Population health management (PHM) plays a crucial role in improving the overall health outcomes of a specific group of individuals. By implementing effective PHM strategies, health plans can proactively address the health needs of their members, leading to better health outcomes and reduced healthcare costs.
One of the key reasons why population health management is important is its ability to identify high- and rising-risk individuals within a population. By analyzing data from various sources, such as electronic health records, claims data, and social determinants of health (SDOH) factors, health plans can identify individuals who are at a higher risk of developing chronic conditions or experiencing adverse health events. This allows plans to intervene early and provide targeted interventions to prevent the progression of diseases and improve overall health outcomes.
Advancements in healthcare technology solutions including data analytics, machine learning and AI-enabled intelligent automation have increased the effectiveness of PHM programs, enabling better data collection, analysis and implementation of care strategies. This has resulted in a notable increase in demand and level of investing in these types of program among health plans. According to Market.us, the U.S. PHM market is projected to grow 14.1% from 2024 to 2033 to reach $118.6 billion. In additional to technological advancements, factors affecting market growth include the increased prevalence of chronic diseases, the push to coordinate care across the healthcare continuum, and growing importance of tracking care quality and outcomes.
Selecting the right vendor partner for population health management solutions is a critical decision for health plans. The National Committee for Quality Assurance (NCQA) Population Health Management Prevalidation is a valuable credential that health plans should consider when choosing a vendor. NCQA prevalidation ensures that the vendor's solutions meet the highest standards of quality and effectiveness, providing health plans with the assurance that they are partnering with a trusted and reliable vendor.
NCQA prevalidation assesses vendors based on a set of rigorous criteria, including data integration capabilities, analytics and reporting capabilities, care management capabilities, and patient engagement capabilities. By selecting a NCQA prevalidated vendor, health plans can be confident that the vendor's solutions have undergone a thorough evaluation and have been proven to deliver positive outcomes.
In addition to ensuring quality and effectiveness, NCQA prevalidation also streamlines the vendor selection process for health plans. By narrowing down the options to just a handful of NCQA prevalidated vendors, health plans can save time and resources in the vendor evaluation process. This allows health plans to expedite the implementation of population health management solutions and start reaping the benefits much sooner.
Working with NCQA prevalidated vendors offers several key benefits for health plans. It provides health plans with access to proven and effective population health management solutions. NCQA prevalidation ensures that the vendor's solutions have been rigorously evaluated and have demonstrated positive outcomes in improving health outcomes and reducing healthcare costs.
Partnering with a NCQA prevalidated vendor also allows health plans to leverage the vendor's expertise and experience in population health management. These vendors have a deep understanding of the challenges and opportunities in managing population health and can provide valuable insights and guidance into the future.
In addition, working with a NCQA prevalidated vendor can enhance the reputation and credibility of the health plan. By partnering with vendors that have been prevalidated by NCQA, health plans can demonstrate their commitment to quality and effectiveness in population health management, thereby attracting more members to the health plan and differentiating it from other competitors in the market.
Lastly, consider a PHM prevalidated vendor that can be a partner on your journey towards harnessing the capabilities of artificial intelligence (AI) and other cutting-edge technologies that are the foundation of a next-generation PHM program. By thoughtfully integrating these advanced solutions into your operations, you strategically position your organization for sustained success.
Implementing population health management solutions requires careful planning and execution. To ensure success, health plans should consider best practices that have been proven to maximize the effectiveness of these solutions, including the following:
Health plans have successfully gained a competitive advantage by partnering with NCQA prevalidated population health management vendors. By leveraging vendor solutions, plans can identify high-risk members, provide targeted interventions, and improve health outcomes. These success stories serve as inspiration for other health plans looking to implement similar solutions and achieve similar results.
Vital Data Technology is proud to be NCQA PHM Prevalidated, demonstrating our commitment to delivering the highest quality population health management solutions to health plan clients across the U.S. Contact us for more information on how we can help you with your population health management initiatives.