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Epic Systems, Cerner Remain Leading Population Health Companies

Epic Systems and Cerner Corporation continue to lead the population health management marketplace as health IT companies press on with value-based care.

Population health management companies and value-based care

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- The major health IT powerhouses will continue to dominate the population health software market as EHRs, predictive analytics, and revenue cycle tools merge into comprehensive patient management platforms, according to a new report from Black Book Research.

Epic Systems and Cerner Corporation, along with Allscripts and other leading health IT vendors, are all expanding their health IT offerings to encompass more of the clinical and administrative functions required to stratify risk, track patient movement across the care continuum, engage individuals in their own care, and monitor associated value-based revenues.

These health IT competencies will be critical for organizations that hope to succeed with accountable care initiatives in the near future. 

“The activity and energy is high," says Doug Brown, managing partner of Black Book Research. "Clearly, the best articulation of this energy is coming from the leading electronic medical record (EMR) suppliers, namely Epic Systems, Allscripts and Cerner, that have previously provided fee-for-service (FFS) platforms and are now fully investing in new, non-FFS tethered platforms to manage population health."

Organizations that invest in integrated health IT offerings are likely to have an edge over competitors spending time, energy, and money on cobbling together disparate systems, he added.

READ MORE: How to Choose the Right Healthcare Big Data Analytics Tools

"Systems like Epic that were developed from the start as a single, longitudinal patient record spanning inpatient, outpatient, post-acute and billing will have the advantage,” said Brown.

Naturally, representatives from Epic heartily agree with this assertion.

"It's true that many systems were developed to track separate healthcare encounters in order to get paid in a fee-for-service reimbursement model," says Alan Hutchison, Vice President of Connect & Population Health at Epic Systems. "Those systems are struggling to accommodate the need to transition to a holistic understanding of their patients, with cost and utilization tracked at every point along the care continuum.”

“This leaves single-solution systems and systems built through acquisition less able to effectively understand the total cost of care and where the greatest opportunities are to reduce variation, improve outcomes and lower costs."

While Epic is an extremely popular solution for many providers, Cerner’s focus on integration and longitudinal patient planning also keeps it a favorite choice for top industry stakeholders – now including both the Department of Defense and the Department of Veterans Affairs.

READ MORE: Using Risk Scores, Stratification for Population Health Management

"Population health is shifting the focus of healthcare from managing episodic encounters to managing individuals across the continuum," said Ryan Hamilton, Senior Vice President of Population Health at Cerner.

"Risk-holding organizations — health systems, health plans, ACOs, employers and government agencies — are looking for enterprise platforms that can span the heterogeneous nature of the emerging networks, but allow for deep integration into the provider workflow."

Both market leaders offer their own takes on health information exchange and interoperability, and have committed to developing industry-wide approaches to data sharing that can be leveraged by organizations using a variety of different EHR platforms.

This process may get easier as providers embrace the single solution mentality and shift away from patchwork best-of-breed architecture, Brown predicts.  The health IT market will follow suit by entering into a wave of mergers and acquisitions mimicking the initial narrowing of the EHR vendor market at the start of meaningful use.

"Single solutions will likely continue to merge, be acquired, or be usurped by integrated technologies within comprehensive platforms that are natively integrated at the point of care and accessible by patients and community-based organizations," he said.

READ MORE: How to Get Started with a Population Health Management Program

Navigating this changing landscape will be tricky for provider organizations who will be loath to repeat the health IT mistakes of the past.  Instead of trying to make difficult and expensive population health management technology decisions on their own, providers are turning to consultancies.

In 2018 and 2019, Black Book predicts a 177 percent rise in healthcare advisory service contracts centered on value-based care, big data analytics, operational efficiencies, and population health management strategies.  KPMG is likely to remain a strong leader in the space, respondents to an executive survey stated.

“For providers running health plans, there's also an emerging services business around health plan creation and financial administration, along with provider network management,” Brown noted.

Value-based reimbursement and risk-based contracting will remain a strong motivator for making these significant technical and organizational changes, the report said.  Both payers and providers will need to equip themselves with the personalized tools, knowledge, and strategies required to succeed in this turbulent financial environment.

"Transformation is a combination of people, processes and tools," said Cerner’s Hamilton. "Payers and providers are increasingly looking for partners that can provide a combination of advisory services, solutions and operational services to guide and accelerate their transformation."

Epic is also seeing a strong interest in value-based care from providers who are asking themselves difficult questions about their own particular financial needs and population health opportunities.

"Is 100 percent capitation the best model for everybody? Likely not,” said Hutchinson. “What is the ideal ratio between fee-for-service and value-based reimbursement for a given organization? How do they adjust care delivery based on their historical performance to reduce total cost of care while improving outcomes?

“The answers differ depending on the organization, their patient population and payer mix. That type of guidance is important to provide throughout the development and execution of any population health strategy."

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