Compare · McKesson PACS

McKesson PACS System Alternatives, Stratus Imaging PACS and Change Healthcare PACS Compared

The short answer

McKesson PACS is the radiology PACS McKesson built from A.L.I. Technologies, sold as Horizon Medical Imaging and then McKesson Radiology. It became Change Healthcare Radiology Solutions in 2018 and has been owned by Optum since October 2022, next to the cloud Stratus Imaging PACS. Federal buyers hold 172 of its PACS awards with a $178,935 median.

Search for McKesson PACS and you get Optum's product pages, trade press from a decade ago and two comparison pages written by other PACS vendors. Nobody independent puts the record in one place, and the buyer usually arrives with a Radiology Solutions 14.x maintenance renewal or a Stratus Imaging PACS proposal on the desk. This page is for a hospital, health system, VA or DoD imaging IT lead running McKesson Radiology or Change Healthcare Radiology Solutions who has to decide whether to stay, move to Stratus, switch PACS, or keep the PACS and fix the read. Every figure comes from a public record we can point to.

The Reading Station

Assistant ready

Worklist

Not for diagnostic use

Structured report

Draft

Run the assistant to draft this report for review.

You review & sign

Decision support. The radiologist reviews and signs every study.

Drafted in · you review & sign Worklist re-prioritized

Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional judgment.

See the comparison

Flag · prioritize · draft · you review and sign

Optum sells the imaging platform: Change Healthcare Radiology Solutions, Enterprise Viewer, Mammography Plus and the Stratus Imaging cloud suite. Radiological.ai sells none of that. It is an assistant that works alongside the PACS you already run, McKesson and Change Healthcare included, and helps the radiologist get through the worklist.

Side by side

McKesson PACS against the PACS on a hospital shortlist

The choices a McKesson Radiology or Change Healthcare Radiology Solutions site is usually weighing at renewal. Every row is a published fact or a public record, not a benchmark we ran.

What to compare	McKesson Radiology and Change Healthcare	Other PACS (Sectra, Agfa, Fujifilm, Visage, GE)
Who owns it	Optum (UnitedHealth Group) since October 3, 2022, still sold under the Change Healthcare brand. McKesson bought A.L.I. Technologies in July 2002 for about $350 million.	Sectra (Sweden), Agfa (Belgium), Fujifilm (Japan), Visage (Pro Medicus, Australia), GE HealthCare (US).
Product lines	Change Healthcare Radiology Solutions 14.x (the McKesson Radiology line), Enterprise Viewer, Mammography Plus, Workflow Intelligence, and the Stratus Imaging cloud suite.	Each sells one main PACS line, except GE with Centricity, True PACS and Intelerad.
Cloud option	Stratus Imaging PACS on Google Cloud, launched 2021, live first with StatRad, sold at a price per study.	Sectra One Cloud, Agfa Enterprise Imaging Cloud and Fujifilm Synapse on AWS, Visage 7 hosted, GE True PACS SaaS.
Newest FDA 510(k)	K241981 Change Healthcare Stratus Imaging PACS, November 12, 2024. Before that K181185 Enterprise Viewer (2018) and K140909 McKesson Radiology (2014).	Fujifilm K261713 Synapse PACS 7.6.0 (June 2026). Agfa K252199 Enterprise Imaging (October 2025).
FDA recalls	18 radiology PACS recall records since 2010. Open ones include Stratus Imaging PACS 1.4 (HL7 data tied to another patient's study) and Radiology Solutions 14.2.2 (reports not fully displayed, 2025).	Agfa has two open XERO recalls. GE Centricity has 31 open recall entries.
Independent record	Best in KLAS large PACS 74.8 in 2024 and 72.6 in 2025, fifth of seven ranked. KLAS 2023: nine organizations replaced it, citing nickel-and-diming and lack of innovation.	Sectra won the KLAS large PACS segment in 2024 (88.6) and 2025 (91.0). Agfa won small PACS in 2026.
End of life	No Optum notice found. The VA records vendor end-of-life dates of September 30, 2022 for 12.3.x and March 31, 2023 for 12.4.x.	Ask every vendor for the support end date of the exact version you would buy.
Where it wins	A large federal install base on the DIN-PACS contract vehicle, a cleared cloud PACS with per-study pricing, and no migration if you stay.	Sectra and Agfa on user satisfaction, Visage on speed for large hospitals, Fujifilm and GE on breadth.
Switching cost	Staying avoids a vendor change, but 12.x to 14.x or Radiology Solutions to Stratus is still a migration.	High. Priors migration, interfaces and training. Budget it as its own line.

Ownership facts come from McKesson and Change Healthcare SEC filings and press releases. Version history and end-of-life dates come from the VA Technical Reference Model (updated January 15, 2026). KLAS figures are from public Best in KLAS pages. FDA data is from the openFDA 510(k) and recall databases. All collected October 5, 2026.

What the public record shows

What federal buyers paid for McKesson and Change Healthcare PACS

Optum publishes no Radiology Solutions price, so we read every federal award to a McKesson or Change Healthcare recipient and kept the ones that are radiology PACS.

Group of awards	Count and value	What it tells a buyer
Radiology PACS awards	172 awards, $98.17M	Descriptions that name PACS, McKesson Radiology or Change Healthcare radiology. $84.68M of it was ordered on two Defense Logistics Agency imaging contracts.
Typical award	Median $178,935	Quartiles $59,165 and $635,413. 24 awards were $1 million or more.
Largest award	$6,131,109 (VA, April 2023)	Described as healthcare PACS. Next is $5,742,530 for a picture archiving system in August 2016 and $5,140,162 for the Milwaukee VA medical center PACS in June 2021.
By agency	VA 144 awards, $91.03M	DoD 28 awards, $7.14M, through the DIN-PACS vehicle that runs to December 14, 2027.
After the 2024 cyberattack	51 awards, $18.51M	Federal sites kept buying upgrades, refreshes and maintenance after February 21, 2024, including a $1.53M PACS refresh in December 2025.

Source: USAspending.gov prime awards, award types A to D, fiscal 2008 to 2026, pulled October 5, 2026. 1,510 rows read by hand. Excluded: drug and medical supply distribution, pharmacy automation, claims and eligibility services and other McKesson IT, 21 cardiology PACS awards ($11.85M) and 39 awards with opaque descriptions ($21.18M) that are probably but not provably PACS.

Side by side

Radiological.ai vs McKesson PACS, honestly

A fair look at what each does well. Both are capable tools. Here is where they differ.

What matters	Radiological.ai	McKesson PACS
What you are buying	Software that flags suspected findings on the image, prioritizes the worklist and drafts the structured report.	The PACS: Radiology Solutions or Stratus Imaging PACS, with the viewer, archive and image sharing.
Relationship to your PACS	Works alongside it. It reads from the PACS you already run, McKesson and Change Healthcare included.	It is the PACS. A move to Stratus or another vendor replaces what you have.
Unit of cost	Per reading radiologist, published: $399 a month on the Practice plan or $199 a month billed annually, and $598 a month on the Group plan or $299 a month billed annually.	Unpublished. Radiology Solutions is quoted per site and contract; Stratus is sold at a price per study.
Project size	Days to weeks. No image migration.	Months. Priors migration, interfaces, archive and training.
Who signs the report	The radiologist. The assistant never signs anything.	The radiologist, in whichever reporting system you run with the PACS.
Best suited for	McKesson and Change Healthcare sites whose radiologists need more studies read per hour before the PACS decision is made.	Health systems that want PACS, viewer, archive and sharing from one vendor, or a per-study cloud PACS.

Comparison reflects general, publicly understood positioning. Capabilities change, so check each product for the latest.

This page covers one PACS vendor. For the category, PACS software separates the deployment models, and PACS pricing and cloud PACS cost benchmarks quotes against real federal awards, which is useful when a per-study Stratus quote has to be compared with a site license.

If another hospital PACS is on your shortlist, Sectra PACS alternatives, Agfa PACS system alternatives and Visage PACS alternatives work through those quotes the same way. Sites on another legacy platform from the same era can compare GE Healthcare Centricity PACS alternatives and IntelliSpace PACS alternatives. Stratus went live first at a teleradiology group, and StatRad teleradiology alternatives covers that provider.

If the PACS is fine for now and the real ask is AI, how the assistant integrates with your PACS explains what connects to what, radiology worklist prioritization shows how urgent studies surface first, and the pricing page lists the per-radiologist plans.

Why groups pick Radiological.ai

One assistant across the whole read

Ask for your end-of-life date in writing

Optum has published no end-of-support notice, but the VA lists vendor end-of-life dates of September 2022 for 12.3.x and March 2023 for 12.4.x. If you are on 12.x, ask which version your renewal covers and when its support ends.

Read the open recalls

Five radiology recalls are still listed as ongoing in openFDA, including Stratus Imaging PACS 1.4, where HL7 data could attach to another patient's study, and Radiology Solutions 14.2.2, where reports may not display fully. Ask which apply to your version and how they were closed.

Price per study against per site

Stratus is sold per study, while Radiology Solutions is usually a site license plus maintenance. Model five years of your real study growth before you compare the two quotes, because per-study pricing rewards flat volume and punishes growth.

Separate the PACS decision from the AI decision

If your radiologists are short on time today, you do not have to wait for a PACS migration. An assistant that reads from Radiology Solutions flags suspected findings, sorts the worklist and drafts the report while the PACS question runs its course.

Good questions

McKesson PACS vs Radiological.ai, answered

Optum, part of UnitedHealth Group. McKesson moved its technology business into the Change Healthcare joint venture in March 2017, the product was renamed Change Healthcare Radiology Solutions in July 2018, and UnitedHealth closed its roughly $13 billion purchase of Change Healthcare on October 3, 2022. Optum still sells the line under the Change Healthcare name.

Optum has published no end-of-support notice. The VA Technical Reference Model records vendor end-of-life dates of September 30, 2022 for McKesson Radiology 12.3.x and March 31, 2023 for 12.4.x, and lists no date for 14.x. In 2021 the VA also ordered work described as updating a Change Healthcare end of life PACS system.

Stratus Imaging PACS is Change Healthcare's cloud-native PACS on Google Cloud, announced in August 2021 and live in clinical use from November 2021, first at StatRad. It is built on the Nucleus.io platform Change Healthcare bought in 2020, it received FDA clearance K241981 in November 2024, and Optum sells it at a price per study.

Optum does not publish prices. Federal records give a real reference: 172 McKesson and Change Healthcare radiology PACS awards totaling $98.17 million, with a median of $178,935 and quartiles of $59,165 and $635,413. Most lines are workstations, upgrades, refreshes and maintenance ordered through the DoD DIN-PACS contract.

Optum has not said publicly whether its imaging products were affected. The February 21, 2024 ransomware attack hit Change Healthcare's claims and payment systems and exposed data on about 192.7 million people. Federal sites kept ordering Radiology Solutions upgrades and maintenance afterwards, 51 awards worth $18.51 million.

Hospitals replacing McKesson or Change Healthcare PACS most often look at Sectra, Agfa, Fujifilm Synapse, Visage and GE HealthCare. Imaging centers also look at Intelerad, RamSoft and Konica Minolta Exa. If the real problem is how many studies each radiologist reads, you can add AI to the read without replacing the PACS.

Yes. An assistant receives studies from Radiology Solutions or Stratus over standard DICOM and sends results back to the worklist and the reporting system. Radiological.ai flags suspected findings for review, prioritizes the worklist and drafts the structured report. The radiologist reviews, edits and signs every study.

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See every radiology use case

From the blog: what the PowerScribe 360 end of life means for radiology groups, how much radiology AI costs, and the full comparison of the best AI radiology software in 2026.

See how Radiological.ai reads alongside your group

One assistant that flags suspected findings, prioritizes the worklist, and drafts the structured report on X-ray, CT and MRI. You review and sign every study.

See pricing

Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional medical judgment.