Monday, April 15, 2013

Population Health or Bust!

My April editorial post for Clinical Innovation + Technology is called "Population Health or Bust!".   The premise is that we know reimbursement models are changing from "Volume-Based to "Value-Based care", which may range from gain-sharing to bundled payments to full capitation... And thus we need certain types of tools to better manage our populations of patients.  So I defined what these population management tools should do and what to consider when purchasing them:

First, population health management means that you (1) define a specific population and (2) manage that population in the most efficient, cost-effective and highest quality manner possible.  In other words, instead of treating everyone the same, you provide the right care to the right people in the right time and in the right format. This helps to ensure that we focus our limited resources on the people who need them most, while using innovative strategies and technologies to leverage care for others.
Second, be on the lookout for some key functionalities when choosing your population management tools. These include risk stratification, impactability analysis, care gap identification, outreach capabilities, care coordination dashboard, patient engagement systems and analytics reporting.
Third, population health tools are everywhere right now, including offerings from your EHR vendor, your insurance companies and various third parties. Factors to help guide your decision will include not just the strength of their offering, but their ability to integrate into your workflow, their ability to work with multiple data sources, and their future visions. Additionally, we are starting to see interesting gain-sharing business models that may make initial investments free or cheap.
I ended my post explaining why I believe that when dividing populations into "Low, Medium, and High" risk, that the really cool innovations (e.g. mobile monitoring, telehealth, automated care) will be in the Low and Medium categories, rather than the High risk ones.  And furthermore, that this will hopefully open up more free time for physicians to spend with the "High risk" patients who needs more of the face to face care we consider traditional right now.  Said another way... let's automate the easier stuff so we can allow for more time, critical thinking and compassion for the tougher stuff! 
Companies in the Population Health Space (at least a partial list)
·         Advisory Board Company:
·         CareMerge (focus on elderly):
·         Care Team Connect:
·         Clairvia http:
·         Click4Care:
·         Clinigence:
·         Curaspan (SAAS – Handoffs):
·         Essence HC:
·         EvolentHealth (UPMC + ABC):
·         GSI Health (Lori Evans) (CC Platform):
·         Healarium (Mobile Pt Activation Apps):
·         Humedica (bought by Optum 1/13):
·         Intelligent Healthcare:
·         Lumeris (ACO for hospitals):
·         Medventive (bought by HBOC 2012):
·         Outcome Advantage:
·         Patient Point:
·         Pharos (Dz mgt, Randy Williams):
·         Phytel:
·         RipRoad:
·         See Change (Insurance and Systems for Employers):
·         Symphony (ACO Software):
·         TCS:
·         US Health Centric (Dx/Wellness mgt):
·         Valence Health:
·         Vital Health:
· (Checklist based Workflows for Discharges):
·         Wellcentive:
·         xG Health Solutions (Geisinger Spin-off): 

I will edit this list over time - but it gives one a sense of how many companies are already in the space in one form or another (and this does not even include all the EMR vendors and their offerings).

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