{"id":1044,"date":"2015-04-23T20:05:00","date_gmt":"2015-04-23T20:05:00","guid":{"rendered":"http:\/\/localhost\/projects\/horsesforsources\/population-health-blueprint_042315\/"},"modified":"2015-04-23T20:05:00","modified_gmt":"2015-04-23T20:05:00","slug":"population-health-blueprint_042315","status":"publish","type":"post","link":"https:\/\/www.horsesforsources.com\/population-health-blueprint_042315\/","title":{"rendered":"Accenture and Cognizant battle it out in Population Health’s Winner’s Circle… with EXL knocking"},"content":{"rendered":"
With the HfS Blueprint season<\/a> now in full swing, we can celebrate the coming-out party of one of our rising star analysts, Barbra McGann<\/a>, who’s put together one of our finest pieces of research (yet) looking at the rampant Population Health and Care Management business services industry:<\/p>\n There’s such a loud call for change in the U.S. healthcare industry these days, Barbra. \u00a0Please tell us a little bit about what you see going on…<\/strong><\/span><\/p>\n Healthcare is just too complex. Through the Patient Protection and Affordable Care Act, we all have the right to access healthcare, but for a lot of people it\u2019s still difficult and expensive to do so. Healthcare providers and payers are on a mission to take the \u201csting\u201d out of healthcare. The goal is to make healthcare more personal, user-friendly and cost effective. That\u2019s a monumental task and requires change in the way many of them do business. It will take some creativity and new approaches to get it done.<\/p>\n Of all the activities in healthcare, Barbra, why did we zero in on Population Health and Care Management? <\/strong><\/span><\/p>\n Organizations need to help individuals engage and manage their own health \u2013 empower them to be healthier. This is the scope of population health and care management. Population health involves understanding who needs what kind of support to live a healthy lifestyle, reaching out and connecting early when there is potential need for medical support. Care management covers the coordination of care for people who are managing chronic conditions, helping them achieve better health, and the authorization of that care from the financing entity. While there used to be a pretty clear distinction between healthcare providers addressing population health and health plans covering financing and care management, these two are overlapping more and more with the focus on the individual as a whole rather than on a single stage.<\/p>\n So How can service providers help healthcare organizations get more personal with consumers, members, and patients? <\/strong><\/span><\/p>\n Service providers have been providing BPO support for healthcare organizations for years now to operate more efficiently and lower costs. And to do it, they have hired clinical executives and staff, developed industry certification and training programs and technology enabled IP, and established onsite and global centers. We believe they have the capability now to work closely with healthcare organizations of all sizes to help them be successful. Service providers have proven they can partner to help increase adherence to care plans, reduce readmissions, and reduce administrative costs, for example. They work with sets of population data to help design models that identify and drive interventions, and make calls to targeted patients to remind them about appointments and help them figure how to get there, and provide smooth back office operations for utilization management with a combination of skilled clinical and non-clinical resources and automation.<\/p>\n How is this Blueprint going to help current and potential services buyers? <\/strong><\/p>\n There\u2019s a lot of discussion about healthcare IT capability for population health, and not much about BPO. So we took a look at which service providers are offering business services and experience addressing:<\/p>\n It\u2019s a collection of activities that together help healthcare organizations manage outcomes focused on well-being, health, and care \u2013 wellness in every day life or specific times like pregnancy, adherence to care plans and medications, emergency room visits, hospital stays, and readmissions, for example.<\/p>\n How did the Blueprint analysis turn out?<\/strong><\/span><\/p>\n There are 8 service providers who stepped up to the opportunity to share their current capability \u2013 skilled resources like clinicians and healthcare data scientists and technology IP and platforms \u2013 as well as vision for the future of population health: Accenture, Cognizant, Dell, EXL, HCL, Hinduja Global Services (HGS), Sutherland Global Services, and Wipro.<\/p>\n Winner\u2019s Circle:<\/span><\/strong><\/p>\n High Performers:<\/span><\/strong><\/p>\n What separates the Winners Circle members from the High Performers is the depth and breadth of experience in healthcare business services within this value chain, clarity of vision for population health and care management in the healthcare industry, and collaboration with clients to date. Each of these service providers has capabilities that can match a business need or challenge of a service buyer. The key is to make the right match.<\/p>\n Thanks for your insight, Barbra. \u00a0So to sum up this Blueprint research, how do you see this market evolving further down the road? <\/strong><\/span><\/p>\n Barbra McGann is Managing Director, Research, at HfS (Click for bio)<\/p>\n<\/div>\n For the most part, population health management has been the realm of healthcare providers, while payers drove care management. Healthcare providers in an annual \u2018check up\u2019 looked for opportunities to identify and intervene in potential on-set of health issues. Payers identified candidates for care management after an event through claims analysis. But all healthcare organizations, and pharma and medical device companies, need to help in achieving a healthier society. So, activities are overlapping and shifting as healthcare becomes more proactive and individualized.<\/p>\n To be successful, services buyers and services providers will need to build tightly knit ecosystems and interoperable networks of technology, process, and people. We will see an increase in hybrid operating models, therefore, that combine internal and external resources. This enables them to get to know and connect with patients in a more individual and friendly fashion, and take the \u201csting\u201d out of healthcare.<\/p>\n HfS readers can click\u00a0<\/i><\/b>here<\/i><\/b><\/span><\/a>\u00a0to view highlights of all our 23 HfS Blueprint reports.<\/i><\/b><\/span><\/p>\n<\/a><\/p>\n
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