Financial tools seeping into population health management

The definition of population health management (PHM) differs depending on whom you talk to. But the lines are blurring between PHM and financial management, according to a blog post at Chilmark Research.

Quality and care management groups might have a different definition than those dedicated to financial and risk management. But the financial tools can help healthcare organizations better manage population risk, it says.

It can encompass all the tools for value-based reimbursement including EHRs, health information exchange, analytics, care management, revenue cycle management and more.

A care manager, for instance, might want to see the predicted total cost of care for a set of high-risk patients. A risk manager might want to view clinical quality measures alongside paid-claims-based risk scores.

IDC Health Insights notes the lack of a common definition in a report on the PHM market, which it calls very active.

Its definition includes functionality to identify or predict populations at risk, the ability to create and monitor care plans, and the ability to communicate with individual patients as well as communities of patients, according to an announcement.

Physician practice groups are the most likely clients in this market, it says, followed by integrated delivery systems and payers.

Differentiators include the depth and breadth of analytic capability (patient risk identification and performance measurement), the degree of integration with EHRs, and the sophistication of care plan development.

It predicts a high level of activity in the market for the next 18 to 24 months.

Population health was a hot topic at the American College of Healthcare Executives Congress in March, with healthcare leaders sharing ways to improve health under value-based care initiatives.

George Conklin, CIO and senior vice president of Irving, TX-based Christus Health, sees it as one way to deal with slashed budgets at the same time the organization must increase IT investments for ICD-10 and other regulatory burdens.

Meanwhile, Jason Burke, a senior advisor for advanced analytics at the University of North Carolina School of Medicine, says population health management offerings these days look "remarkably like yesterday's offerings" and organizations will need to find new methods to move beyond the status quo.

To learn more:
- find the Chilmark post
- here's the announcement