Carle Health + HealthCatalyst: We keep hearing from experts that the way to improve healthcare operations is to make sure…
Sean Carroll is CEO of Arcadia of Burlington, MA.
Tell me about yourself and the company.
I am a 32-year veteran of healthcare IT over six companies, all focused on some aspect of healthcare data. Some of those companies were service-oriented businesses, some have been technology focused, and one or two have been a combination of both.
I’ve been on an explicit mission over my career to be part of tangible progress in the evolution of healthcare. I firmly believe that progress must be founded in healthcare data as at least as one of the major levers that has to be pulled. I’ve been at Arcadia for five and a half years. I’m glad to be here because Arcadia has the capabilities and positioning in the market to be an instrumental player in that necessary transformation of healthcare. We are seeing that with our customers.
The company is positioned as a population health management company, specializing in delivering population-level analytics in care management to enterprise-class customers. We serve enterprise provider organizations and nationally branded, recognized health plans. We also have a nice partnership business. Since we last talked in mid-2015, the company has experienced significant expansion and growth, elevating itself to 50 million patients and 50,000 providers in our platform. We have continued to maintain top rankings and positioning with all of the analysts who track this market since we emerged in the KLAS report in the end of 2016.
What changes have you seen since 2015 in population health management, value-based care, and the availability and harmonization of EHR data?
It has evolved a lot. One of the positive developments in the ultimate transformation of healthcare is that the commitment to value-based concepts has remained steadfast, even with all of the crosswinds that we all face every day politically and from other influential angles. That’s been a positive trend of staying in that direction.
The market has, without a doubt, matured in many ways in the last three to four years. Organizations that are pursuing technology or services that support value-based care transformation have probably been through one or two tries at implementing something. They have some battle scars and they’re smarter about what they want. Vendors who support them in this effort also have learned a lot about what it takes to be an excellent provider of technology or value-based care services to support these transformations. It’s hard work and the market has come to understand that.
A lot of companies and investors have jumped into population health management technology. What changes have you seen as companies have developed a good or bad performance track record?
The vendor landscape has changed the most in that time frame. Some organizations have fallen down or fallen out of the market. Investors and operators are learning that the economics of providing population health technology require substantial investment and substantial time for that business model to mature, all while simultaneously delivering a high-quality customer outcome. It takes a unique bond among investors, customers, and vendors to make it all work. We have seen that ourselves and with competitors who don’t have those elegant relationships and therefore have struggled or failed to be successful in the marketplace.
KLAS’s recent population health management report commends Arcadia and a couple of other vendors for being good at offering customers strategic guidance as well as technology. How does a health system move from the vague idea of becoming involved in population health management to then developing a strategy and looking at technology?
The organization first typically organizes, within themselves, the right core team to drive that agenda. It becomes a focused strategic element that is driven by a population health executive, title notwithstanding, who has a clear vision of what they’re trying to achieve.
Population health management has a number of entry points. Priorities can be set in a lot of ways. Sometimes we see an absence of priorities or clear priorities, but the organization has good leadership, good governance, and an understanding the foundational elements of successful population health implementation. That’s the starting recipe for how organizations come together. Where we come in on the strategic side is helping them, once they have or are implementing the right set of tools on the right data asset, determine how they might focus. These are very specific, on-the-ground efforts, given the outcomes we’re seeing through the data and the tools that we avail to them to explore that data. It’s a tactical strategy.
Are health systems and insurers interested in improving an individual’s long-term health beyond simply reducing their own short-term cost and risk?
That gets to the heart of what we believe is exemplary population health management. It starts with a clear economic mandate. We’ve shifted our business with all of our capabilities to focus on making our customers economically successful first, in terms of proper execution in their risk contracts, so that they have the opportunity to make other investments in population health management outside of that. We’ve learned in the past five or six years that there’s a lot of things to chase in population health for the good of population health, but sustained financial success is the bridge to sustained successful health management of a population.
Would an insurer approach population health management differently than a large health system?
I would say no at the highest level, but obviously they have different business mandates than providers. We’ve been able to foster the notion between health plans and provider organizations that a properly-positioned, highly-usable, high-quality data asset in the marketplace — where the population at large is visible in every sense of the word from a data perspective — serves all parties, both in their own strategic designs and in the broader design of what we all want for healthcare.
We talked last time about the number of provider organizations that either don’t have a data strategy or are knowingly or unknowingly using bad data to drive their decisions. Has that improved?
It definitely has improved. Everyone understands now that data is important. Not everyone has prioritized it at the top of the list of their value-based care strategy, which we would recommend be the case. We last talked that it was still, in many cases, a challenge to get some organizations to understand why clinical data was an enhancement for them in the context of a data asset. That really is no longer the case.
How do you position and differentiate the company?
A lot of the data work that we do demands a certain quality level that is informed by tenure. We have been working at data harmonization for longer than most organizations in the space, probably by an order of magnitude. Some of that shows up in KLAS reporting in terms of the types of enterprise customers who choose Arcadia. We hear a lot that that’s because of our experience. Outcomes, as in the tangible and referable results from the deployment of our technology over time — improvements in risk coding, reductions in total cost of care, dozens of other outcomes — we focus on seeing that our customers can not only deliver those for themselves, but are eager to talk to other customers about that. Referenceability is a crucial, crucial item for us.
From a market perspective, we’re the only vendor that serves both health plans and providers. That has continued for us since the beginning. That position in the market is important since we believe in this concept of density of market, where providers and health plans in given markets are working together to advance population health. We approach the market a little bit differently in that regard.
Do you have any final thoughts?
We are enthusiastic about where the market is. We feel fortunate to be in the category of leader in advancing progress in managing population health. We’re equally excited about the nature of the market, which has settled out with some really good companies trying to advance this important goal for healthcare.
As a company, we’re excited about our ability to deliver what we believe is the most important thing for the next phase of advancement in this marketplace, which is both speed to value and lasting value for customers. If companies like Arcadia can continue to deliver that to the pioneer organizations that are trying to advance healthcare by better population health management, then everyone will benefit. We’re excited to be in the top category of companies that are delivering against that.