05 Dec Now is the Opportune Time for Pop Health Management

Source: Managed Healthcare Executive

Healthcare reform, emerging payment models that reward quality versus volume, and technology are driving providers toward a trend that payers have embraced for years: population health management (PHM), according to a recent KPMG survey.

In addition, provider organizations are realizing that effective PHM and cost reduction requires a holistic view of data, including claims, medical records and other information from throughout the healthcare ecosystem. Not only have payers invested in data analytics tools and in-person chart reviews to validate diagnoses and identify care gaps, they have also worked to ensure that the highest-risk patients are receiving the care necessary to avoid emergency department or hospitalization utilization.

However, unlike periodic chart reviews, provider organizations have access to technology that can automatically mine data and offer real-time notifications regarding high-risk patients based on their electronic health record (EHR) and payer claims data. This holistic approach to data management offers providers the opportunity to successfully manage population health, with continued support from payers, in ways that were never truly feasible before.

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