Provider-based care management technologies market taking first real steps

Chilmark Research's first report on care management finds that products for HCOs new to risk-based contracts represent a good first step

Mar 01, 2016, 07:43 ET from Chilmark Research

LAS VEGAS and BOSTON, March 1, 2016 /PRNewswire/ -- Chilmark Research is pleased to release the 2016 Care Management Market Trends Report at this year's Healthcare Information and Management System Society's HIMSS16 conference. This inaugural report on the growing market for provider-centric care management solutions provides the most in-depth, comprehensive review of offerings in the market today – products that are expected to be promoted strongly at this year's industry event.

The Patient Protection and Affordable Care Act (ACA) put care management back in the spotlight – only this time, it shifted the risk burden away from payers, pushing healthcare organizations (HCOs) to provide healthcare as opposed to "sick care" and better treat (if not outright prevent) chronic conditions as well better coordinate episodic care.

This paradigm shift has left HCOs in a bind. In the present, HCOs continue to operate in a fee-for-service (FFS) payment environment but increasingly have their payments tied to various performance measures – and, in some cases, receive a capitated dollar amount for a particular episode of care. Regardless of the payment reform environment, HCOs will increasingly shift the way they practice medicine and invest in affiliated or owned care management resources to better coordinate care and enhance self-management support.

At a fundamental level, care management requires medical professionals to practice medicine differently. Care management will have to increasingly become a team sport, with the physician as quarterback leading a team of mid-level practitioners: office staff, nurse care managers and coordinators (both centralized and embedded), pharmacists, dieticians, social workers, family caregivers, and the patient.

To address these concerns, dozens of health IT vendors have started to roll out solutions aimed at streamlining care management, executing evidence-based care plans, and supporting the workflows of multi-disciplinary care teams. They come from a variety of health IT technology domains that, individually, play a key role in coordinating care with their own best practices, insights, advantages, and challenges. This report is the result of Chilmark's comprehensive review of over 100 solutions currently available in the market, for which a subset of leading vendors have been comprehensively reviewed.

These solutions have a long way to go before reaching maturity. They must grow beyond core competencies that only address individual stages of the care management lifecycle. They must balance their own proprietary standards for risk stratification, clinical workflow, and evidence-based care with the unique needs of current and prospective customers. Above all, in a market with so many competitors, they must be able to answer the question, "Why should we choose you?"

According to Matt Guldin, Chilmark analyst and author of the report, "Provider-led care management is really in its infancy. Today, HCOs are only experimenting with these tools and using them for revenue assurance and utilization management. The next major stage in their evolution will be to help drive better patient care and allow them to successfully scale their care management efforts to support larger numbers of patients. Looking ahead, HCOs will look to incorporate care management across a wider variety of care settings, incorporate additional clinical and non-clinical stakeholders, and directly embed a higher level of automation and workflow processes within these solutions."

For HCOs adopting these solutions, the choice is not easy. While HCOs have familiarity with their electronic health record vendor and its capabilities, care management is a new area for most EHR vendors, and these solutions remain immature. A wide range of other vendors are looking to provide the solution that will meet the HCOs care management needs, but there is not a single vendor today that will have everything needed to fully enable a care management strategy across the community and stakeholders that they serve.

The report is available to subscribers of the Chilmark Advisory Service or may be purchased separately. For more information, visit Direct inquiries for purchase should be addressed to Sean Campbell at

About Chilmark Research
Chilmark Research is the only industry analyst firm focusing solely on the most transformational trends in healthcare IT. We combine proven research methodologies with intelligence and insight to provide cogent analyses of the emerging technologies that have the greatest potential to improve healthcare. We do not shy away from making tough calls, and are respected in the industry for our direct and thoughtful commentary. For more information visit:

Vendors Profiled: The Advisory Board Company, Aetna ActiveHealth, Allscripts, athenahealth, Caradigm, CareEvolution, Cerner Corporation, Conifer Health Solutions, eClinicalWorks, Enli Health Intelligence, Epic Systems Corporation, eTransX, Geneia LLC, HealthEC, IBM Watson Health, Influence Health, InterComponentWare AG, Medecision, Optum, Orion Health, Wellcentive, Inc., ZeOmega. Other vendors discussed: ACTmd, Blueprint Healthcare IT, Conversa Health, Cureatr, Forward Health Group, HealthLoop, PatientIO, Rounding Well, Wellframe, Zynx Health

Media Contact:
Matt Guldin 
o: 617.615.9344 x712
c: 814.574.8077

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SOURCE Chilmark Research