US Population Health Management Growth Opportunities

US Population Health Management Growth Opportunities

Data Management and Care Coordination Challenges Necessitate Cloud-based Technologies and SaaS Business Models to Drive Transformational Growth

RELEASE DATE
16-Feb-2022
REGION
North America
Research Code: K6A3-01-00-00-00
SKU: HC03505-NA-MT_26276
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Description

This research service will provide an overview of the US population health management (PHM) market. The study period is from 2021 to 2026. The report will provide a detailed analysis of the PHM market and applications, such as data & analysis, care management, and performance management. Discussions include industry challenges, drivers, and restraints as well as a revenue forecast for each application area. The study’s revenue forecast will involve an end-user level breakdown for the US market during the study period. The top end users of PHM IT solutions are accountable care organizations (ACOs), non-ACO hospitals, non-ACO physician practices, payers, and payer-providers. The study delivers detailed analyses of important business models, regulatory outlook, cost structure, and competitive landscape. We will identify and describe the top growth opportunities for the total US PHM market in the context of user relevance and calls to action.

In this market, 3 Strategic Imperatives are at play.

Internal Challenges: Currently, more than 50% of all PHM information technology (IT) solution users in the United States fail to meet their overarching clinical, financial, and operational objectives. Core reasons include low clinician engagement with the technology, an inability to convert patient-generated data into actionable intelligence, lack of support to engage patients across the care continuum, and an inability to generate analytics-led insights that may improve corporate performance at an enterprise level. In the next 2–3 years, PHM IT solutions will become much more accessible, personalized, and result-driven. Modernized analytics and care coordination solutions will help payers manage provider performance on value-based care (VBC) contracts. Providers will also leverage next-generation (next-gen) PHM solutions to gain a competitive advantage in patient experience, claims management, and workforce management.

Disruptive Technologies: Agile platforms are disrupting the PHM sector’s status quo. Enterprise-grade companies are deploying Software-as-a-Service (SaaS)-based PHM capabilities that address a wide variety of VBC objectives for providers (accountable care organization [ACO] design and management, payer connectivity, and patient engagement) and payers (utilization management, standardization of care, and network design and management). By 2023, the US PHM market will see increased adoption of SaaS-based PHM capabilities from all types of payers and providers. These modular, plug-in-based capabilities will compliment various electronic medical record (EMR) workflows and pave the way for health-on-cloud consumerism at a population level.

Emerging Business Models: Most companies do not efficiently manage their PHM program deployments. This results in poor outcomes that include the costly procurement of external databases; delivery of manual Structured Query Language queries to link disparate databases, requiring 3rd-party PHM consultants to identify gaps in care management; and high lead time for reports. Best-in-class PHM companies will offer more targeted capabilities that address most concerns by 2023. These firms will offer a single PHM IT value proposition that incorporates numerous elements of data management, care coordination, patient engagement, and quality reporting via self-service-based and cloud-powered infrastructure, applications, and delivery solutions.

Author: Koustav Chatterjee

Table of Contents

Why Is It Increasingly Difficult to Grow?

The Strategic Imperative 8™

The Impact of the Top 3 Strategic Imperatives on the US Population Health Management (PHM) Market

Growth Opportunities Fuel the Growth Pipeline Engine™

Scope of Analysis

Market Scope

Application Segmentation of the US PHM Market

Revenue Segmentation by Application Areas

Evolving Value Propositions of PHM IT & Service Solutions

Benchmarking the Strategic Attractiveness of PHM Segments

PHM—Market Maturity Indicator

Key Competitors in the US PHM Market by Application Area, 2021

Key Growth Metrics for US PHM Market

Growth Drivers for the US PHM Market

Growth Restraints for the US PHM Market

Revenue Forecast, US PHM Market

Revenue Forecast by End User

Revenue Forecast Discussion

Revenue Forecast by Segment Discussion

Competitive Environment, US PHM Market

Industry Imperative—Role of PHM in Value-based Payment Enablement

PHM Market Opportunity Summary

Market Overview—Most End Users Are Not Satisfied

PHM Market Opportunity—Voice of Customers

PHM Capability Gap Analysis

PHM Capability Outlook—Discussion

PHM Capability Outlook—Discussion (continued)

PHM Capability Outlook for Total Market—End-user Feedback

PHM Capability Outlook for Total Market—End-user Feedback (continued)

PHM Capability Outlook for Provider Market—End-user Feedback (continued)

PHM Capability Outlook for Provider Market—End-user Feedback (continued)

PHM Capability Outlook for Payer Market—End-user Feedback (continued)

PHM Capability Outlook for Payer Market—End-user Feedback (continued)

Top 3 Focus Areas of PHM Deployment

Top Features and Functions for PHM IT and Platform User Interface

Top IT Requirements of PHM in 2021

PHM IT Priorities

3 Objectives of Platform Play in PHM

PHM Platform Architecture for 2026

Key Growth Metrics for ACOs

Revenue Forecast, ACOs

Revenue Forecast Analysis, ACOs

Key Growth Metrics for Non-ACO Hospitals

Revenue Forecast, Non-ACO Hospitals

Revenue Forecast Analysis, Non-ACO Hospitals

Key Growth Metrics for Non-ACO Physician Practices

Revenue Forecast, Non-ACO Physician Practices

Revenue Forecast Analysis, Non-ACO Physician Practices

Key Growth Metrics for Payers and Payer-Providers

Revenue Forecast, Payers and Payer-Providers

Revenue Forecast Analysis, Payers and Payer-Providers

Growth Opportunity 1—Healthcare Consumerism as the Next Frontier of PHM to Expand the Scope of Intervention

Growth Opportunity 1—Healthcare Consumerism as the Next Frontier of PHM to Expand the Scope of Intervention (continued)

Growth Opportunity 2—Community-level RPM as Key to Improve PHM Program Efficiency

Growth Opportunity 2—Community-level RPM as Key to Improve PHM Program Efficiency (continued)

Growth Opportunity 3—PHM Analytics Must Be Prioritized to Propel the Growth of RoI from VBC Contracts

Growth Opportunity 3—PHM Analytics Must Be Prioritized to Propel the Growth of RoI from VBC Contracts (continued)

Your Next Steps

Why Frost, Why Now?

List of Exhibits

List of Exhibits (continued)

Legal Disclaimer

This research service will provide an overview of the US population health management (PHM) market. The study period is from 2021 to 2026. The report will provide a detailed analysis of the PHM market and applications, such as data & analysis, care management, and performance management. Discussions include industry challenges, drivers, and restraints as well as a revenue forecast for each application area. The study’s revenue forecast will involve an end-user level breakdown for the US market during the study period. The top end users of PHM IT solutions are accountable care organizations (ACOs), non-ACO hospitals, non-ACO physician practices, payers, and payer-providers. The study delivers detailed analyses of important business models, regulatory outlook, cost structure, and competitive landscape. We will identify and describe the top growth opportunities for the total US PHM market in the context of user relevance and calls to action. In this market, 3 Strategic Imperatives are at play. Internal Challenges: Currently, more than 50% of all PHM information technology (IT) solution users in the United States fail to meet their overarching clinical, financial, and operational objectives. Core reasons include low clinician engagement with the technology, an inability to convert patient-generated data into actionable intelligence, lack of support to engage patients across the care continuum, and an inability to generate analytics-led insights that may improve corporate performance at an enterprise level. In the next 2–3 years, PHM IT solutions will become much more accessible, personalized, and result-driven. Modernized analytics and care coordination solutions will help payers manage provider performance on value-based care (VBC) contracts. Providers will also leverage next-generation (next-gen) PHM solutions to gain a competitive advantage in patient experience, claims management, and workforce management. Disruptive Technologies: Agile platforms are disrupting the PHM sector’s status quo. Enterprise-grade companies are deploying Software-as-a-Service (SaaS)-based PHM capabilities that address a wide variety of VBC objectives for providers (accountable care organization [ACO] design and management, payer connectivity, and patient engagement) and payers (utilization management, standardization of care, and network design and management). By 2023, the US PHM market will see increased adoption of SaaS-based PHM capabilities from all types of payers and providers. These modular, plug-in-based capabilities will compliment various electronic medical record (EMR) workflows and pave the way for health-on-cloud consumerism at a population level. Emerging Business Models: Most companies do not efficiently manage their PHM program deployments. This results in poor outcomes that include the costly procurement of external databases; delivery of manual Structured Query Language queries to link disparate databases, requiring 3rd-party PHM consultants to identify gaps in care management; and high lead time for reports. Best-in-class PHM companies will offer more targeted capabilities that address most concerns by 2023. These firms will offer a single PHM IT value proposition that incorporates numerous elements of data management, care coordination, patient engagement, and quality reporting via self-service-based and cloud-powered infrastructure, applications, and delivery solutions. Author: Koustav Chatterjee
More Information
No Index No
Podcast No
Author Koustav Chatterjee
Industries Healthcare
WIP Number K6A3-01-00-00-00
Keyword 1 PHM
Keyword 2 population health management
Keyword 3 population health management system
Is Prebook No
GPS Codes 9564-B1,9600-B1,9612-B1