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Population Health Care Management 2019
Adoption Early But Gaining Traction

author - Bradley Hunter
Bradley Hunter
author - Paul Warburton
Paul Warburton
December 16, 2019 | Read Time: 4  minutes

Care management is where the rubber meets the road in population health management (PHM). Many provider organizations are able to access their data, analyze it, and ascertain patient risk, but now they are pushing for better, more automated ways to manage the care of at-risk patients. Many vendors are struggling to keep pace with delivering care management (CM) capabilities due to siloed data and high variation in customer needs. Notably, several high-profile PHM vendors are not included in this research because their CM functionality is too limited, too early, and/or lacks sufficient adoption.

This report, KLAS’ first look at the use of PHM software specifically for care management, shares what functionality vendors provide and how well those tools support care managers’ work—by first pulling in data to create a longitudinal record and then providing actionable insights and helping to identify and close care gaps.

EMR Vendors Struggle to Deliver Customized Workflows

supports identification and closing of care gapsGenerally, EMR vendors struggle to effectively facilitate CM workflows. Amid slow delivery of new functionality, athenahealth customers say identifying patients requires significant manual effort from care managers. Allscripts and Epic customers want more out-of-the-box functionality. For Allscripts customers, this means easier-to-use tools that connect to the primary care setting. Epic clients are looking for smoother care manager workflows; data is not consolidated or easy to navigate, and tools do not fit care managers’ workflow needs. Cerner offers identification and documentation tools; a couple of customers want more guidance on pulling together data from different sources.

Conversely, third-party vendors’ technology is helping organizations to surmount some of these issues. Arcadia consistently delivers new functionality that improves care manager workflows, making it easy to identify and document care gaps. Arcadia’s attentive partnership approach also helps care managers resolve issues, including downtime, and this drives efficiency. Enli, HealthEC, and i2i Population Health customers also report success thanks to high-quality technology that automates care managers’ manual tasks, freeing them up for work that requires a human touch. Enli and i2i customers praise their ability to customize prioritization based on the facility’s care targets. HealthEC’s solution autogenerates a care plan that care managers can adjust and then put into action.

Flexibility and Customization from HealthEC, Enli, and Innovaccer Help Care Managers Get Actionable Insights

To get actionable insights that fit their specific care management goals, organizations need flexible tools. HealthEC, Enli, and Innovaccer stand out for their ability to customize the longitudinal care record to focus on what is important to the specific organization, enabling care managers to spend time closing relevant care gaps. HealthEC customers appreciate how much planning and scoping the vendor does to make sure the tools are aligned correctly with an organization’s needs. Those using Enli for care management report the vendor excels in providing actionable insights because of consistent tool development and their experience with quality measures. Innovaccer customers feel their vendor can custom-build anything; one area for improvement is more guidance throughout the care management journey.

longitudinal record vs provides actionable insights

In Care Management, Enli Leads with Strong Adoption
and Solid Satisfaction

Vendors’ CM capabilities vary widely today. Many offerings have gaps, and adoption of available functionality is often very early. EMR vendors often offer many capabilities and have solid adoption, but customer satisfaction tends to be lower. Among PHM-specific vendors, Enli stands out in adoption and satisfaction partly because they are responsive to customer development needs, building high-quality technology to fill gaps.

vendor care management snapshots

HealthEC Partners to Fill Gaps in Social Determinants
of Health Data

vendor capabilities for social determinants of health

† The care management user bases of Enli, HealthEC, and i2i Population Health are made up mostly
of ambulatory organizations.
‡ The clinical data autopopulated in assessments comes only from Epic’s EMR (no outside EMRs).

SDOH capabilities are driven primarily by customer needs, and organizations (especially more advanced ones) are pushing vendors to pull in assessment and clinical data on SDOH. HealthEC provides the broadest SDOH capabilities; customers highlight their partnering approach to development. Other vendors are behind—for example, athenahealth because of issues integrating athenaClinicals with the PHM solution.

Allscripts: Provides variety of CM functionality under CareInMotion. Tools work well independently; few deploy full suite due to à la carte pricing. Much of interfacing, data cleanup left to customer. CM functionality released in 2017. Tight integration. Flexible tool with prioritized workflows. Also offers CM services (not measured in this report).

athenahealth: Strong past CM performance; recent concerns around lack of development. Reporting and integration gaps inhibit CM.

Cerner: Natively integrated CM tools in separate tab in physician workflow. Need for additional guidance, development to further enhance workflows, improve data reconciliation.

Enli: Very robust technology can be tuned to user workflows. Reporting highly accurate and usable, enables workflow prioritization.

Epic: Broad CM technology natively integrated in EMR, customized by clients. High variation in deployed functionality. Advanced customers able to push for development to meet CM needs.

HealthEC: Robust, customizable CM functionality. Close customer partnerships. Meets outcome expectations. Consistent development.

i2i Population Health: CM functionality closely aligned with needs of FQHCs (large portion of customer base). Niche focus. Strong value and effective support.

Innovaccer: InCare (part of larger PHM platform) specific to CM. Functionality can be quickly customized to customer workflows and goals. Optimism for future delivery due to historically strong data aggregation, nimble development.

Lightbeam: High-quality technology. Attentive guidance supports solution optimization. Also offers outsourced CM services (not measured in this report).

Medecision (GSI Health): Care coordination tool with broad functionality. CM data too limited to share performance, but broader PHM base wants usability enhancements, more customized workflows.

NextGen Healthcare: Acquired EagleDream Health in 2017, has since built out solution under native PHM platform. CM data too limited to share performance, but early adopters optimistic about upcoming functionality.

Optum: Very broad technology platform. Long history working with payers. Most clients are very large organizations. Customizable solution that Optum can help optimize. Slow CM adoption due to lack of ready-to-deploy tools. CM data too limited to share performance.

author - Amanda Wind Smith
Amanda Wind Smith
author - Madison Moniz
Madison Moniz
author - Robert Ellis
Project Manager
Robert Ellis
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.