Skip to main content
Subscribe
  • Login
  • My Account
  • Logout
  • Register For Free
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HLTH 2024
    • Sponsored Content: Vital Signs Blog
  • Opinion
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Healthcare Marketing Impact Awards
    • Innovators Awards
    • Diversity Leaders
    • Leading Women
    • Best in Business Awards
    • The 2030 Playbook Conference
    • Innovations in Patient Experience
    • Leading Women Conference & Awards Luncheon
    • Leadership Summit
    • Workforce Summit
    • Best Places to Work Awards Gala
    • Diversity Leaders Gala
    • - Looking Ahead to 2025
    • - Financial Growth
    • - Hospital of the Future
    • - Value Based Care
    • - Looking Ahead to 2026
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Skilled Nursing Facilities
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
    • Sponsored Content
MENU
Breadcrumb
  1. Home
  2. Patient Care
Sponsored Content Provided By HMS
This content was created by and paid for by an advertiser. The Crain's editorial department was not involved in the creation of this content.
February 27, 2020 10:47 AM

The Role of Population Health in Value-Based Care

Emmet O’Gara, EVP, Group President – Population Health Management, HMS
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    value based care stock graphic

    As value-based care gains momentum, healthcare systems and insurers are looking at care with a new lens. Reimbursement is dependent on positive patient outcomes, not the volume of services rendered. As a result, providers must take a team-based approach to care that focuses on the whole person, not just the conditions that patients present at a given point in time. 

    Within five years, value-based care could be the norm for most patient populations. The Health Care Payment Learning and Action Network, a public-private partnership established by the Centers for Medicare and Medicaid Services, has set aggressive goals. By 2025, they expect 50% of Medicaid and commercial insurance payments and 100% of traditional Medicare and Medicare Advantage payments to be tied to quality and value.
     
    Value-based care organizations recognize that a significant key to success is getting the treatment plans right the first time for the right individuals. However, delivering the right care to the right people at the right time, requires providers to have comprehensive knowledge about their patients. 

    Value-Based Care + Population Health Management – A Perfect Match


    To deliver true value-based care, healthcare providers need insight into the characteristics of both individuals and larger groups of patients. 

    Population health management replaces "one size fits all" care with tailored, cost-effective interventions based on patients' risk levels. This approach is well aligned with the goals of value-based care. 

    Adopting population health management enables organizations to:

    • Consider the physical, social and economic conditions that may affect health. Untreated behavioral health issues, for example, can become a catalyst for serious physical health issues. Nonclinical risk factors like physical environment, income status or availability of basic resources can also affect a person's ability to access care and maintain healthy habits. 
    • Focus on prevention. Preventive care is an essential component of value-based care. Focusing on "well care" can prevent patients from developing serious illnesses. The goal is to identify risks and arrest risk progression by proactively getting ahead of health issues. 
       
    Coordinated Care Requires Data, Analytics and Technology Solutions


    To deliver coordinated care efficiently, healthcare systems must eliminate data silos, unleash the power of information through analytics, and communicate in frictionless ways with providers and patients. Three keys to achieving this vision include:

    • Interoperability. To make value-based care a reality, physicians need comprehensive patient data, including information about social determinants of health. Access to this level of patient data will only be possible when healthcare information systems are integrated. When healthcare systems become truly interoperable, they provide a multi-layered understanding of patients which enables clinicians to care for the whole person. 
    • Predictive and prescriptive analytics. These are essential for identifying hidden and rising patient risks in real-time. Artificial intelligence-driven prescriptive analytics and other advanced analytical techniques can process hundreds of predictors from claims, self-reported consumer data, electronic health records, census, and social determinant data. Thanks to advances in technology, predictive and prescriptive data analytics are no longer limited to healthcare organizations with deep pockets and PhD-level data scientists on staff. The return on investment is clear, based on the cost savings that analytics can deliver.
    • Patient engagement solutions. These technology platforms consider the underlying factors that often inhibit people from practicing healthy habits. With this information in mind, communications and other outreach campaigns are designed which motivate patients to take positive actions for their health. 

    Thanks to population health technologies, healthcare providers have insight into patients' unique needs and the power to create care plans that are tailored to those needs in real-time. The result is healthier communities and lower cost services – the very definition of value-based care.

    To learn more about HMS’ Population Health Management solution, visit our website to discover how HMS can help you move toward value-based care.
     

    About the Author:

    Emmet O’Gara serves as EVP, Group President, Population Health Management (PHM) at HMS, a healthcare technology, analytics and engagement solutions company where he oversees all aspects of the PHM division’s business development, product innovation and delivery capabilities.


    Sponsored By:


    hms logo

    HMS advances the healthcare system by helping organizations reduce costs and improve health outcomes. Through our industry-leading technology, analytics and engagement solutions, we save billions of dollars annually while helping consumers lead healthier lives. HMS provides a broad range of coordination of benefits, payment integrity and population health management solutions.

    Most Popular
    1
    Here are new state healthcare laws taking effect in 2025
    2
    Meet Modern Healthcare's 2025 Leading Women
    3
    New York-Presbyterian layoffs affect 2% of employees
    4
    Evernorth, Optum, CenterWell units buoyed insurers in Q1
    5
    Epic CEO Judy Faulkner on AI, antitrust and consolidation
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2025. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HLTH 2024
      • Sponsored Content: Vital Signs Blog
    • Opinion
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Healthcare Marketing Impact Awards
        • Innovators Awards
        • Diversity Leaders
        • Leading Women
        • Best in Business Awards
      • Conferences
        • The 2030 Playbook Conference
        • Innovations in Patient Experience
        • Leading Women Conference & Awards Luncheon
        • Leadership Summit
        • Workforce Summit
      • Galas
        • Best Places to Work Awards Gala
        • Diversity Leaders Gala
      • Virtual Briefings
        • - Looking Ahead to 2025
        • - Financial Growth
        • - Hospital of the Future
        • - Value Based Care
        • - Looking Ahead to 2026
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Skilled Nursing Facilities
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing
      • Sponsored Content