Healthcare Reform, Payment Models & Acquisitions

John Moore

Earlier this week, GE announced the release of Centricity Advance, their solution for the ambulatory market. Centricity Advance is basically a build-out/rebranding of MedPlexus an SaaS EHR solution vendor that GE acquired in March 2010.  GE now joins others (see below) in the EHR market who are striving to provide a complete acute to ambulatory EHR portfolio.

Editor’s note: See also THCB founder Matthew Holt’s podcast interview this week with GE VP Mike Barber for more context on this story.

Recent weeks have seen a number of intriguing developments in this space, including:

AllScripts’ acquisition last week of Eclipsys.

NextGen, a traditional ambulatory EHR vendor whose parent, Quality Systems Inc. acquired Sphere Health Systems and Opus Healthcare Solutions to target rural acute care facilities.

While some may argue that the HITECH Act and meaningful use requirements are core drivers for these acquisitions (e.g. tap future incentives payments in new markets), the real reason is the need for large healthcare organizations to more closely align smaller affiliated practices to their operations in anticipation of healthcare/payment reform (bundled payments, patient-centered medical home, etc.). These large institutions are increasingly seeking out such fully integrated acute to ambulatory solutions and is one of the core reasons that EPIC (they started in ambulatory and grew organically into acute) has seen success in the market.  It remains to be seen if those pursuing an acquisition strategy will be as successful as EPIC for it often takes years for two systems to be combined in a truly integrated fashion.

Looking to the future, one has to wonder what will be the fate of those who remain in either just the acute or ambulatory sector.  Our quick assessment of a few of the ambulatory vendors…

athenahealth: athenaclinicals is new to the market and the company has an opportunity to tap its existing customer base. Short-term, they’ll stay independent but likely to be acquired in 3-5 years.

eClinicalWorks: Fiercely independent and will likely attempt to pursue a strategy similar to EPIC’s and grow organically and stay independent. Will make some niche app acquisitions where needed to accelerate time to market.

Greenway: Will be acquired in next 1-2 years.

Sage: Like Greenway, acquired in near future.

Practicefusion: Will stay independent, may be rolled-up into a larger offering from a bigger entity that comes from outside healthcare sector, e.g., minority investor Salesforce.com

Now this is only our educated guess (and we certainly welcome yours in the comment section below), but in our conversations with numerous stakeholders in the market, this guess is one we’d be willing to bet on.

John Moore is an IT Analyst at Chilmark Research, where this post was first published.

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  2. I hope GE (esp. in this tough economy) can make a positive “go” at the rebranding effort. Centricity Advance has great potential and a large market. – David

  3. Very interesting analysis of current events. Why would so much investment go into seamless integration within hospital-to-ambulatory associations, when the supposed goal of meaningful use is widespread interoperability? Seems to me that broadly interoperable platforms aren’t what the big players are after, given the apparent investment in silos. Here is where the public sector should take note and step in to ensure the current HIT funding and effort doesn’t just build bigger silos. Community-based HIEs with multilateral oversight seems the logical solution. The open market has had 20+ years to solve the problem; I hold no illusions it will produce HIT interoperability at this juncture without some regulation – especially when the potential profits for big silos now include billions in federal stimulus funding. That money belongs to the taxpayers, so regulation would be absolutely legitimate.