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Population Health Performance 2016
The Training Wheels Are Off
Providers knew that value-based care was inevitable. To prepare, they practiced on their employees, took on a few payer contracts, and selectively implemented a few tools. Now, having gotten their balance, many are taking off the training wheels and taking on more risk. But are PHM vendors ready as well? This report seeks to answer three major questions: Which vendors are geared to meet needs for more data faster and with less effort? Who has strengthened and tuned their workflows for program administrators, care managers, and clinicians at the point of care? Where are the adaptable, responsive partners that providers need to help them stay upright in a rapidly changing, high-risk environment?
1. ENLI AND I2I MAKE EMR-FOCUSED PHM EASY; PHILIPS WELLCENTIVE IS MOST BALANCED BETWEEN EASE AND SCALE
Data aggregation is in low gear as no vendor has proven capable of building data feeds easily and at scale. Enli and i2i Population Health make aggregation simpler for providers with a few (or fewer) EMR feeds. Valence Health handles more feeds, but greater effort is required of customers. Philips Wellcentive strikes a balance thanks to broad experience and a proactive data management strategy that pairs data experts with individual customers. Early feedback from a handful of Health Catalyst, HealthEC, and Arcadia Healthcare customers looks promising.
2. ATHENAHEALTH, OPTUM, AND PHILIPS WELLCENTIVE STEER THROUGH DIVERSE DATA; EMR VENDORS EXPAND
A decision is only as good as the data it is based on, and providers say the best data comes from combining a variety of sources. Among fully rated PHM vendors, athenahealth, Optum, and Philips Wellcentive have the highest percentage of customers merging both clinical data from EMRs and claims data from payers. Cerner customers commonly aggregate from payers and non-Cerner EMRs. Epic users are in the early stages of doing both. Claims data is a universal challenge, even for payer experts Advisory Board and Verscend (previously Verisk).
3. CERNER, ENLI, AND PHILIPS WELLCENTIVE ARE THE MOST FLEXIBLE PARTNERS; SOME AQUISITIONS IMPACT SERVICE
Population health management is an evolution, even for experienced providers who are rapidly adding and changing payer agreements. An important source of confidence comes from PHM vendors who are responsive to customer needs and readily adapt to the latest requirements. Leaders by example, Philips Wellcentive provides strong guidance, Enli delivers quick turnaround on requests, and Cerner closely collaborates with customers of the still-emerging HealtheIntent solution suite. Some Optum and Verscend (previously Verisk) users say slow development has them spinning their wheels. Some Explorys and Phytel customers say IBM’s acquisition is impacting service, echoing former Humedica users who are now with Optum.
4. NO VENDOR HAS BOTH BREADTH AND DEPTH TO MEET ALL NEEDS FOR ALL TYPES OF CUSTOMERS; IN LESS COMPLEX ENVIRONMENTS, ENLI AND I2I SATISFY MULTIPLE PHM ROLES
Cerner and IBM Watson Health bridge the data needs of both program administrators and care managers. Allscripts and Philips Wellcentive streamline workflows for care managers and clinicians using EMRs at the point of care. Advisory Board, athenahealth, Optum, and Valence have difficulty keeping up with complex needs of larger customers. EMR vendors are holding on to their customers and tempting best-of-breed users as development progresses.
5. HOW WELL DO MODULES FROM THIS VENDOR WORK TOGETHER?
Designer
Natalie Jamison
Project Manager
Robert Ellis
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.