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Population Health Management Market Reaches Adolescence: Progress Made in Full Strategy Enablement, but Significant Gaps Remain

by John Moore III | March 05, 2018

Chilmark Research’s Population Health Management Market Trends Report shows that the market for PHM solutions is not one-size-fits-all.

BOSTON, MA, March 5, 2018 – Population health management (PHM) solutions are at a level of maturity to meet many of the needs of healthcare organizations (HCOs). Yet a clear divide between the different types of solutions is emerging, according to the latest report from Chilmark Research.

In the inaugural Population Health Management Market Trends Report, Chilmark Research is the first analyst firm to identify three distinct markets for PHM products and services based on customer use case. The report provides a comprehensive review of more than 25 solutions available today and evaluates the relative ability of each solution to serve these three critical submarkets: Independent ambulatory, captive ambulatory, and payer-provider.

This report evaluates PHM solutions on four main technology domains of functionality: Data aggregation, analytics, care management, and patient engagement. According to Matt Guldin, Chilmark analyst and co-author of the report:

For many organizations, care management has become the focal point for building PHM programs. Care management applications rely on all of the technology – data aggregation, analytics and reporting, and patient engagement – needed by sponsors to improve population-level health. The solution that best meets this need with a proven track record of success will have a significant advantage over the competition in buying decisions.

Only within the last 18 months have PHM solutions reached a level of maturity to enable a PHM strategy. The earliest solutions focused on the needs of HCOs caring for Medicare Shared Savings Program (MSSP) patient panels, primarily addressing care gaps, and simple quality reporting. Next, vendors added functionality (deeper analytics and care management) to support bundles, readmissions, risk scoring and private payer programs.

Today’s leading PHM vendors are deploying solutions that address all of these needs, but to varying degrees of competency. While all vendors are aggressively adding functionality, current solutions vary greatly in their ability to address the full needs of HCOs.

Providers have also been hesitant with their PHM plans as the business mandate for providers to embrace PHM slowed in the last year over questions regarding the future of the Affordable Care Act (ACA). More recent stabilization of ACA, the continuing roll-out of more Advanced Payment Models (APMs) by CMS, and commercial payer-owned initiatives point to a robust market for PHM solutions over the next five years.

Until recently, most vendors in this report gravitated to hospitals and health systems, which have been more aggressive about embracing risk contracts than independent ambulatory networks of physicians. Such buyers represent the bulk of past buying activity in PHM. But independent networks of providers are becoming a bigger target market as risk contracts become more common. In addition, converged payer-provider networks are emerging as providers establish health plans and payers and employers become more heavily involved with community-based organizations to deliver value-based care.

While there is much greater clarity in the market for PHM solutions in 2018 than there was in 2015, due diligence remains a high priority for healthcare organizations (HCOs) choosing solutions to support their PHM strategies. Providers or payers looking for technology to support PHM programs will find this report an invaluable aid to sifting through technology vendor claims. Consultants, investors, employers, brokers, conveners, and others will also benefit from this in-depth research and analysis.

The report is available to subscribers of the Chilmark Advisory Service or may be purchased separately. For more information, visit www.chilmarkresearch.com/reports. Direct inquiries for purchase should be addressed to John Moore at john3@chilmarkresearch.com.

About Chilmark Research:

Chilmark Research is the only industry analyst firm focusing solely on the most transformational trends in healthcare IT. We combine proven research methodologies with intelligence and insight to provide cogent analyses of the emerging technologies that have the greatest potential to improve healthcare. We do not shy away from making tough calls, and are respected in the industry for our direct and thoughtful commentary. For more information visit: www.chilmarkresearch.com/

Vendors Profiled: Allscripts Inc., Arcadia.io, athenahealth, Caradigm, CareEvolution, Cerner Corporation, Change Healthcare, Conifer Health Solutions, eClinicalWorks, Enli Health Intelligence, Epic Systems Corporation, Evolent Health, Forward Health Group, Geneia Inc., GSI Health, Health Catalyst, HealthEC, IBM Watson Health, Lightbeam, Medecision, NextGen, Optum, Orion Health, Philips Wellcentive, and ZeOmega.

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