- Mixed signals from the Trump administration and provider reluctance to abandon fee-for-service, combined with the need for quick return on investment, have dampened population health management uptake over the past 18 months. Still, the shift to value-based care will continue to fuel growth in PHM tools, a new Chilmark research report concludes.
- The 2018 Population Health Management Trends Report identifies distinct markets for PHM products and services: captive ambulatory networks, independent ambulatory networks and converged payer-provider networks.
- Most PHM adoption to date has been by hospitals, which can finance these programs and view PHM as another element in their broader service portfolio. However, independent ambulatory efforts are starting to emerge and are in a position to grow significantly, the report says.
The population health management market is expected to grow at a compound rate of 16.1% over the next six years, reaching $69 billion by 2025.
With the ongoing move away from inpatient care, healthcare providers are looking to data integration, data analysis and care coordination to boost population health programs and improve patient outcomes while lowering costs.
Chilmark talked with more than 40 vendors to learn where the market is today and how it’s evolving. Driving the sector are a determination to lower healthcare costs, a growing belief that value-based care is here to stay, support from private payers and employers and the fact medical schools are now teaching population health management.
Of the four main product domains, data analytics is the most mature, followed by data aggregation, care management and patient engagement.
In analytics, the most common application is reporting. The opportunity is to move from simple reports to incorporating the analytics output into existing service line business applications, Brian Murphy, senior analyst at Chilmark Research, said in a webinar discussing the report’s findings. The other opportunity is the ability to predict what might happen to a patient’s disease progression or health.
“Data aggregation in population health management is, unfortunately, more an artisanal process than an automated process … It has to be done one-off on a customer-by-customer basis,” Murphy said. While most vendors are pushing the idea of a data platform, that reality is still a ways away, he added.
In terms of care management, care plan content is still in its infancy with lots of vendor differentiation regarding how patients are identified and assigned to programs. Prior authorization is also a challenge and needs to be integrated into workflows in PHM products, according to the report.
Patient engagement is the least mature PHM category, with tools focused on single care episodes or delivery systems. They fail to tie what patients are doing with their records to larger business objectives and goals for improving the patient experience, Chilmark analyst Brian Eastwood said.
Solutions are also struggling to meet the needs of converged payer-provider business lines and streamline data flow among such entities.
“There is a crying need for better interorganizational process coordination and products that actually enable those processes,” says Brian Murphy, senior analyst at Chilmark Research. “People talk about meds reconciliation and referrals and scheduling a lot … There are a whole host of other processes that nobody really talks about — processes that unite hospitals and post-acute care, acute care hospitals and various community-based therapists. There’s a tremendous opportunity for automating some very basic processes that occur among community participants.”