Reflections from two advanced platforms for population health management

Hospitals and health systems participating in advanced population health management initiatives generally have certain traits in common.

Most likely, they are seeking to redesign how they care for vulnerable populations. They realize that achieving the necessary degree of change is difficult in a fee-for-service scenario because much of what’s needed to offer holistic care is not reimbursable.

Several large health systems sharing that outlook have combined their efforts over the last year in two new companies, Risant Health and Longitude Health. The companies are creating the resources and bandwidth for participating health systems to make population health management a central part of their operation.

“I think we recognized long ago at Geisinger that [population health] was a critical piece of our future,” said Jaewon Ryu, MD, JD, formerly president and CEO of Geisinger and now CEO of Risant Health, of which Geisinger is a charter member.

“And so then it just became a question of: How do you accelerate, and especially at the same time that you need to continue investing in your technology, you need to continue to make sure there are enough ICU beds and so forth?

“How do you invest in all of that and at the same time invest in this thing that you know is your North Star?”

Transformative goals

Speaking in May at the 24^th Population Health Colloquium, hosted by Thomas Jefferson University in Philadelphia, Ryu described moving from his leadership position at Geisinger to helm Risant Health. The company had been launched by Kaiser Permanente in 2023 as a platform to promote successful adoption of value-based care.

Geisinger became the first health system to join Risant, and Ryu accepted an offer to head up the new company. Risant since has added Greensboro, N.C.-based Cone Health.

“It absolutely would have been very easy for Geisinger to stay on its own,” Ryu said, noting the organization had a positive profit margin in the year immediately before the Risant synergies kicked in.

However, “We would not have gotten to that North Star as quickly as we knew we needed to be [there].”

Geisinger and Cone Health both had ample experience with population health management, especially in operating their own health plans. But both organizations thought they would benefit from the unique expertise of Kaiser Permanente, which for decades has been almost a healthcare ecosystem unto itself, with a health plan and provider venues that contract primarily with each other.

Risant Health is looking to incorporate another five to seven health systems over the next half-decade, Ryu said. Selection criteria include not-for-profit status and “a reputation [for] being the go-to place for their communities around quality, experience, affordability.

“The other [priority] is they have to be walking the talk of value-based care — either to have their own health plan, a sizable [accountable care organization], a lot of downstream-risk environments or contracts with other payers, some way to have that substrate to practice that craft.

“And then the other [key] is a solid set of stand-alone financials, so they have to be fiscally sustainable.”

Seeing ‘the writing on the wall’

Founding members of Longitude Health, which launched in October 2024, are Baylor Scott & White Health, Memorial Hermann Health System, Novant Health and Providence. The new company has three platforms: one focused on the patient financial experience, one on prescription drugs and one on population health management (the last is called Longitude PHM).

The four health systems said, “We see the writing on the wall: The future as traditional health systems is not rosy. There is a business pivot we need to make, and we don’t have the capabilities to make it,” Craig Samitt, MD, MBA, the CEO of Longitude PHM, said at the Population Health Colloquium.

In Samitt’s view, fundamental change is the only option.

 “If you’re in the health system world, I’m not sure what the sustainable ongoing strategies are for success,” he said. “We can double down on our traditional model. We can hope that more money comes to us per visit, per procedure, per hospitalization. It’s not coming — there isn’t going to be more money coming into healthcare.”

Longitude Health is not looking to start with small changes, although, like Risant Health, it will be judicious in adding new participants.

“The first thing that we’re going to try to do is to bring performance to a new level,” Samitt said. “Healthcare improvement can’t be incremental. It needs to be transformational.”

Independent but together

Both Risant Health and Longitude Health respect the need for their member health systems to remain independent, locally controlled, and focused on the distinct needs of their communities. They will make available best practices such as a laser focus on evidence-based care protocols that are tailored to individual patients and readily accessible by care teams, but they will not try to dictate the business model of their participants.

“[Moving care delivery] further upstream, transforming how care is delivered … investing in the tech and processes to systematize the right way to take care of people, or what we would say is the better way to take care of people, and doing so in these pluralistic environments,” Ryu said, referring to health systems that contract with an array of payers across programs. “That’s what we’re trying to do.”

The goal at Longitude Health is for participants to excel in measures of care quality, access, service improvement and total cost of care, Samitt said. The ability to succeed simultaneously in all of those areas is exceedingly rare, in his observations over several decades spent in various sectors of healthcare.

Thus, while recognizing the importance of system independence, he said, “We need to have a very scalable and replicable and imitable population health strategy that allows us to deploy what we’re building everywhere.”