To earn legitimacy and resources within a healthcare organization, care management programs need objective, data-driven ways to demonstrate their success. The value of care management isn’t always obvious; while these programs may, in fact, be responsible for improvements in critical metrics, such as reducing readmissions, C-suite leaders need visibility into care management’s impact and processes to understand precisely how they’re improving care and lowering costs at their organizations. Five analytics-driven technologies give healthcare leaders a comprehensive understanding of care management performance: The Patient Stratification Application The Patient Intake Tool The Care Coordination Application The Care Companion Application The Care Team Insights Tool

1. Measuring the Value of Care Management:
Five Tools to Show Impact

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The Value of Healthcare Management
When care management programs fail, it’s
rarely because they’re ineffective.
Most likely, it’s because health systems don’t
have an accurate way to measure care
management’s success and, therefore, don’t
fully understand (or communicate) its impact
on outcomes improvement or cost savings.
For care management programs to be
successful and demonstrate their value
around critical metrics, such as readmissions,
health systems need effective technologies
and tools that leverage data to give leaders
visibility into care management’s processes.

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The Value of Healthcare Management
This presentation explains the challenges
health systems encounter when it comes to
demonstrating and understanding the
measurable value of their care management
programs, and how analytics-driven
applications can help prove care manage-
ment’s positive impact on outcomes.

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Care Management’s Fight for Value
Health system leaders must constantly measure
the success of their care management programs
to continue allocating the resources required for
them to improve outcomes and lower costs.
Health systems have varying perspectives on
care management, depending on whether they’ve
transitioned to value-based care (VBC) or still use
a fee-for-service (FFS) payment model.
Organizations that have taken on more risk under
VBC tend to be more motivated to invest in care
management to mitigate that risk, while those who
have stayed with, or are returning to, FFS will see
less value in care management.

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Care Management’s Fight for Value
Before the 2010 Affordable Care Act (ACA)
provisions incentivized care management by
reimbursing health systems for certain care
management activities, ambulatory care
management programs were not widespread.
Even though many healthcare leaders
understood the importance of care
management in population health
management, they still made decisions
based on the financial bottom line.
Today, as the healthcare ecosystem goes
back and forth between VBC and FFS, care
management is often caught in a tug of war
for resources and legitimacy.

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Measuring Care Management Value: Five Tools
To build and demonstrate care management’s value,
organizations need technologies, processes, and tools
to answer several key questions:
Is our care management program identifying the right
high-risk and rising-risk patients?
Do we have visibility into which care managers are
managing which patients in the program?
Can patients communicate directly with their clinicians?
Does our program have an effective workflow tool?
Can care managers communicate directly with
internal clinicians?
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Measuring Care Management Value: Five Tools
Care management technology innovators are
introducing tools that address these questions and,
with better tracking and support of care management
activities, give organizations the data to demonstrate
the value of their programs.
The Health Catalyst Care Management Suite, includes
five mobile applications that, separately or as a suite,
support effective, sustainable care management:
1. Patient Stratification Application
2. Patient Intake Tool
3. Care Coordination Application
4. Care Companion Application
5. Care Team Insights Tool

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Measuring Care Management Value: Five Tools
Patient Stratification Application
The Patient Stratification application helps care
managers identify the most impactable patients
in their populations for care management.
Care management resources can be very
expensive, and many health systems have a lot
of potential candidates for care management.
A patient stratification tool helps organizations
allocate often-scarce resources most effectively
by understanding which patients will benefit
most from outreach.

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Measuring Care Management Value: Five Tools
Patient Intake Tool
With the Patient Intake tool, care management teams can
track and assess their program’s progress and productivity.
Patient intake data gives care managers a meaningful
way to demonstrate to administration and high-level
leadership that they’ve appropriately
distributed patients among the care
management team.
A patient intake tool uses the risk score
data from the patient stratification process
to determine how to best assign each
patient to a care manager.

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Measuring Care Management Value: Five Tools
Patient Intake Tool
Patients are matched with care managers based on the complexity of the
patient’s situation, diagnosis, and need for psychosocial support.
This creates transparency in the care management
process and workflow, from identification
through discharge.

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Measuring Care Management Value: Five Tools
Care Coordination Application
The Care Coordination app gives care managers a more effective
workflow tool to coordinate patient care.
Care managers have previously used less efficient tools
(e.g., Outlook and Excel) to manage workflow.
As care management increasingly includes more
complex data, managers need care coordination
tools that can streamline the process, from ingesting
data and developing care plans to sending reminders
for upcoming activities.
With an efficient app, care managers can spend more
time with patients and less time managing workflows.

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Measuring Care Management Value: Five Tools
Care Companion Application
The Care Companion app empowers patients to
take an active role in their outcomes by helping
patients better understand and get involved in
their care plans.
Patients can engage directly with their care
managers from their mobile devices, and
research has positively linked patient
engagement with improved outcomes.

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Measuring Care Management Value: Five Tools
Care Team Insights Tool
Care managers can use the Care Team Insights
tool to track their program’s performance.
This app breaks down the clinical, EMR, and
transactional data from the patient intake and care
coordination tools to give a robust view of process
metrics and demonstrate ROI.

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Measuring Care Management Value: Five Tools
Care Team Insights Tool
Care managers can easily view key program
metrics—and share them with leadership:
How they’re becoming more efficient
(e.g., how quickly they’re engaging patients).
The success of engagement tactics
(e.g., outcome metrics for specific
care management tactics).
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With Measurable Success, Care Management
Establishes Clear-Cut Value
Technologies that provide a
comprehensive, data-driven view of care
management’s performance—how it’s
improving care across the organization
(including ROI)—can help healthcare
leaders, as well as the entire organization,
understand care management’s positive
impact on outcomes and cost.

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With Measurable Success, Care Management
Establishes Clear-Cut Value
With visibility into all aspects of care management—from the patient
stratification and intake processes to patient engagement, workflow, and
key performance metrics—analytics-driven applications give these
leaders an accurate, accessible way to demonstrate the important role
care management plays within their organizations.

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For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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More about this topic
Link to original article for a more in-depth discussion.
Measuring the Value of Care Management: Five Tools to Show Impact
Is Your Care Management Program Working: A Guide to ROI Challenges and Solutions
Dr. Amy Flaster, VP, Population Health Management and Care Management
Kathleen Clary, BSN, MSN, DNP, VP of Care Management & Patient Engagement
Introducing the Breakthrough Health Catalyst Care Management Product Suite
Paul Horstmeier, Senior VP
How Care Management Done Right Improves Patient Satisfaction and ROI
Dr. Amy Flaster, VP, Population Health Management and Care Management
How Care Management Improves Performance for Clinicians, Compliance with MACRA, and
Outcomes for Patients Like Olivia – Dr. John Haughom, Senior Advisor, Health Catalyst
Integrated Care Management—Improves Care and Population Health While Reducing Costs
Health Catalyst Success Story

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Kathleen joined Health Catalyst in May 2017 as VP of Care Management & Patient
Engagement. Prior to coming to Catalyst, Kathleen worked for MultiCare Health System as the
Administrator of Patient Navigation & Care Coordination. Kathleen has a degree in Bachelors
of Nursing from Mount Marty College, a Masters of Nursing from University of Washington,
Tacoma, a Doctorate of Nursing Practice in Systems Leadership from Rush University, Chicago
and currently enrolled (graduate 2018) at the Army War College to earn a Master’s in Strategic Studies.
Kathleen Clary, BSN, MSN, DNP