Ten Considerations When Purchasing Care Management Software

May 14, 2019 HMS

Implementing a care management system can deliver significant benefits to an organization, but first you must find the right solution for your needs. As you evaluate different options, keep these ten considerations in mind:

1. Does the system integrate information from multiple systems?

This level of interoperability is essential for real-time insight and coordinated care. Robust care management platforms integrate seamlessly with existing information systems and different types of data ranging from guidelines to information from EMRs, in-home monitoring systems, and wearables.

2. Are the workflows and the user interface intuitive?

The best systems are straightforward and easy for care managers to use. This is only possible if the care management solution has been designed with care managers in mind. A good care management platform empowers users to serve patients without getting in the way.

3. Will care managers have access to a comprehensive, single-member view?

One key to effective care management is the ability to detect issues in high-level member information and then drill down to more detailed data to isolate the root causes of problems. This is one of the best ways to proactively identify opportunities to help patients. The best care management solutions provide a single member view with both summary and detailed information.

4. Does the solution address the full spectrum of care management?

Every day, care managers are involved with case management, utilization management, and population management. However, care management doesn’t end there. Comprehensive care management platforms also support appeals and grievances, authorization denials, and payment issues.

5. Are analytics available to predict which patients could benefit from interventions?

Comprehensive care management systems offer leading industry analytics such as the Johns Hopkins ACG System predictive models and other quality measurements.

6. Can routine administrative tasks be automated?

Assessments and individualized care plans are an important part of a care manager’s work, but these administrative tasks often limit the time that care managers can spend with members. A good care management system automates administrative work, enabling care managers to focus on what they are uniquely qualified to do – determine how to deliver the best care to patients, while keeping an eye on costs.

7. Can care managers configure their own reports and dashboards without IT?

Data-driven decision-making is the hallmark of great care managers. Care management solutions should support users with report builders and customizable dashboards that highlight trends, productivity, and other key metrics.

8. Can the system be implemented incrementally to meet your unique needs?

Some care management solutions require organizations to implement their entire solution, even if only a few modules are needed. Flexible platforms exist which enable customers to implement only the care management functionality they need and then add more later, as needs change.

9. Is the vendor committed to outstanding customer support?

Some software companies abandon their customers after the system implementation. The best care management solution providers offer personalized support to clients whenever problems arise. Look for a vendor who will act as a partner and who won’t charge to answer every question that may arise.

10. Are real customers using the solution and what results have they seen?

Don’t be afraid to ask care management vendors for references. Before making a purchase decision, ask other customers what kind of results they’ve seen after using the system? For example, have their task times for clinical entries decreased? Have authorization processing and review times gone down? Is the care management team now able to support more members?

Essette’s next-generation approach to care management and data-driven decision-making transforms care managers into “care traffic controllers.”


As you gather information about care management platforms, we’d invite you to take a closer look at HMS Essette by downloading this free white paper.

Download Buyer's Guide

Previous Article
 America’s Opioid Epidemic: Clues and Potential Answers Reside in Member & Provider Data
America’s Opioid Epidemic: Clues and Potential Answers Reside in Member & Provider Data

See more
How to Reduce Costs & Improve Care Delivery with Analytics and Reporting
How to Reduce Costs & Improve Care Delivery with Analytics and Reporting