Introducing the Care Management Suite: A Data-Driven, Transparent Solution

care managementCOVID-19 has underscored the healthcare imperative of effective care management—in particular, the pandemic demands that health systems rapidly adapt their care management approach based on changing circumstances. Traditional, inflexible care management solutions leave providers and care teams scrambling to make adjustments and feeling frustrated with fractured data and workflows from different sources.

With a lack of customization options and no visibility into the algorithms driving the care management process, care teams can’t pinpoint how patients were selected and identified. Clinicians are left hoping these algorithms, technology, and processes are correct. Relying on guesswork as a guide to delivering the right care to the right patients results in stymied care management programs that don’t demonstrate ROI.

The Health Catalyst® Care Management Suite takes a different approach as a transparent, data-driven, comprehensive care management solution. The suite is the only care management solution built from the ground up, using a data and analytics strategy combined with expertise designed to deliver real ROI.

Fragmented Data and Black Box Solutions: Obstacles to Effective Care Management

Coordinating care across different healthcare environments and teams—inside and outside of the hospital—is critical for improving patient outcomes. Effective care coordination requires using data integrated from many sources (claims, EMR, clinical, and more). However, outdated care management solutions struggle to seamlessly aggregate disparate data and workflows, meaning providers and care teams make care management decisions, with limited resources, based on incomplete data.

The Care Management Suite takes a patient-centric approach that also supports healthcare billing best practices to avoid a common trap of prioritizing EHR and billing needs over patients. Despite advances in care management, health systems continue to feel overwhelmed by these common roadblocks and stymied by their inability to measure results and demonstrate ROI.

The Health Catalyst Care Management Suite: A Transparent, Data-Informed Approach

Health Catalyst built its Care Management Suite on the Data Operating System (DOS™), a sophisticated data platform that combines data from multiple sources. With DOS as one source of truth, care teams can rely on comprehensive financial, operational, and clinical analytics to measure, track, and drive outcomes improvement. The suite features an end-to-end solution for the entire clinical care pathway, from identifying the most impactable patients to implementing interventions and improving outcomes. Additionally, expert services ensure health systems using the Care Management Suite can profitably expand care management initiatives and optimize ROI.

With a transparent, flexible approach to care management, built on a strong analytics foundation, Health Catalyst eliminates the typical “black-box” solution and allows care teams to view and understand algorithms, identify gaps stemming from those algorithms, and efficiently implement changes according to patient needs. With increased visibility in every step of the care management process, care teams leverage a patient-centric view, prioritizing patients’ needs above anything else.

Three Core Pillars Lay the Foundation for Care Management Success

The Care Management Suite consists of three modules that health systems can use together as an integrated solution or independently:

  1. Population Builder™: Stratification Module: With pre-defined registries—built on integrated claims and clinical data—care teams can rapidly identify patients who will benefit most from care interventions. Evidence-based risk stratification models that leverage industry and machine learning risk models also allow care teams to easily customize algorithms to meet the needs of each unique patient population.
  2. Population Care Flow: A fully integrated, end-to-end workflow solution allows care teams to qualify, enroll, and actively manage patients in care management programs, from patient identification to the outcome. With easy access to a longitudinal patient view, all members of the care team can see past encounter information, problems, goals, barriers, activities, and interventions and then tailor care accordingly.
  3. Population Care Insights: Care teams can rely on the analytics dashboard to analyze inefficiencies at each phase of the care management workflow, understanding how to measure and maximize care management ROI effectively. Dashboards also allow care teams to measure, track, and identify areas for financial and operational improvement. The operational and clinical information collected through daily care management activities provides ongoing analytic insights into provider workflows.

Technology and Services Tackle Care Management Challenges

The Health Catalyst Care Management Suite combines its data-driven technology with support from experts boasting years of experience optimizing care management programs and driving ROI. These experts ensure health systems maximize technology and that data and processes support the organization’s care management goals.

The Care Management Evaluation Service

The Care Management Evaluation Service brings deep expertise and proven methodologies to help determine where—and whether—an organization has succeeded in its goals for care management. Led by experts in healthcare finance, analysis, and accountable care strategy and design, this service delivers valuable insight into care management ROI and its drivers in the organization.

Care Management Program Design

The Care Management Program Design service delivers clinical, operational, and financial expertise to help organizations devise and implement programs that optimally meet patient needs, align with goals for population health, and maximize resources and workflow efficiency.

Care Management Population Design

The Care Management Population Design service combines analytics and expertise to deliver expert guidance and help stratify patient lists efficiently, transparently, and optimally. This approach allows organizations to reach their most impactable patients and target their most crucial care management goals.

Care Management Assessment

The Care Management Assessment service leverages Health Catalyst experts to conduct a comprehensive assessment of an organization’s current care management infrastructure, capabilities, and opportunities. Based on this insight and in concert with organizational priorities, the team delivers targeted recommendations for implementing programs grounded in current contractual and cultural realities, informed by a careful accounting of ROI, and aligned with the overall organizational strategies.

Transparent, Adaptable, and Flexible Care Management

Effective care management practices can improve patient outcomes, and in a COVID-19 world, part of the care management process means mitigating harm from deferred care and missed routine care appointments. With the Health Catalyst Care Management Suite, health systems can quickly and easily tailor and adapt interventions to more effectively manage patient populations at any point in the care journey. For example, care teams can swiftly change populations with Population Builder: Stratification Module, change and adapt care in Population Care Flow, and monitor results in Population Care Insights.

As health systems, providers, and clinicians alike face COVID-19-related healthcare challenges along with an uncertain future, they can depend on the transparent, data-driven approach—the foundation for the Care Management Suite as a guide to improving operational, financial, and clinical outcomes.

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

  1. Activity-Based Costing in Healthcare During COVID-19: Meeting Four Critical Needs
  2. Population Health Management: A Path to Value
  3. Six Need-to-Know Guidelines for Successful Care Management
  4. Succeeding in Population Health Management: Why the Right Tools Matter
  5. Achieving Stakeholder Engagement: A Population Health Management Imperative
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