SCI Solutions acquires Clarity Health

SCI Solutions, a leader in referral management and patient scheduling, announced that it has acquired Clarity Health, a software-as-a-service solution provider that delivers insurance authorization and referral management services to health systems and independent providers. This combination creates one of the largest referral management and care coordination software firms in the industry, serving more than 10,000 physician practices and 700 hospitals, health systems and imaging centers in 275 geographic markets across the United States.  

Seattle-based Clarity Health offers a unique referral and insurance authorization service that enables healthcare providers to improve patient referral success rates, avoid payment denials and reduce administrative costs. Clarity’s solution combines a proprietary analytics platform enabling adherence to health plan payment and utilization guidelines with a world-class service organization to deliver quick, accurate insurance authorizations. Clarity’s services are used by more than 100 health systems, Accountable Care Organizations, imaging centers and physician practices nationwide.

Market research firm Frost & Sullivan projects that the care coordination software market will grow at a compound annual rate of 26 percent between 2015 and 2020. Within this market, care coordination tools deployed by physician practices are expected to be the fastest growing segment, with a CAGR of 43 percent, while the hospital market is pegged for 33 percent growth.

“As health systems and accountable care networks build strategies for creating advantage in value-based care environments, they require better ways to intelligently manage utilization at the point of referral,” said Joel French, CEO of SCI Solutions. “Together, Clarity and SCI have delivered a first-of-its-kind solution our clients will use to smartly steer clinically-appropriate utilization across their networks, improve convenience for patients and referring providers and reduce excessive costs associated with navigating complex insurance prior-authorization requirements.”

In parallel with the acquisition, SCI completed a financing to support its growth strategy. Columbia Pacific Advisors and ORIX Ventures participated in the transaction as did current SCI investors The Wicks Group and New Enterprise Associates. 

“This combination enables our joint clients to access a complete service – from initial patient referral, to easy appointment confirmation, to compliant reimbursement across all Medicare, Medicaid and commercial payers,” said Bill Bunker, CEO of Clarity. “This integrated capability will enable our clients to improve financial performance and patient experiences in parallel.”

The acquisition builds on a distribution and technology integration agreement the companies executed in 2014, resulting in substantial sales to joint clients, commercially delivered products and SCI client organizations already using the combined solution in their environments. 

Financial terms of the agreement were not disclosed. 

The combined company will be headquartered in Seattle. 

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