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Population health management (PHM) is at the forefront of strategic initiatives being undertaken across the healthcare industry. Prompting these strategic initiatives is the massive shift in risk, via payment reform, from payers to providers. This shift is likely to completely redefine the healthcare delivery system in the U.S. However, the healthcare sector today is ill prepared to make the transition to a PHM model of care delivery. There are a number of challenges that stand in the way of healthcare organizations’ (HCOs) adoption of PHM-centric strategies. Few HCOs have the requisite expertise in PHM and the technology infrastructure to support this transition. The dynamic shift from fee for service (FFS) to value-based reimbursement (VBR) models leaves providers in the difficult situation of having to invest in PHM for the future with little if any near-term returns on investment (ROI). Lastly, the IT solutions that will be needed to support PHM initiatives remain immature and require HCOs to take a portfolio approach to investing in a range of best-of-breed solutions to support their PHM strategy. No single vendor today can offer a comprehensive PHM solution suite, though countless vendors will try to convince HCOs otherwise.
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