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How an Enterprise Health System assessed it’s Population Health programs to improve Value Based Care opportunities

Case study
A prominent US health system partnered with Decimal.health to identify operational improvements for closing gaps in care to optimize patient care.
CAPABILITIES
Strategy, Operations
INDUSTRY
VBC, Population Health
CLIENT
Health system

AT GLANCE

The Story

Like many US healthcare systems, a leading provider network's population health division faced budget constraints and limited capacity while aiming to provide top-quality care.

The Ask

The client requested Decimal.health's support in identifying opportunities to improve core operations for their Medicaid line of business across all existing population health programs. The aim was to enhance care gap closure and improve performance in measuring and achieving quality measures.

THE APPROACH

We performed an in-depth analysis of the client's Population Health Management (PHM) operations to identify gaps in the current organization.

From this assessment, we have pinpointed three overarching actions for enhancing the effectiveness of the population health program operations: centralization, automation, and resource reallocation, each supported by specific recommended initiatives.

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RESULTS

Equipped with a clear understanding of the gaps and well-defined improvement initiatives, the client is now focusing their efforts on prioritized actions that hold the greatest potential for additional revenue generation. By addressing these key priorities, they achieved multi-million short-term top-line revenue growth in the first year of implementation already.

Key Highlights

  • 6 PHM programs enhanced for revenue generation
  • 3 Strategic actions for optimizing operations
  • $5M+ Additional short-term revenue potential from just one program alone 

     

THE TEAM

Kamal Jethwani
KAMAL JETHWANI, MD, MPH MANAGING PARTNER AND CEO
Vini Metha
MANASVINI MEHTA ASSOCIATE PARTNER, STRATEGY PRACTICE

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