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Updated: Mar 28, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Identifying PHM market and network opportunities.

Mark E Grube, Anand Krishnaswamy, John Poziemski

    Healthcare Financial Management : Journal of the Healthcare Financial Management Association
    |December 22, 2015
    PubMed
    Summary

    Healthcare organizations must identify market opportunities and define network scope for financially sustainable population health management (PHM). Key considerations include patient populations, market dynamics, and network essentiality for successful PHM initiatives.

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    Area of Science:

    • Healthcare Management
    • Population Health Management
    • Strategic Planning

    Background:

    • Healthcare organizations are increasingly shifting towards population health management (PHM) to ensure financial sustainability.
    • Establishing a successful PHM program requires careful planning and strategic execution.
    • Identifying market opportunities and defining network scope are critical initial steps.

    Purpose of the Study:

    • To outline the key processes for healthcare organizations to establish financially sustainable population health management (PHM) programs.
    • To identify critical variables for assessing PHM market opportunities.
    • To define essential criteria for determining the scope of a PHM network.

    Main Methods:

    • The study identifies two primary processes for PHM sustainability: market opportunity identification and PHM network scope determination.
    • Analysis involves considering key variables for market opportunities, including patient demographics, insurance markets, and product types.
    • Evaluation of network scope incorporates traditional strategic criteria alongside five additional factors: essentiality, adequacy, service distribution, growth strategy, and organizational agility.

    Main Results:

    • Successful PHM market opportunity identification hinges on analyzing patient populations, the insurance/employer market, and available insurance products.
    • Determining PHM network scope requires evaluating traditional criteria plus network essentiality, care continuum, adequacy, service distribution, growth strategy, and organizational agility.
    • These processes provide a framework for organizations to build financially viable PHM initiatives.

    Conclusions:

    • Healthcare organizations must strategically identify market opportunities and define network scope for successful population health management.
    • A comprehensive approach considering patient, market, and network factors is essential for financial sustainability in PHM.
    • Organizational agility and a clear growth strategy are crucial for adapting and thriving in the evolving PHM landscape.