10 min Care management software solves a persistent challenge for the healthcare industry: transforming fragmented data into a roadmap for high-quality patient care. By bridging the gap between raw data and clinical action, this technology enables care teams to focus less on chasing information and more on delivering proactive, whole-person interventions that improve outcomes.
FAQs about care management software
In short, here’s what you need to know about care management software:
- Care management software is a tool that health organizations use to streamline patient care workflows.
- The software’s core features include patient data aggregation, workflow automation, patient engagement tools, artificial intelligence (AI), shareable workflows, and performance visualization.
- Care management solutions benefit care managers, payers, and patients by enhancing care coordination and supporting the patient journey.
Below, we provide a more detailed breakdown of these highlights.
What is care management software?
Care management software is a tool that health organizations use to streamline patient care workflows. For example, care management solutions facilitate treatment planning, medication management, and care coordination. These tools allow providers to personalize patient care, track patients’ progress in a treatment plan, and manage risk more effectively.
What are the essential functions of care management software?
Care management platforms provide tools for nearly every aspect of care delivery, including:
- Patient data aggregation consolidates medical records, histories, and treatment plans into a single accessible platform, eliminating data silos.
- Workflow automation streamlines burdensome administrative tasks and clinical processes, easily keeping managers informed and up to date.
- Patient engagement tools facilitate and support ongoing patient-provider interaction, from initial outreach to treatment plan adherence to end-program assessment.
- Predictive analytics and AI analyze historical data to anticipate and prevent negative health outcomes using machine learning.
- Shareable workflows coordinate care between teams, enabling organizations to collaborate with confidence.
- Performance visualization tracks and displays provider performance to aid in clinical improvement efforts.
Care management software saves time and reduces costs. With continued use, your team can refine its operational efficiency and focus on patient care.
Why is care management software beneficial?
At its core, care management software supports the patient journey by enabling patient identification, resource allocation, and impact measurement. It also enhances care coordination by aggregating data, reducing healthcare costs, and automating workflows.
Here’s a closer look at the benefits of care management software:
- Patient identification: Dig deeper into patient histories to identify and analyze eligible populations. Use specialized tools to pinpoint risk factors and create actionable prevention plans.
- Resource allocation: Proactively allocate staff and resources by using the platform to match potential patients to the right providers. Leverage predictive analytics to prioritize the riskiest populations and customize outreach. Analytics tools enable payers to identify high-risk patients, prioritize interventions, and allocate resources accordingly.
- Performance measurement: Keep a pulse on your performance with platform case control and retrospective review. As a team, you can then communicate your findings to key stakeholders, schedule automated assessments, and course correct over time.
- Data aggregation: Care management software makes patient information accessible to the teams that need it, fostering collaboration between payers and providers.
- Cost reduction: AI-powered predictive modeling helps payers identify preventable health events, like hospital readmissions, and helps providers intervene proactively.
- Workflow automation: From patient outreach to decision-making, care management platforms reduce administrative burden by automating repetitive tasks.
10 care management software vendors to consider
Arcadia is the leading provider of care management software, offering insights from its comprehensive, longitudinal patient data set to drive efficient caseload management. Below, we’ve summarized the highlights of Arcadia’s platform and rounded up a list of other top solutions for health organizations to consider.
| Vendor | Best for | Target audience | Key capabilities |
|---|---|---|---|
| Arcadia | Connecting AI-powered patient insights to automated care workflows using unified longitudinal data | Healthcare providers, payers, accountable care organizations (ACOs), clinically integrated networks (CINs), life sciences organizations, government organizations | AI clinical chart summaries, SDoH & risk stratification, task workflow automation, EHR sync, data aggregation & analysis |
| Vim | Displaying care gap alerts directly inside a doctor’s existing EHR screen | Payers, providers, health tech innovators | In-EHR app embeds, referral routing, real-time quality alerts, overlay software |
| Medisolv | Quality performance monitoring and management | Hospitals, ambulatory clinics, ACOs, health systems | Quality performance dashboards, EHR data import, compliance tracking |
| HealthHelper | Patient outreach and appointment scheduling | Primary care practices, independent ACOs, regional health systems | Managed care campaigns, automated patient engagement, care continuity tracking |
| athenahealth | Care coordination for athenaOne users | Medical groups, enterprises and health systems, startup practices, CHCs and FQHCs, urgent care centers | Mobile patient portal, telehealth tools, EHR-embedded care planning |
| AssureCare | Managing complex medication plans alongside insurance care reviews | Payers, pharmacies, providers | Utilization reviews, automated care planning, pharmacy workflow tools |
| HealthEdge | Health plan clinical care management and automated care plan workflows | Health plans, payers | Community referrals, automated care planning, mobile clinician access |
| ShiftCare | Staff scheduling and field worker tracking for home health agencies | Home care, disability agencies | Mobile app, family portal, goal tracking, document management |
| Elligint Health | Customizable, secure care planning for large healthcare networks | Health plans, ACOs | Point-and-click workflow setup, built-in utilization review, standard data sharing |
| Cognizant Health | Automated health plan, case, and disease management | Payers, large health plans | Touchless approval workflows, clinical guideline matching, member portal, prior authorizations |
Arcadia
With data-driven tools that help care management teams scale their programs, Arcadia leads the care management software Arcadia Ascent™ Care pairs more than 20 years of connecting healthcare data with agentic AI to help provider and payer care management teams scale chronic, transitional, and non-clinical care coordination programs. Its features include:
- AI-powered care management: Generative AI copilots deliver a 360-degree view of each patient, recommend next-best clinical actions, and streamline documentation within care team workflows.
- Care coordination and referral management: Route and track referrals alongside shared care plans and tasks.
- Continuous patient prioritization: Real-time EHR data connections and predictive risk models automatically surface and rank high-risk patients based on clinical complexity, cost drivers, and social determinants of health (SDoH) factors. These insights make it easier to identify who needs attention, why they need it, and where care teams can have the greatest impact.
- Two-way patient outreach: Leverage Ascent™ Care to more effectively coordinate outreach to improve outcomes. Handle inbound and outbound communications through text, email, and phone, automate care gap campaigns, and proactively track medication adherence follow-through.
- Analytics dashboards: Bring together clinical, claims, social, and program data to better assess needs and support personalized care. Visualize patient data, share reports with key stakeholders, and evaluate organizational performance in a single, centralized location.
- Unified data & bi-directional EHR sync: Consolidate claims, medical records, HIE feeds, and SDoH information into a single source of truth accessible directly at the point of care.
Ascent™ Care aligns care teams and payer partners who share risk around the same patient context, shared care plans, and task management in a single platform, so every step of the care journey is informed, coordinated, and measurable.
Vim
Vim is an integration platform that supplements existing EHR workflows with critical data, insights, and applications. By closing quality gaps, streamlining referrals, and supporting care coordination, this platform enhances care management workflows to improve patient care.
In addition to the platform’s built-in applications, Vim allows users to retrieve data from connected EHRs and deploy custom applications to support their unique workflows.
Medisolv
Medisolv is an analytics platform focused on quality performance monitoring and management. Their CEHRT-certified ENCOR platform relies on advanced analytics to help users assess the quality of care delivery and pinpoint areas for improvement. By providing actionable insights into patient care, Medisolv equips providers to employ targeted interventions and drive improved patient outcomes.
HealthHelper
HealthHelper is a tech-enabled care coordination service that helps providers streamline appointment scheduling, close care gaps, and reduce administrative burden. Through care campaigns tailored to organizations’ specific needs, this partner supports care management workflows by providing care continuity and an unmatched patient experience. HealthHelper is also AI-enabled, allowing clients to access advanced analytics that fuel data-driven strategies.
athenahealth
athenahealth is a cloud-based healthcare management service that offers EHR integration, revenue cycle management, and population health tools through its athenaOne solution. The platform’s standout features include patient engagement tools, advisory services, care coordination, and telehealth support.
In addition, athenaOne’s mobile services extend access to care for clinicians on the go, while the separate athenaPatient app lets patients log their progress and message their care team.
AssureCare
AssureCare serves payers, providers, pharmacies, and the government to enhance transitional care management, reduce treatment delays, and coordinate with pharmacists. The platform combines utilization management, care management, and medication therapy management for a threefold solution for synchronized care.
AssureCare is known for care coordination, care planning, risk assessment, population health analytics, and tools for patient engagement to support value-based care.
HealthEdge
Health Edge’s care management solution, GuidingCare, is a comprehensive platform for whole-person care that simplifies workflows for both health plans and providers. Its next-generation data integration and workflow management tools facilitate coordination and collaboration, accelerate quality improvement, and promote provider and patient engagement.
GuidingCare specializes in health plan administration and core administrative processing for payers with automated care planning, community referrals, and mobile clinician access.
ShiftCare
ShiftCare zeroes in on home and community-based care management solutions, helping organizations coordinate care to clients in non-institutional settings. The platform’s progress tracking and sharing, accessible care plans, family access, goal tracking, and document management system help care teams meet their goals and establish good relationships.
ShiftCare also includes a mobile app and a dedicated family portal, so all parties can stay informed on the latest care developments.
Elligint Health
Elligint Health operates Helios CM, which provides broad spectrum visibility to promote care coordination, collaboration, and value-based care delivery. This platform is available in different product tiers and configuration levels based on your team’s management needs. With user-friendly point-and-click tools, it also facilitates more efficient day-to-day use.
Elligint’s commitment to security also underpins its software, as it has been HITRUST-certified across care, disease, utilization, and population health management tools.
Cognizant Health
Cognizant Health seeks to integrate as many care management processes as possible through its shared CareAdvance and Value-Based Benefits solutions which are both hosted on a member portal. In turn, this automates providers’ authorization and utilization management processes to help lower costs and improve care quality.
Cognizant Health uses touchless operation processing to automate prior authorization processes for providers to get more immediate approvals that meet business requirements and clinical guidelines.
How to choose a care management platform
As you search for the right care management software that fits your needs, there may be several questions you’re juggling — in particular, “How do I know which platform is best for me?” To guide your decision-making, take the following quiz:
Key takeaways about care management software
The goal of care management is to facilitate informed and proactive intervention strategies that improve the quality of care. By providing a reliable source of updated measurement information, care management software reduces the risk of misaligned resources and unreliable results. With a robust care management platform, healthcare organizations can rely on comprehensive, data-backed support for every patient’s journey, from identifying programs to interpreting results.
