Population health management aims to improve health outcomes across large patient groups, which requires cohesive healthcare strategies. Rather than manually gathering and filtering population health data, leveraging population health management software makes it easier and more efficient for health teams to engage patients, stratify risk, and improve care quality.
This article provides an overview of population health management software, including the top solutions on the market today. We’ll cover:
Here are a few highlights about population health management software:
Below, we provide a more detailed breakdown of these highlights.
Population health management (PHM) software refers to digital tools used to manage the health outcomes of a group of individuals within a predefined population. The goal of PHM software is to help healthcare providers deliver proactive, value-based care through preventive interventions that reduce the risk of illness progression.
Population health management software works in the following steps:
Different PHM solutions offer varying features, but a few common features are shared across solutions, including:
By leveraging all of these features, healthcare organizations can transition from reactive care to proactive health management. However, the specific solution your team chooses will also depend on your population health goals. For instance, you might prioritize finding a solution with user-friendly capabilities that connects disparate care teams. This promotes more effective disease management across different settings and providers.
The benefits of PHM software include:
When implemented properly, PHM software aligns all stakeholders — providers, payers, and patients — to drive success in value-based care.
Provider name | Main audiences | Core functions | Integration architecture | Data ingestion type |
Healthcare providers, payers, ACOs, life sciences organizations, government organizations | Closing the gap between insight and execution with data aggregation and AI-powered analytics and workflows | Vendor-agnostic data platform | Clinical, financial, administrative, social determinants of health (SDoH) | |
Primary care practices, ambulatory groups | Closing care gaps and handling referrals while keeping patients in-network and improving continuity of care | EHR-integrated patient engagement application
| EHR and clinical data feeds | |
Health plans, health systems, hospitals, life sciences companies, nonprofits, foundations | Mapping SDoH risk metrics to illuminate how social risk impacts communities, populations, and business performance | Vendor-agnostic specialized analytics engine | Geographic, economic, and socio-economic data | |
Health systems, labs, research institutions, health information exchanges, companies that serve the healthcare community | Developing customized solutions and strategies for healthcare interoperability, clinical data exchange, accountable care, and population health | Integration services and custom software framework
| Client’s native data
| |
Medical groups, enterprises and health systems, startup practices, CHCs and FQHCs, urgent care centers, | Streamlined care coordination as well as medical billing, patient scheduling, and visit documentation | EHR-native software module | Native clinical/EHR entries and practice management data | |
ACOs, provider networks, safety net organizations, health plans, hospitals/health systems, rural healthcare organizations | Tracking patient panels, improving patient care and outreach, and generating actionable insights for deeper healthcare collaboration | Vendor-agnostic reporting and analytics platform | Clinical, payer, HIE, and SDoH data | |
Hospitals, health systems, physician practices, employers, unions | Transforming health data into actionable insights for increased member engagement and benefit plan utilization | Outsourced service platform with custom interface integrations | Institutional billing records and multi-facility EHR data | |
Care teams, healthcare payers | Tracking longitudinal care, managing population risk registries, and delivering native point-of-care alerts | EHR-native unified module | Real-time, native Epic EHR database entries | |
Ambulatory groups, multi-specialty clinics, and independent practices | Automating regulatory quality reporting, identifying gaps in preventative care, and stratifying ambulatory patient risk | EHR-native software application | Ambulatory clinical charts and practice management billing databases | |
Providers, payers, employers, brokers and consultants, government agencies | Helping employees and members receive high-quality care through employee benefits and health services | Enterprise cloud data platform | Commercial/government claims feeds and integrated clinical records | |
Large-scale global health systems and public sector medical networks running Oracle Health/Cerner clinical applications | Normalizing multi-vendor clinical data, managing enterprise health registries, and distributing cross-network clinical alerts | Vendor-neutral database platform running on cloud infrastructure | Multi-EHR clinical data pipelines and payer enrollment files | |
Value-based care organizations, health plans, and health systems optimizing specialist referral networks | Benchmarking episode-of-care costs, scoring provider performance, and mapping patient clinical pathways | Cloud-native predictive analytics engine | Longitudinal Medicare, Medicaid, and commercial claims databases alongside clinical datasets | |
Solo practices, mid-size specialty groups, multi-site ambulatory networks, provider organizations | Consolidating clinical records into a unified patient view to enable proactive care | Cloud-based EHR-native software platform | Clinical, claims, pharmacy, laboratory, HIE |
Recognized by KLAS Research as one of the most well-rounded population health management vendors, Arcadia leads the market in PHM software. Arcadia’s analytics platform provides a solid foundation of data that enables sustainable success within a value-based care framework.
Arcadia’s standout features include:
Arcadia’s platform empowers healthcare systems to drive better outcomes for populations big and small, complex and simple. With a solid foundation of unified data, organizations can rely on actionable insights within existing workflows to direct their population health management efforts.
HealthHelper is a care coordination tool that specializes in panel management, equipping providers to proactively manage a population’s health needs. This solution’s panel analytics, care gap closure, and detailed reporting tools enable providers to implement targeted interventions that address population health needs before they escalate to adverse health events.
J2 Interactive’s software development and IT consulting services support health teams navigating complex data and interoperability needs. Especially when tracking patient data and care management efforts across large populations with diverse needs, health teams can deliver improved care at scale with support from J2 Interactive.
athenahealth is a PHM platform designed to aggregate, maintain, and normalize clinical, financial, and payer data to provide health teams with reliable datasets. Providers can then quickly choose the right care plans for individual patients with configurable, evidence-based content.
Then, with help from athenahealth, providers can maximize outreach by adjusting their approach to each patient. As healthcare organizations expand, they can rely on reporting dashboards to show cost and utilization across populations. athenahealth also offers a reliable EHR mobile app that lets patients access results, book appointments, and message care managers on the go.
Azara is a provider of population health solutions for standalone and physician networks, community health centers, and more. Azara engages patients through pre-configured “set it and forget it” programs that automatically initiate patient contact (via text), and track response and follow-up actions.
Additionally, its data analytics capabilities combine EHR data with screening results from SDOH demographic information to create a multi-faceted picture of patient health. Its set of dashboards and reports incorporates data from health plans and other payers with clinical EHR data to offer a detailed utilization view.
Conifer Health Solutions’ PHM tools are created to prioritize outreach and engagement for people serving hospitals, health systems, and unions.
This solution integrates with health plans to bring pharmacy benefit managers, third-party administrators, provider networks, and other benefit solution vendors together. Specifically, Conifer Health Solutions specializes in personal care nursing, case management, disease management, and utilization management to help members find the right care at the right time.
With Epic’s PHM suite, Healthy Planet, care teams can monitor patient health and take action with engagement tools. Its data aggregation capabilities eliminate the need for duplicate testing and combine a wide range of data from labs, risk scores, paid claims, and external systems.
The solution provides contract performance and improvement opportunities using analytics to track and intervene on target contact metrics. Epic Healthy Planet also promotes patient wellness with integrated health and social care tools that assess patient needs and connect them with the right resources.
NextGen Population Health Analytics is a care platform created to offer a clear view of your patient population. This comprehensive software incorporates risk management, cost control, revenue optimization, and targeted interventions.
Specifically, NextGen’s referral management capabilities access information on where patients receive health care services, including specialty care at the population and patient level. It then displays these patient insights alongside patient charts in the EHR.
Optum Population Health Solutions is built to help employees choose the right doctor and understand their treatment options and medications. Their main areas of focus are case management, condition management, and cancer support.
The platform’s integrated benefits data enables organizations to analyze performance and financial trends against industry norms and prior performance benchmarks. For example, Optum’s dedicated women’s health programs identify related risk factors and educate mothers and families to reduce complications while lowering costs.
Oracle Health’s technology solutions emphasize chronic condition management and prevention. The platform also has a nationwide network of diverse health systems that conduct clinical trials and outcomes research alongside them.
Oracle Health provides advanced SDoH solutions to intervene at the point of care by using evidence-based screening tools and suggested goals. This way, care teams can keep an eye out for vulnerable populations and make targeted and informed interventions.
Clarify Health’s enterprise analytics platform, Meridian, harnesses the power of big data for business and clinical insights. This solution leverages thousands of trained models to cut and harness data to provide case-mix adjusted predictive values for clear insights.
With Meridian, providers can map the patient journey against predetermined benchmarks and recent trends. This way, they can provide personalized recommendations for each patient based on reliable data.
CureMD is a cloud-based EHR and practice management platform that brings integrated care management and population health analytics into a single system. Its enterprise data warehouse consolidates records across EHRs, pharmacies, labs, and health information exchanges into one unified patient view, helping care teams identify at-risk patients and close gaps in care.
Built-in predictive analytics and real-time dashboards enable provider organizations to stratify risk, monitor high-cost, high-risk populations, and track progress toward quality and MACRA/MIPS reporting goals. CureMD also supports care coordination across the continuum, connecting stakeholders and settings so providers can act on gaps in care before they turn into costly, adverse events, while improving quality scores and lowering the cost of care for populations with chronic conditions.
Modern PHM software reimagines care management with robust analytics and reporting capabilities that allow for coordinated, efficient workflows. As a result, this technology helps reduce overall costs through informed resource allocation that prioritizes high-risk populations.
When deciding which software is right for your organization, choose a solution that will scale with your needs and complement your existing workflows. This will make the transition smoother and provide a higher long-term ROI.
3. Socially Determined
SDoH data holds significant implications for population health, making Socially Determined a critical element of providers’ population health management tech stacks. This platform provides targeted data and analytics for a fuller picture of a patient’s social risk. As a result, health organizations can factor social risks and non-medical health influences into patients’ care plans.