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Value-Based Care Managed Services 2019
Which Vendor's Profile and Performance Match Your VBC Needs?

author - Bradley Hunter
Bradley Hunter
January 8, 2020 | Read Time: 5  minutes

Despite reduced regulatory pressure, competitive and financial factors continue to drive organizations toward value-based care (VBC), yet making the transition is a complex and expensive undertaking, especially for smaller or midsize organizations, who may lack the resources and expertise of their larger peers. An array of services firms and software vendors offer managed services designed to help. These offerings vary widely, and provider organizations will want to consider several factors when choosing the firm that is right for them. This report examines eight services firms and software vendors who offer VBC managed services to examine the types of projects and organizations they work with and how well they perform.

Selecting a VBC Managed Services Firm

selecting a vbc managed services firm
option 1

Services from a Full-Service Firm

Full-service firms bring technology to the table but lead with managed services, helping large, complex clients with a wide variety of risk arrangements, including standing up a health plan. Client-validated capabilities span all six pillars of the KLAS population health framework. Clients typically have an urgent need to lead or catch up with VBC in their local market. Engagements are expensive and large in scale, involving dozens of firm-supplied resources. These firms are the only ones that both directly invest capital in their client organizations and tie fees to measurable results.

full service firm profiles

Evolent Health Evolving Strategy; Lumeris a Good Partner for Many

Evolent Health and Lumeris take on some of the largest, most complex VBC engagements, working with very large organizations, including academic health systems and large IDNs. Each has a number of clients in this research who are happy with the service they have received. In Lumeris’ case, over half are highly satisfied. However, neither firm delivers consistently across clients, with many client frustrations stemming from a lack of execution.

customer satisfaction full service firms
execution vs partnership full service firms

One-fourth of Evolent Health customers report dissatisfaction overall, with several citing disappointment in the firm’s execution and partnership. In general, Evolent overpromises and underdelivers, leading to missed timelines, unkept promises, and lack of trust in Evolent’s data. Evolent has indicated that while they will continue to work with health systems that embrace VBC, their provider growth strategy will focus more on physician groups. In the payer market, Evolent will focus on serving existing health plans in their value initiatives.

Many clients identify Lumeris as a good partner, saying the firm is willing and able to adapt to unique needs, even if it takes a while. At the same time, some report that turnover issues and resource shortages have led to poor execution and a disjointed customer experience.

option 2

Services from a Focused Firm

Focused firms offer most capabilities in the PHM framework but specialize in specific types of projects or organizations (e.g., setting up rural ACOs or managing capitated plans). Projects tend to be of low to moderate complexity, be less expensive, and involve fewer firm resources. Typically, clients want to take on a low to moderate level of risk or don’t need a full set of services. The two focused firms in this report specialize in different areas and are not direct competitors of each other.

focused firm profiles

Caravan Health and Conifer Health Solutions Drive Outcomes for Unique Client Bases

caravan health outcomes and moneys worth

Caravan Health provides less experienced organizations a fast on-ramp to value-based care through Caravan-managed ACOs. The firm’s leadership is considered innovative and knowledgeable. Some clients feel they eventually outgrow Caravan’s standardized approach and are concerned the net benefit no longer justifies the cost.

conifer health solutions outcomes and moneys worth

Conifer Health Solutions’ long history of managing capitation for physician organizations and health systems has resulted in accurate, actionable data, a robust tool set, good reporting, and overall reliability, leading to enduring relationships and good perceptions of value.

option 3

Services from a PHM Software Vendor

PHM software vendors in the VBC managed services market lead with software but also offer limited VBC managed services as a value-add to their population health technology. Services are often closely tied to the technology (e.g., they support data aggregation and analytics). With the exception of Arcadia, who has expertise across a broader set of risk arrangements, these firms have experience primarily with Shared Savings. Clients are typically smaller organizations just starting out who want to avoid deep risk and are content to ramp up over time, forgoing the more comprehensive support of full-service firms in light of tight budgets.

software vendor profiles

High-Performing Software Firms Expanding Client Relationships through Services

execution vs partnership software vendors

Four of the five top-performing PHM software vendors have forayed into VBC managed services. Each has unique strengths. Serving mostly outpatient clinics, HealthEC is a consistently high performer for their smaller client base. Most clients are taking on more limited risk through Shared Savings and Medicaid programs. Clients report very strong partnership and collaboration, describing their vendor relationship as unique from any other they have. This includes appreciation of the firm’s executives, in whom clients have strong trust.

executive involvement and quality of staff

Arcadia is noted for being responsive and transparent when challenges arise, for not shying away from difficult situations, and for being willing to adapt to clients’ unique needs. Some smaller clients report that Arcadia gives them the same attention a larger client would receive, leading clients to feel the firm is a true partner. Health Catalyst clients report a strong sense of partnership with the firm’s broad bench of experts and say they receive proactive coaching and believe the firm really wants to help them improve. Lightbeam—a lower-complexity firm—is highlighted for proactively checking in with clients and soliciting feedback.

option 4

Do It Yourself with PHM Software Tools

Organizations that choose a DIY approach to value-based care are typically large organizations who have the expertise, experience, and infrastructure needed to set up and manage value-based contracts internally. These organizations are often innovative and want to tackle VBC without the constraints of a third-party partner. Benefits of this approach could include lower upfront cost, greater ability to customize, autonomy in choice of technology partner, and not having to share the money earned from value-based contracts. Trade-offs could include a greater need for upfront capital, longer ramp-up time, longer time to value, increased risk of losing money, and having to shoulder all of the work internally, including developing resources and expertise. More information on the software performance of various PHM vendors can be found on KLAS’ website.

author - Elizabeth Pew
Elizabeth Pew
author - Natalie Jamison
Natalie Jamison
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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.