VBC Operations

The VBC (Value-Based Care) Operationscategory focuses on solutions that enable healthcare organizations to efficiently deliver care aligned with value-based models. Care Managementplatforms coordinate patient care across multiple providers, ensuring patients receive the necessary services for chronic condition management and preventive care. These solutions help improve health outcomes by supporting patients throughout their care journeys.

Care Navigationtools guide patients through complex healthcare systems, helping them access the right care at the right time, such as referrals, specialized services, or community resources. Care Gap Closure and Service Extenderssolutions identify and address gaps in care, ensuring patients receive timely interventions to meet performance benchmarks and quality measures. Service extenders, such as community health workers or digital assistants, help expand the reach of care teams, facilitating engagement and improving patient adherence. Together, these tools promote efficient care delivery, enhance patient outcomes, and support financial sustainability under value-based care models.

Market Map
Care Gap Closure and Service Extenders
Care Gap Closure and Service Extenders include companies that provide direct care delivery services aimed at closing care gaps, capturing coding opportunities, or delivering on other clinical activities to drive financial performance under VBC contracts. These are typically companies that extend an organization's scope of direct care delivery services, for example by conducting annual wellness visits in patients' homes. Organizations in this category are generally also considered Last Mile Care organizations with targeted value-based care expertise and use cases. Criteria: - Direct care delivery services - Expertise in the clinical activities that drive VBC contract performance
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Care Management
Market Map
Care Management refers to the oversight of a patient's care to achieve improved health outcomes. Vendors in this category provide solutions to support providers in managing the care of their populations to achieve VBC targets. These solutions include provider-facing enablement tools that help providers structure and oversee their patients' care plans, patient engagement tools that encourage patients to take greater ownership of their own care, and patient-facing services delivered by professionals credentialed in care management, care navigation, and/or care coordination. Companies in this category generally overlap with companies found in the care plan management category and care management functions can often overlap with Care Navigation functions. Criteria: - Software or services oriented around enabling care planning and follow through to achieve health outcomes
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Care Navigation
Care Navigation refers to the routing of care through high value networks. Generally this involves management of referral processes to ensure patients are receiving the right services from the right providers for optimal clinical outcomes with minimized cost. Care Navigation products range from software-only solutions that enable existing care teams through services including teams of patient-facing care coordinators. Companies that provide Care Navigation services often also provide Network Design services. Criteria: - Software or services oriented around impacting referrals - Products that enable greater price and quality transparency for patients and referring providers.
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