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Population Health

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Bradley Hunter
VP VBC, Payer, and Core Solutions
KLAS VP VBC, Payer, and Core Solutions - Bradley Hunter

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Healthcare Management Consulting 2025
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As the healthcare industry evolves, healthcare organizations often need strategic help to ensure operational success and better serve patients. Management consulting firms, with their wealth of expertise, are uniquely positioned to fulfill this need. KLAS’ Healthcare Management Consulting 2024 report shared which consulting needs were being prioritized by healthcare leaders. Building on last year’s findings, this report shares (1) the scope and type of validated healthcare management consulting (HMC) services provided by firms and (2) how firms perform—first examining the HMC market overall and then the six individual segments it comprises. The report is intended to help healthcare and payer organizations determine which firms may be best suited to meet their complex needs, with a particular focus on level of expertise, actionable deliverables, and outcomes.
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Value-Based Care Enablement Services 2024
05 December 24    |   Andy Paulsen and Benjamin Cassity
The transition from a fee-for-service payment model to a value-based care (VBC) and risk-based model can be daunting for provider organizations, especially those that lack the necessary data and resources to realize an ROI on VBC initiatives. Organizations can streamline the transition by joining ACOs managed by VBC enablement firms. With these firms’ services and technology offerings, organizations can aggregate more data, develop care management models, and effectively manage risk-based contracts. This services firm guide is intended to provide a simple starting point for organizations investigating VBC enablement services. All such firms known to KLAS as of October 2024 are included in this guide. In the future, KLAS plans to publish a follow-up report exploring organizations’ adoption of and satisfaction with these firms.
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Population Health Management 2024
01 October 24    |   Andy Paulsen and Benjamin Cassity
In recent years, purchasing energy in the population health management (PHM) market has cooled among large acute care organizations—only 10% of interviewed organizations report a recent or in-progress PHM purchase decision. This trend is largely the result of healthcare organizations deprioritizing initial investments in new solutions and instead focusing on cost reduction and improved ROI through vendor consolidation, better data access and utilization, and improved functionality that supports value-based initiatives (i.e., care management, whole-person care, downside risk contracts). Physician-led ACOs don’t always face the same challenges as large acute care organizations (the majority of the sample included in this data set), so they may make decisions differently. With fewer decisions being made for acute care organizations, there is greater pressure on vendors to more thoroughly prove their platform’s capabilities during the RFP process. To help healthcare organizations navigate purchasing decisions in this market, this report draws from 40 purchase decisions validated by KLAS between July 2022 and June 2024 to examine (1) which vendors’ customer bases are growing, being maintained, or decreasing amid market shifts and (2) which factors contribute to current buying energy. Satisfaction data from current customers is also included.
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The Garage Bridge 2024
15 May 24    |   Benjamin Cassity and Jacob Mortensen
Healthcare organizations use many different data sources for care information and coordination, and data management is critical in order for organizations to deliver effectively on value-based care contracts. The Garage aims to help organizations on this front with Bridge, a value-based care platform. This report examines the Bridge customer experience.
Perception
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Social Determinants of Health 2024
13 May 24    |   Andy Paulsen and Benjamin Cassity
Many healthcare organizations are working to proactively address socioeconomic barriers to patients receiving needed healthcare—prompting vendors to roll out technology solutions that can collect and manage social determinants of health (SDOH) data. This report uses KLAS’ Framework for a Successful SDOH Program (introduced in this overview ) to compare several SDOH vendors’ offerings and share vendors’ thoughts on how their technology is intended to help organizations achieve their SDOH goals. Note that this report is based on vendor-reported and publicly available information and does not represent any KLAS-validated performance data or other findings. Later in 2024, KLAS intends to publish a report that examines customers’ experiences with their SDOH solutions.
First Look
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COPE Health Solutions Analytics for Risk Contracting (ARC) 2024
10 April 24    |   Bradley Hunter and Jacob Mortensen
With the rapid rise in value-based care contracts and emphasis on patient population health, healthcare provider organizations are looking for insights into specific populations and metrics to manage outcomes and coordinate care. COPE Health Solutions seeks to meet this need by providing analytics and visualizations of population health data through the Analytics for Risk Contracting (ARC) solution. This report takes a first look at customer satisfaction and key functionality adoption among ARC customers.
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Revenue Cycle Analytics 2024
05 March 24    |   Dustin Cragun and Jaren Day
For revenue cycle leaders, it is critical to stay on top of trends in payer interactions and identify opportunities to address billing and collection inefficiencies. All healthcare organizations use RCM analytics solutions—their EHR offering, a third-party solution, or a combination of both—to comprehensively understand their RCM practices and glean actionable insights that can optimize revenue and inform decisions. Drawing from the experience of organizations using third-party tools that ingest data from multiple disparate sources, this report provides insights into the performance of three different solutions.
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How Services Firms Can Drive Successful Client Engagements 2023
04 October 23    |   Sam Eaquinto and Warren Whitford
In 2022, KLAS interviewed 27 HIT services firms with broad market experience, asking them about their best practices for driving successful client engagements. Drawing from those insights and correlating them with the KLAS performance data of high-performing firms, this study—part of KLAS’ Vendor Excellence series—looks at four critical areas firms should evaluate to ensure successful engagements: measurement of outcomes, sales and contracting, internal hiring and training, and engagement execution.
First Look
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CareAllies Value-Based Care Managed Services 2023
06 September 23    |   Bradley Hunter and Jacob Mortensen
Competitive and financial factors continue to drive organizations toward value-based care. A widely varied array of services firms and other vendors offer services and solutions designed to help. This report details CareAllies’ value-based care managed services offering and examines client experiences.
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Oracle Health (Cerner) Complete Look 2023
18 July 23    |   Paul Warburton and Tyson Blauer
When making a core HIT purchasing decision, healthcare organizations must take into account how prospective partners deliver across a variety of key technology areas. This Oracle Health (Cerner) “complete look” provides a high-level analysis of the key products that make up Oracle Health’s enterprise suite. (Other reports in the series do the same for Altera Digital Health [Allscripts] , Epic , Evident , and MEDITECH .)
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Epic Complete Look 2023
18 July 23    |   Paul Warburton and Tyson Blauer
When making a core HIT purchasing decision, healthcare organizations must take into account how prospective partners deliver across a variety of key technology areas. This Epic “complete look” provides a high-level analysis of the key products that make up Epic’s enterprise suite. (Other reports in the series do the same for Altera Digital Health [Allscripts] , Evident , MEDITECH , and Oracle Health [Cerner] .)
Performance
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Altera Digital Health (Allscripts) Complete Look 2023
18 July 23    |   Paul Warburton and Tyson Blauer
When making a core HIT purchasing decision, healthcare organizations must take into account how prospective partners deliver across a variety of key technology areas. This Altera Digital Health (Allscripts) Sunrise “complete look” provides a high-level analysis of the key products that make up Altera Digital Health’s enterprise suite. (Other reports in the series do the same for Epic , Evident , MEDITECH , and Oracle Health [Cerner] .) This report focuses on the core Sunrise suite and its supporting technology; data on Altera Digital Health’s standalone ambulatory platforms (TouchWorks and Professional) is excluded.
Performance
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MEDITECH Complete Look 2023
18 July 23    |   Paul Warburton and Tyson Blauer
When making a core HIT purchasing decision, healthcare organizations must take into account how prospective partners deliver across a variety of key technology areas. This MEDITECH Expanse “complete look” provides a high-level analysis of the key products that make up MEDITECH’s enterprise suite. (Other reports in the series do the same for Altera Digital Health [Allscripts] , Epic , Evident , and Oracle Health [Cerner] .) This report focuses on the core Expanse suite; data on MEDITECH’s MAGIC, C/S, and 6.x platforms is excluded.
Performance
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Population Health Vendor Overview 2023
15 June 23    |   Andy Paulsen and Bradley Hunter
As more healthcare organizations start to leverage population health management (PHM) technology in their journey toward offering value-based care, they are sometimes uncertain about how well vendors can fulfill their unique needs, as PHM programs vary in breadth and complexity. This report—a follow-up to KLAS’ 2021 report —provides an overview of several PHM offerings to help readers understand (1) what types of organizations typically use the solutions, (2) what the customer experience is like, (3) which solutions see the most market energy and why, (4) which vendors facilitate value-based contract revenue, and (5) how broadly PHM capabilities are adopted. Note: Although there are six PHM pillars, one pillar—patient engagement—is not covered in this report (view the KLAS website for more information on this pillar).
Point of Light
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Points of Light 2023 Case Study 21
15 April 23    |   Aurene Wilford and Boyd Stewart
The collaborators in this case study noted that some patient populations were completing preventive annual health assessments at lower levels than other populations. To address this disparity and help clinics close care gaps at the point of care, the collaborators implemented a program aimed at incentivizing frontline staff and physicians on a monthly basis for time spent addressing open care gaps. As a result of the program, the participants have seen improved gap closure, improved performance in quality measures, improved coding accuracy, and higher staff morale and engagement.
Point of Light
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Points of Light 2023 Case Study 23
15 April 23    |   Aurene Wilford and Boyd Stewart
Poor interoperability between payers and providers negatively impacts many areas, including care quality, administrative workload, and documentation for regulatory requirements. With a shared goal of improving care for all patients, the collaborators in this case study worked together to automate the data exchange process and make it easier for providers to identify and close care gaps. This improved interoperability has increased preventive care, improved quality measure performance, and enabled providers to better address patient needs at the point of care.
Point of Light
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Points of Light 2023 Case Study 20
15 April 23    |   Aurene Wilford and Boyd Stewart
Inpatient treatment for high-risk cardiovascular patients comes with a significant cost for patients, providers, and payers. Costs are lower and outcomes are better when the care for these patients is effectively managed outside the hospital. To achieve this, the collaborators in this case study combined payer and provider data to better predict costs and patient outcomes and then established a bundled payment contract that reduces the costs of caring for patients with high-risk cardiovascular diseases while ensuring they receive the care appropriate for their condition. Outcomes include reduced hospitalization and lower costs.
Point of Light
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Points of Light 2023 Case Study 11
14 April 23    |   Aurene Wilford and Boyd Stewart
Hoping to provide improved care management for individuals with high-risk chronic conditions, the collaborators in this case study launched a program aimed at providing deviceless remote patient monitoring for recently discharged individuals with hypertension, COPD, or congestive heart failure. If patient-entered data is outside the normal thresholds, virtual care navigators receive real-time alerts and can intervene to prevent the patient’s condition from deteriorating. Outcomes include reduced ED visits and readmissions as well as lower costs.
Point of Light
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Points of Light 2023 Case Study 17
14 April 23    |   Aurene Wilford and Boyd Stewart
Vulnerable and underserved populations face a variety of barriers that can make it difficult for them to adhere to their prescribed medication regimens, and the impacts of non-adherence—in terms of health outcomes and costs—can be severe. Low medication adherence was a particular problem for the healthcare organization in this case study, whose patient population covers one of the most vulnerable and underserved zip codes in the country. To encourage better adherence among high-risk individuals, this organization collaborated with a payer organization and value-based care partner to identify patients in need of additional support and help resolve their barriers to adherence. Results include better health outcomes and higher CMS Star ratings.
Point of Light
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Points of Light 2023 Case Study 7
13 April 23    |   Aurene Wilford and Boyd Stewart
The provider and payer organizations in this collaboration recognized that progress in their population health and value-based care initiatives would not be possible without each organization having access to comprehensive patient and member data. Embracing their shared goal of enabling better managed care, the organizations worked with their technology partner to aggregate claims and clinical data and utilize analytics to gain insights into cost, utilization, quality, network, and performance metrics.
Perception
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Transitions of Care 2022
29 December 22    |   Bradley Hunter and Paul Warburton
Inefficient care transitions lead to wasted time and energy, increased risk of human error, and potentially poor experiences for both patients and providers. Despite the industry’s attempts to ensure the right information is sent to the right people at the right time, healthcare organizations must often revert to manual processes for data entry, verification, and communication. Some organizations use or want to use technology to streamline their transitions of care (TOC). This report—KLAS’ first to look at TOC—draws from the perspectives of 95 healthcare leaders across multiple care settings to understand their adoption of care transition technology, the challenges they encounter in their care settings, and the vendors they are considering.
Perception
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Value-Based Care Reimbursement 2022
17 November 22    |   Bradley Hunter and Cathy McCabe
Value-based care (VBC) has been established as a priority among healthcare organizations and payers as participants have gained more experience in managing their quality metrics and contracts, ultimately realizing returns on their investments. For this report, KLAS talked to 54 healthcare executives—including CEOs, CFOs, CIOs, CMIOs, COOs, VPs and directors of population health, and VPs of analytics—to gauge how they are moving beyond pay-for-performance into risk-bearing contracts over the next three years and their perceptions on which vendors can help them achieve their upcoming goals with VBC.
Perception
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Optum/Change Healthcare Merger
16 August 22    |   Boyd Stewart and Sam Eaquinto
In January 2021, Optum announced their intentions to acquire Change Healthcare. The merger remains unfinalized, however, as the US Department of Justice blocked the deal in February 2022 due to anticompetition concerns—such a merger would give UnitedHealth Group, Optum’s parent company and the nation’s largest insurer, access to rivals’ sensitive data. The legal proceeding is ongoing and scheduled to go to trial August 1, 2022. This report shares Optum and Change Healthcare customers’ reactions to the merger and their perceptions of its impact. Between March 2021 and April 2022, KLAS interviewed 48 individuals from 46 unique organizations; of these respondents, 9% are Optum customers, 56% are Change Healthcare customers, and 35% are customers of both vendors.


KLAS VP VBC, Payer, and Core Solutions - Bradley Hunter
Subject Expert
Bradley Hunter
VP VBC, Payer, and Core Solutions
KLAS VP VBC, Payer, and Core Solutions - Bradley Hunter




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