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Population Health & Care Management Tools that Improve Care Delivery

BLOG | October 28, 2022

The Value Revolution is Here.

An important technological capability for organizations pursuing value-based care is the ability to act on insights to improve patient care. Population health, care management, care coordination, and clinical decision support tools from Cedar Gate make it possible.

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As organizations and providers transition to value-based care delivery models, managing the health of patients with the most complex conditions is paramount. According to the Peterson-KFF Health System Tracker, health expenditures are extremely variable and a small subset of people incur almost all the healthcare costs:

  • The top 1% of individuals account for 24% of spending
  • The top 5% of individuals account for 49% of spending
  • The bottom 50% of individuals account for only 2% of total spending

To combat these costs and achieve optimal outcomes, payers, providers, and employers need advanced and wide-ranging care management tools that encompass:

Care Management

“Continuity of care” is a phrase often used in medicine and assessing risk and guiding members to effective treatment options, while minimizing redundancies and inefficiencies, is an essential part of value-based care. It’s particularly important for members with chronic conditions who need ongoing care management and support, sometimes from multiple care teams and specialists.

Cedar Gate Care Management software powers workflows and helps teams focus on activities that will yield the greatest health and financial impacts based on:

  • Utilization management
  • Condition management
  • Prevention and wellness

It’s also completely customizable based on the unique parameters of various value-based care and payment agreements. Care managers can engage with patients and share information in near-real time to meet the needs of every individual on a care plan.

Care Coordination

Care teams must have evidence-based workflows that facilitate optimal clinical outcomes. Tasks, reports, and next steps must be carefully synchronized so everyone can work at the top of their license to meet patients’ needs in the most efficient ways possible. This level of efficiency was the promise from the earliest days of software in clinical practice, but most technology to date has not delivered on that promise.

Part of the ongoing challenge is finding systems that actually augment care, without adding extra “computer work” that gets in the way of quality care and slows team members down. But Cedar Gate’s Care Coordination tools make it easy with:

  • Task-based workflows you can build for specific cohorts or roles
  • Event-based workflows for things like pre-visit prep and chronic care management
  • Pre-configured or customizable workflows that support population health initiatives
  • Improved communication tools to keep everyone aligned with patient goals
  • Bi-directional EHR integration to reduce redundant task and improve efficiency
Clinical Decision Support

Evidence-based medicine yields the best and most cost-effective results for patients. The challenge for providers is not always knowing exactly what the right care or next steps should be for each patient. With Cedar Gate Clinical Decision Support (CDS), providers get all the information they need to create an effective treatment plan. It features a KLAS-award-winning user interface that surfaces priority care gaps, including HCC (Hierarchical Condition Categories) coding opportunities, at the right time using risk calculation methodologies guidelines tailored to each individual patient.

All these tools together combined can have a powerful impact on healthcare delivery by improving overall patient health and care management. It’s an essential part of the move to value-based care delivery systems.


Making these changes is not optional, so it’s time to either march forward on this journey or fall behind. Let’s turn the page on healthcare history together.

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