Description

Research Overview

This Frost & Sullivan research service presents a comprehensive analysis of the market potential and dynamics of the population health management (PHM) market in the United States (US). The study provides a strategic PHM road map to progressive health entities that aspire to practice proactive care monitoring at a community level and synthesize clinical, administrative, and financial information to improve the well-being of the patient population while taking responsibility of a value-driven reimbursement relationship.

It includes market drivers, challenges, forecasts, and trends. This research examines the following market segments:

Services
•     Advisory: Clinical & Financial Consulting
•     Data Analysis: Data Aggregation & Management, Risk Stratification & Modeling
•     Care Management: Care Coordination, Patient Engagement
•     Performance Management: Clinical Performance Management, Financial Performance Management

Customers
•     Accountable Care Organizations (ACO)
•     Payers & Payer-Providers
•     Hospitals outside of ACO contracts
•     Physician practices outside of ACO contracts


Market Overview

Population health management is the leading growth opportunity in a post-EHR healthcare era.

The rising cost burden of chronic disease management coupled with evolving value-based payment programs supports the requirement of individualized digital interventions that aim to transform care delivery and improve chronic conditions at a population level.

The adoption of PHM solutions that demonstrate meaningful use of IT applications is expected to accelerate in 2016 through 2020. Patient care is moving into a broader but coordinated environment where routine, manual tasks are automated by PHM solutions that unify siloed systems, stratify comorbidities, empower patients through engagement, and benchmark outcomes at network, practice, and patient level.

Health systems, on the road to accountable care, are striving to identify appropriate care workflows, control readmissions, and promote self-care so that incoming patients heal quickly, transitioning patients avoid the need to be readmitted, and healthy populations stay healthy.

Payer, payer-provider, and ACO communities are the top promoters of PHM in the United States. Best-in-class solutions are sought to help track, monitor, analyze, and manage provider/member performance. These groups are expected to invest in technologies that support value-based contracts, set provider-specific quality goals, initiate member engagement, and minimize financial risk through episodic care management.

Additionally, the need to coordinate care departments, meet payer targets, and engage patients during, pre-, and post-care is expected to strongly accelerate investment in the non-ACO hospital segment. Non-ACO physician practices are challenged by growing competition, imposing regulations, and limited investment capabilities. However, as CMS drives new MU objectives that consider physician preferences, the adoption of PHM solutions across this segment is expected to be substantial during 2018–2020.

The US PHM supply market is at a nascent stage and a select few companies have managed to improve patient outcomes and minimize financial risk for their clients. Many providers and payers are in dire need of a suite of healthcare technology solutions and services that improve care delivery efficiency and enable transitions toward various value- or risk-based healthcare ecosystems. The market is likely to observe fierce competitive rivalry as small modular PHM firms compete against large, platform providers. Winners will successfully weigh in market needs and offer secure, interoperable, and highly customized PHM solutions that achieve the ever elusive goal of equilibrium between cost, quality, and accessibility.