The healthcare industry is rapidly shifting from volume-based care (fee-for-service) to a value-based reimbursement structure (fee-for-value) with a population health approach. This approach is patient-centred and uses data from across the healthcare continuum to improve the patient experience of care (quality and satisfaction), improve the health of populations, and reduce the cost of care. Effective population health management (PHM) has the power to transform healthcare. Population health management solutions help providers and health systems to stratify and select target populations, identify gaps in care, predict outcomes and apply early interventions to improve health and care. Moreover, PHM can enable an organization to understand its aggregate performance in undertaking disease-specific plans for multiple patients; thus, leading to improved clinical and financial outcomes. “Meticulous Research” in its latest publication states that, the “global Population Health Management Solutions Market for is expected to grow at a CAGR of 24.0% from 2018 to 2023 to reach $58,111.2 million by 2023.”
This growth is primarily driven by Affordable Care Act (ACA) in the U.S., trend towards value-based care, improving HCIT infrastructure and adoption of HCIT solutions such as EMRs and HIE, increasing focus on personalized medicine and preventive care, advancing IT & big data capabilities, government support for co-ordinated care, and proliferating Accountable Care Organizations (ACO).
According to CMS (Centers for Medicare & Medicaid Services), the U.S. health expenditure grew 4.3% to $3.3 trillion in 2016, or $10,348 per person, and accounted for 17.9% of GDP. Under current law, the U.S. health spending is projected to grow at an average rate of 5.5% per year for 2017-26 and to reach $5.7 trillion by 2026, largely driven by fundamental economic and demographic factors.
These factors include changes in projected income growth, increases in prices for medical goods and services, and enrolment shifts from private health insurance to Medicare related to the aging of the population. According to a study published in March 2018 in the Journal of American Medical Association (JAMA), health care spending in the U.S. greatly exceeds that in other high-income countries (average health spending of 11.5% of GDP), but the amount of spending doesn’t necessarily translate into better health outcomes. The low healthcare performance and high costs are mainly driven by high physician pay, high prescription drug prices, and greater administration expenses.
In the U.S., the Patient Protection and Affordable Care Act (PPACA) also known as ACA, signed into law in March 2010 by the ex-president Barack Obama, primarily aimed to expand health insurance coverage, improve quality reporting, and reduce overall costs by encouraging primary care. The ACA is expected to improve access to healthcare by increasing health insurance enrollment by an estimated 30 million people by the year 2021. Accountable Care Organizations (ACO) have been key to the ACA achieving quality care at decreased costs and the success of ACOs relies on population health management (PHM) solutions. Moreover, growing patient demand for quality care has further pushed the U.S. healthcare system to implement advanced technologies such as PHM that curtail costs, improve care quality, and reduce operational inefficiencies.
Lately, President Donald Trump and his administration have been putting several efforts to repeal and replace the ACA. However, healthcare providers are willing to commit a long-term population health strategy despite ACA uncertainty. This is evident by survey conducted by Health Catalyst in July 2017, that shows 68% of healthcare executives indicated PHM is “very important” to their healthcare delivery strategy over the next two years. Thus, the adoption of PHM solutions in the U.S- the largest PHM market in the world is expected to fuel during the forecast period.
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The report provides meticulous analysis of population health management solutions market by segmenting it on the basis of Solutions (PHM) Market by Component (Software, Service), Mode of Delivery (Web based, On premise, Cloud), End User (Hospital, Clinic, Payor, Employer, Government, ACO), and Geography.
The key players analyzed in the population health management solutions market are Koninklijke Philips N.V. (The Netherlands), Cerner Corporation (U.S.), McKesson Corporation (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Healthagen, LLC. (U.S.), Optum (U.S.), IBM Corporation (U.S.), Conifer Health Solutions, LLC (U.S.), Health Catalyst, LLC (U.S.), i2i Population Health (U.S.), Verscend Technologies, Inc. (U.S.), Accenture plc (Ireland), and Deloitte Touche Tohmatsu Limited (U.S.).
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