Provider-based care management products making strides in the right direction

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

Feb 26, 2016, 07:53 ET from Chilmark Research

BOSTON, Feb. 26, 2016 /PRNewswire/ -- Chilmark Research is pleased to release the 2016 Care Management Market Trends Report. This inaugural report on the growing market for provider-centric care management solutions provides the most in-depth, comprehensive review of in the market today.

Healthcare organizations (HCO) are adapting their workflows to meet changing payment models that reward outcomes over a patient's health journey as well as meet heightened patient expectations. New payment models require HCOs to better understand and facilitate care processes outside their four walls that optimize outcomes and utilization. Cross-organizational collaboration is becoming more of a reality than merely a desirable goal. Patients increasingly expect that their experience of care be continuous and that different HCOs have a similar understanding of their health needs.  

At its core, care management is concerned with "closing the loop" – ensuring that care transitions are smooth, prescriptions are filled, medications are taken, care plans are understood, goals are achieved, and patients are kept at the lowest-intensity venue possible. This aligns with the Triple Aim – improving the care experience, improving population health, and reducing overall care costs – as well as the emerging Quadruple Aim, which adds the goal of improving the experience for those who deliver care.

HIT vendors are responding to these needs with products that let multi-disciplinary clinical care teams from different HCOs build and execute evidence-based care plans. 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 will be critical to enable an HCOs population health management strategy.

Care management solutions available today  help HCOs maximize revenue (hitting quality targets) and enhance traditional FFS reimbursements (closing care gaps). A secondary objective is to help HCOs reduce medical costs and unnecessary utilization (readmissions reduction and low-acuity, non-emergent utilization). The care management solutions of tomorrow will need to do a far better job of providing extensibility beyond the confines of clinician workflow engaging other stakeholders in the community including the patient and caregiver.

The report points to an important, ongoing challenge — incorporating cross-organizational and handoff considerations into existing workflows. For most of these solutions, clinicians toggle from their electronic health record (EHR) to a clinical portal to access care management functionality. EHR vendors have incorporated care management functionality into their products and are building on existing customer relationships to see good initial uptake of their offerings, but again, these solutions fall short of engaging the extended community.

According to Matt Guldin, Chilmark analyst and author of the report, "Care management by providers is really in its infancy. Today, HCOs are experimenting with these tools and using them for revenue assurance and utilization management for now. The next major stage in their evolution will be to help drive better patient care and more uniform practices between HCOs and the communities they serve. Looking ahead, HCO are going to be asking for more functionality to support referrals, including the ability to integrate disparate scheduling systems. They will also be looking for better medications reconciliation functionality to help reduce the amount of time spent on this activity in most patient-clinician interactions."

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, 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

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

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SOURCE Chilmark Research