Population Health Management

A successful Population Health Management program requires several key ingredients including strong physician-patient relationships, a customer service orientation, and technology that empowers all constituents with powerful analytics to identify priorities and support evidence-based protocols.

CMS, commercial insurers and Medicaid programs continue to embrace payment models grounded in value-based care, high risk contracts and larger patient populations, which has placed a lot of pressure on providers to have access to comprehensive data upon which to make more informed decisions. As margins thin, population health management strategies must encourage coordination and cooperation among providers to improve the quality of care and reduce unnecessary costs.

HealthEC helps organizations realize remarkable year-over-year improvements in efficiency, quality of care, costs, and quality of life for the patient communities they serve. More precise identification and closure of care gaps, improved forecasting and impact analysis helps organizations manage patients across the care continuum.

ACOs, IPAs, CINs and Health Systems meet care goals, avoid penalties, maximize quality payment program incentives, and realize a quantifiable return on investment through overhead reduction, high-risk patient care intervention and ongoing operational insight. Read HealthEC’s Case Studies to learn more about our proven results.

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HealthEC proudly serves its partners:

  • Last year, organizations using HealthEC realized a $53 Million impact
  • 16 successful ACOs
  • 20 Million lives on the system
  • 12,000 providers
  • 750 Million transactions
  • Identified 123,000 patients at high-risk and requiring care coordination
  • Reduced PMPY costs by over $500

Leaders are looking for a single partner with a comprehensive population health solution to meet the needs of all users – physicians, nurses, dietitians, social workers, behavioral health experts, patients, analysts and executives alike. HealthEC encourages provider engagement with user friendly tools that consolidate and summarize patient care priorities into actionable work lists, and simplify action at the point of care. In addition to providing out-of-the-box functionality for all constituents, HealthEC is flexible and quickly adapts software and services to meet providers’ rapidly changing needs.

Many organizations struggle with various aspects of their value-based care program. HealthEC’s subject matter experts provide an array of advisory services to supplement in-house resources and develop or refine value-based care initiatives that deliver upon your organization’s financial, clinical and operational goals. HealthEC also provides short- or long-term staff augmentation to support organizations in responding to their value-based care business objectives.

HealthEC offers a comprehensive portfolio of solutions that promote population health management within value-based care programs, and supports the incremental implementation of applications within the suite to drive quality and cost initiatives for ACOs, IDNs, CINS, IPAs and other organizations.

Data Aggregation

The foundation of the HealthEC suite is unparalleled data aggregation capabilities. A provider’s ability to manage population health is fundamentally dependent on access to comprehensive, accurate data. HealthEC seamlessly integrates all data (clinical, financial, utilization) from hundreds of systems across the care continuum, and then aggregates, matches, scrubs, attributes and normalizes the data to provide the most complete picture of patient health and support reliable patient care decisions.

Data Analytics

An integrated predictive analytics engine identifies utilization patterns, high risk and rising-risk patients, delays in chronic disease-related preventive care visits (by provider), missing wellness visits (by patient), missing specialist consults/visits for chronic disease patients, physician performance patterns and patient trends. HealthEC’s actionable analytics platform delivers:
  • Unique, proprietary algorithms for risk analysis, patient care planning and disease management
  • Provider/Care Manager scorecards with risk adjusted peer comparison
  • Monitoring of network and referral utilization to help manage leakage

Care Coordination

A Care Management platform with care coordination models based on established clinical guidelines automate personalized, patient-centric care plans and provide workflow prompts in real time - while the patient is in front of the provider. Care coordinators are empowered with a comprehensive longitudinal patient care record, real-time ADT alerts from within and outside the network, and assessment tools to more precisely identify and close care gaps, such as Social Determinants of Health and disease-specific tools.

Patient Engagement

Robust patient engagement tools inform and empower the consumer including enhanced portals, mobile health applications and technologies, wearable devices, HIPAA-compliant video chat, social media, secure messaging, etc. TeleHealth capabilities also support high risk, as well as healthy patients with acute illnesses.

Performance Reporting

HealthEC proactively prepares and aligns health management processes to optimize quality while ensuring compliance with various performance reporting requirements including MACRA/MIPS/GPRO/QCDR, ACI/CIA, HEDIS, HCC/RAF, TCPI/PTN, Comprehensive Primary Care Plus (CPC+), Oncology Care Model (OCM) Registry, State-based Health Homes and more. The ability to integrate all data on a single platform, combined with a library of standard reports and a flexible reporting tool, ensures that providers can successfully submit performance data and meet strategic, financial and regulatory reporting requirements with relative ease.

KLAS Research recognized HealthEC, a first-time participant in its Population Health Performance Report released at the end of 2016, as a "most promising" vendor. HealthEC was rated highly for its data integration and aggregation capabilities, and flexibility in adapting to customer needs.

Health EC was also recognized in Chilmark Research’s 2017 Care Management Market Trends Report as one of the leading care management vendors supporting ACOs, CINs, IPAs, IDNs and other organizations servicing large Medicare, Medicaid and commercial populations. HealthEC’s product capabilities and innovation received the highest letter grade rating of all profiled vendors with consistent performance across all rating criteria, and defined strengths in the support of patient self-management, and communication across caregivers, patients and providers.

Organizations are choosing HealthEC for their value-based care initiatives to achieve results:
  • Reduce Skilled Nursing Facility costs by 33% per assigned beneficiary
  • Reduce ER visits by 8%, and ER visits leading to hospitalizations by 12-16% year over year
  • Reduce total inpatient costs by 6-7% annually
  • Reduce 30-day readmissions by 10%
  • Decrease average annual per-patient costs by up to $700
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