Saving The Payer Role In Population Health Management

December 9th, 2014

Peter Mueller

With contributors:

Patti Freeman Evans , Rebecca McAdams

Summary

Following the introduction of the Affordable Care Act, the US healthcare market is seeing a shift from traditional payer-based care management to provider-driven population health management (PHM). PHM initiatives vary in maturity, yet all new PHM models invariably entail partnerships between payers and providers. This collaboration requires providers to take on more financial risk for patient costs and outcomes, and vendors are responding to this shift with new products and technology. Not surprisingly, eBusiness professionals at payer companies are struggling to determine their place in these models. While many industry insiders believe that PHM will disintermediate payers, Forrester believes that payers still have an important, more nuanced role to play, as they possess core competencies required for both near- and long-term success. This report, the second in a series on payers' digital strategies, examines the current state of PHM and provides recommendations to payer-based eBusiness professionals who are supporting PHM development efforts.

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