order, by FlexTech, Cumberland, Deloitte, High Point Solutions, Optum, emids, Accenture, NTT Data, PwC and Cognizant.

Limited data was available on Deloitte, High Point, Accenture and PwC, the report said.

For the report, KLAS authors spoke with private health plans, provider-owned health plans and a few government health plans. Most were small or medium-sized, and there were a few large payer organizations. KLAS included a caveat that the data gathered included strong opinions, which should not be interpreted as actual facts.

KLAS measured payer services for both advisory and technical services.

IMPACT

Payers are increasingly needing consulting services.

Market regulations have changed, increasing payer organizations' need for improved efficiency, more-accurate software tools, and ways to navigate an increasingly complex market, KLAS authors said.

Payers are looking for IT consulting firms which have the expertise to meet their specific needs and a track record of strong delivery.

Many payer organizations focus on claims software, the lifeblood of health plans, but are looking to move to newer solutions or upgrade their current software.

The core claims solutions most often mentioned as being implemented are Cognizant, TriZetto, HealthEdge, Health Solutions Plus and Epic Tapestry.

WHAT THE REPORT FOUND

Firms that are healthcare-specific are delivering more guidance and flexibility than IT organizations that offer cross-industry solutions, though there are exceptions to this trend, the report said.  Healthcare-specific firms tend to have more satisfied clients than cross-industry firms.

Healthcare specific firms include Optum, emids, Cumberland, Change and FlexTech.

Cross-industry firms, especially the larger firms, often struggle with a rigid approach and lack adaptability, such as flexibility in approach and staffing and agility in making changes, according to the report.

THE RESULTS

Change Healthcare, with a score of 94.6, has highly satisfied customers. The company delivers experienced consultants, is flexible, meets clients' unique needs, and helps keep organizations on track with projects, KLAS said.

FlexTech, at 94.1, delivers consistently high satisfaction because of their market knowledge, experienced consultants, and ability to understand the organizations they work with, adjust their approach as needed, and meet organizations' unique needs.

Both FlexTech and Change Healthcare received praise for providing good
value for the price.

Cumberland, with a score of 92, adapts well to organizations' needs and brings both payer and provider healthcare knowledge to its projects.

Deloitte, at 91.9, has highly knowledgeable consultants who are flexible in meeting client needs.

HighPoint Solutions at 91, stands out for offering high-quality consultants for a low cost.

Optum, at 89.9, delivers strong strategic expertise through knowledgeable consultants; clients also mention the firm is responsive - often due to good executive involvement - and provides high-quality service and delivery. The most common complaint from clients is high cost.

Emids, at 88.2, also has strong executive involvement, allowing them to accommodate requested changes from clients. The firm mainly does optimization work. Respondents feel the midsize firm is able to keep costs down while still bringing in knowledgeable consultants needed for successful projects. A couple of emids clients felt engagements took longer than they expected.

Accenture, at 86.8, had clients who were moderately satisfied overall and reported good execution, though some see the firm as less strategic.

NTT Data, 81.2, was seen as having reliable consultants with strong IT skills, but lacking in strategic expertise, experience in the healthcare industry and adaptability for more complex organizations.

PwC, at 80.7, delivered mixed experiences. Satisfied clients feel the firm is honest and has good bench strength, while dissatisfied clients said they experienced communications issues and felt the firm was not strategic enough.

Cognizant, at 67, scored low in overall satisfaction. Clients said the firm was difficult to work with, was expensive and lacked understanding of the healthcare market and their unique needs.

TREND

Demand for payer IT consulting services continues to rise as changing market regulations have increased the need for improved efficiency, accurate software, and ways to navigate the complex market environment, according to the report.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com