While utilization management and care management solutions have been around for many years, health plans are now looking for technologies to help them manage multiple business lines and adapt to the changing business requirements for value-based care.
In a recent KLAS Decision Insights Report, Payer Care Management 2019, there has been an increase in health plans considering new or relatively new vendors receiving attention over their established or existing counterparts.
KLAS defines payer care management solutions as technologies with functionality such as utilization management, case management, disease management, and care coordination. Forty payer organizations spoke with KLAS about their purchasing decision process, including which vendors they considered, selected, and decided to replace.
As validated in KLAS’s research, future goals are becoming increasingly important in these decisions.
Chris McShanag, vice president, population health at IQVIA’s Healthcare Center of Excellence commented on the report. “A very interesting study by KLAS. I agree, payers are looking for more functionality from their vendors, and IQVIA Healthcare Center of Excellence is positioned to help in this process of evaluation and implementation, based on our deep knowledge and experience in population health and human data science.”