Population
Health
Management
Products & Services
June 2017
Our Approach to Population Health
We provide a wide array of out-of-the-box
applications to support common use cases,
from care management to quality measures to
performance monitoring in risk-based contracts.
This is a common starting point for
organizations early in their journey.
Health Catalyst provides a
simple, pragmatic approach
for how to get started with
some quick wins for those who
are just beginning—
and a long-term strategy to
succeed in an at-risk, valuebased environment, with
technologies and services
As organizations advance, they build a team
who can ask deeper questions of the data,
pushing beyond the abilities of these
applications. Advanced users benefit most
from the underlying capabilities of the
platform, which supports ad hoc analysis,
custom tools, machine learning and more.
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© 2017 Health Catalyst
Proprietary and Confidential
A Simple, Unifying Framework
The Journey to Population Health Management
3A
1
2
Infrastructure
Investments
Aggregate and enhance
data for analysis; most
organizations start with
available claims and the
largest clinical sources
Opportunity
Identification
Evaluate contractual
requirements, available
data, strategic priorities,
and cultural readiness to
prioritize efforts
Payment
Transformation
Ensure financial
sustainability while
straddling FFS and FFV
3B
Care
Transformation
Develop the infrastructure to
provide more effective care
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© 2017 Health Catalyst
Proprietary and Confidential
Principle #1: Infrastructure Investments
Health Catalyst Analytics Platform
Subject Area Data Marts
Applications
Present actionable data to
deployment teams
Community Care
Dashboard
Subject Area Mart Designer
Create and manage
content
Financial
Management
Explorer
Heart Failure
Linking & Standardization
Common Linkable Identifiers, Patients, Labs, Encounters, Diagnoses, Medications, etc.
Content
Population Definitions (800+), Hierarchies, Comorbidities, Risk Stratification, Attribution
Atlas
Provide insight into
analytics system source
metadata
Source Mart Designer
Accelerate analytics with
single source of truth
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Source Marts
EMR
Financial
Patient
Sat.
HR
Administrative
Claims
EMR
Financial
Patient Sat.
HR
Administrative
Claims
e.g. Lawson,
PeopleSoft
e.g. Kronos,
API Time Tracking
e.g. Medicare
Private Payers
e.g. Epic, Cerner
Allscripts
e.g. EPSi,
Peoplesoft,
Lawson
e.g. Press Gainey,
NRC Picker
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• Our ability to aggregate
disparate sources is
unparalleled in the
market (we were
recently named Best in
KLAS in healthcare
business intelligence
and analytics)
• The ability of the
platform to enhance
data and support
custom analysis are
among the most
appealing to our
advanced PHM users
© 2017 Health Catalyst
Proprietary and Confidential
Sources Library
Sources
Financial/
Costing
EMR
(e.g. Cerner, Epic,
Meditech)
Billing
HR
Claims
(e.g. McKesson,)
(e.g. Peoplesoft,
API)
(e.g. QXNT,
CMS)
(e.g. Lawson, EPSI)
2
3
3
2
2
Available
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5
Clinical
Specialty
(Lab,
Rad, Rx,
Clinical Op
Systems)
7
Patient
Satisfaction
HIE
(Health
Information
Exchanges)
1
(Press
Ganey)
1
Other
(External
Benchmarking,
home grown
systems)
7
On Roadmap
© 2017 Health Catalyst
Proprietary and Confidential
Principle #2: Opportunity Identification
Data is Necessary, But Not Sufficient
Data Discovery
and Gathering
Readiness
Assessment
Data Analysis
• Organizational strategic plan
• Contractual requirements for existing VBP arrangements
• Stakeholder interviews with key VBP leaders
• Topics focus on: existing governance, analytic maturity, existing
financial imperatives, and the infrastructure to drive change
• Opportunity analysis
represents a critical
and iterative
competency that your
PHM team will be
required to support
• Data is a critical input
to the process, but
these other inputs help
the organization to
prioritize initiatives
• Claims data is typically the first, critical input. However, depending
on data availability this review may include other sources
• Tools may include KPA, PMPM Analyzer, or CAFÉ.
Leading Wisely supports monitoring
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© 2017 Health Catalyst
Proprietary and Confidential
Principle #3a: Payment Transformation
Ensure You’re Financial Sustainable
Start with Coding and Quality Measures
1
2
3
Cash Received
•
Does coding accurately reflect the risk of your population? (HCC Insights)
•
Are you being compensated for your efforts to improve quality? (Measure Insights)
•
Are your efforts to reduce uncompensated care supported by data? (Propensity to Pay)
•
Are you continuing to keep a pulse on revenue cycle issues? (Rev Cycle Suite)
• Once you’ve taken risk, your
primary levers to succeed are:
1) ensuring you’re getting
paid, 2) reducing utilization,
and 3) reducing costs
Actual Utilization
M(PMPM Analyzer, Bundled Payments for all)
• Are you aware of your performance on your risk-based contracts, by payer and on KPIs?
• Can you identify negative or positive trends and opportunities for improvement?
• Are you aware of the highest priority areas to focus clinical improvement initiatives?
• For organizations early in
their journey, cash received
(coding and quality
measures) should be the
starting point because it is a
“win-win” in FFS and FFV
Cost to Deliver Care
(Activity-Based Costing)
• Are you able to track costs at a grain that allows for insight and improvement
• As you advance, you will want
to incorporate utilization
management and cost
reduction
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© 2017 Health Catalyst
Proprietary and Confidential
Principle #3b: Care Transformation
Lay the Groundwork for Better Care
Start with Care Management, Plan for Populations
1
2
3
Ensure the sickest, most costly patients are well managed
• Are you able to identify high cost/high need and risking risk patients? (Patient Stratification)
• Do you have point-of-care tools to steward team member workflow (CM workflow tools)
• Can you monitor the return on your engagement efforts? (Care Team Insights)
Leverage analytics to support a comprehensive primary care strategy
• Are analytics meaningfully underpinning your PCMH work by providing support for the
management of broad quality requirements? (Community Care)
• Do you have tools to easily segment and monitor patients based on clinical condition or other
variables for focused campaigns? (Precise Patient Registries)
• Do you have tools to engage and manage your employees’ health? (Catalyst4Health)
Use data to unearth opportunities for systematic improvements
• Do you have the ability to identify variability and areas for improvement at the clinical
program level to drive systematic improvement? (Clinical and Operational Apps)
• Are you able to identify the greatest areas of inappropriate utilization? (Patient Harm)
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• In care transformation, it
typically makes the most
sense to start with care
management and quality
measure work
• As you advance and seek
more opportunities to drive
down utilization, you will
need to seek population-level
opportunities for
improvement
© 2017 Health Catalyst
Proprietary and Confidential
Population Health Management Products
Extended
Core
1
2
Infrastructure
Investments
Data Operating System
aggregation of clinical,
claims, and other sources,
across multiple organizations
& systems supports
attribution, predictive
modeling and closed-loop
analytics
•
•
•
•
•
Open web services API
support for data exchange
and embedded integration
3A
Opportunity
Identification
Key Process Analysis
Patient Stratification
Population Explorer
Bundled Payments
Comparative
Benchmarking (CAFÉ)
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3B
Payment
Transformation
• HCC Insights – coding
validation
• MACRA Measures &
Insights
• PMPM Analyzer for
CMS and VBC
•
•
• Activity-Based Costing
(CORUS Suite)
•
•
Care
Transformation
Care Management Suite
Gaps in Care for
Primary Care Offices
(Community Care)
Precise Patient
Registries
Disease Management
(Full suite of clinical
applications for Heart
Failure, COPD,
Diabetes, etc.
© 2017 Health Catalyst
Proprietary and Confidential
Three Systems for Improvement
Leadership, Culture, and Governance
Where do we focus?
How are
we doing?
What should
we be doing?
How do we
change?
Financial Alignment
How are we financially compensated?
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© 2017 Health Catalyst
Proprietary and Confidential
Managing Half a Million Risk-Contracted Lives:
Partners HealthCare Population Health Strategy
Established a multi-disciplinary
governance and sponsorship
approach
Developed and implemented a strategic
PHM framework
advanced ACO /
shared risk population health
analytics platform
Implemented
strong base of end-user
engagement and support
Built
Click to view case study
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“
“The breadth and depth of the
changes required to transform
care delivery present numerous
daunting challenges. Our
experience suggests that partial
approaches will not constrain
cost growth. Organizations
committed to value-based
purchasing need to plan for the
long haul.”
~ Sree Chaguturu, MD,
Vice President
Population Health Management
Partners HealthCare
”
© 2017 Health Catalyst
Proprietary and Confidential
KLAS: Population Health Management 2016
POPULATION HEALTH MANAGEMENT 2016 The Training Wheels Are Off – KLAS Dec 2016 Performance Report
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© 2017 Health Catalyst
Proprietary and Confidential
Our Differentiators
Best in KLAS in healthcare business
intelligence and analytics
T
The depth and breadth of our out-of-the-box solutions to address
common analysis needs, paired with a highly flexible architecture
to support advanced used cases and custom analysis
Our ability to bridge near-term imperatives and longterm needs. We meet you where you are today, but
provide a robust foundation for long-term success.
®
© 2017 Health Catalyst
Proprietary and Confidential
Thank You
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