Health plans have been doing care management for decades, but with ever-increasing pressure to reduce medical costs, they have been looking for new ways to significantly scale care management to broader member populations.
Furthermore, newly released NCQA Population Health Management (PHM) standards provide another catalyst for health plans to forge change. However, expanding whole-person focused (as opposed to disease-state focused) care to a sizable portion of the member population requires health plans to address several challenges.
Some challenges include:
- Siloed, fragmented assessments and care planning that are not scalable or optimized for integrated care management.
- Lack of comprehensive and up-to-date, evidence-based clinical content that is required due to increased complexity for larger populations.
- Absence of scalable and efficient PHM technology platforms that seamlessly integrate clinical solutions with workflows.