Major Growth Driver: Implementation of initiatives to shift the burden of risk from healthcare payers to providers
Globally, various initiatives are being implemented to shift the burden of risk borne by healthcare payers to providers. This shift promotes the adoption of healthcare information technology (HCIT) solutions (such as care management solutions) to increase the efficiency of healthcare delivered and reduce unnecessary costs. For instance, in 2015, Medicare applied the Value-based Payment Modifier program to payments under the Medicare Physician Fee Schedule (PFS) for physicians in groups of 100 or more eligible practitioners.
The Value-based Payment Modifier program offers differential payment to a physician or group of physicians based on the quality of care furnished instead of the cost of care. Value-based care is also promoted through alternative payment models such as bundled payments, physician incentives, and consumer incentives, among others. These models of payment are designed to encourage healthcare providers to accept the accountability of care delivered, thus leading to the shift of risk from payers to providers.
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Healthcare organizations across the globe are aiming to provide coordinated, comprehensive care across the continuum to ensure patient satisfaction and improve overall health outcomes. As care management solutions aid stakeholders in the healthcare sector to achieve this objective, their adoption is expected to increase in the coming years.
Opportunity: Emerging markets
In Asia and Australasia, the rollout of public healthcare programs combined with growing consumer wealth is anticipated to boost healthcare spending at an average of 8.1% from 2014 to 2018 (Source: The Economist Intelligence Unit). Government initiatives for the implementation of HCIT solutions, rise in government spending on healthcare systems, and the presence of skilled IT experts are favoring the growth of the care management solutions market in the Asia Pacific region.
Expected Growth in Revenue During Forecast Period:
The global care management solutions market is projected to reach USD 19.28 billion by 2023 from USD 9.15 billion in 2018, at a CAGR of 16.1% during the forecast period.
Recent Developments in the Global Market:
# February 2016, ZeOmega partnered with Vivify Health, Inc. (US) to integrate ZeOmega’s Jiva platform with Vivify mobility applications
# In 2016 EXL Service Holdings, Inc. partnered with Novu LLC, to develop solutions to enhance consumer satisfaction and reduce costs for payers and providers.
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By end user, the payers segment is expected to command the largest share of the market in 2018
On the basis of end user, the market has been segmented into payers, providers, and other end users. The payers segment is expected to command the largest share of the market in 2018. The deployment of care management solutions is increasing among payers as it helps them in the effective management of patient health records, claims processing and reimbursement tasks, coordinating care for their members, and ensuring better health outcomes to mitigate their risk burden. The growing stringency ofregulations for payers is another important factor driving the adoption of care management solutions in this end-user segment.
North America to dominate the market in 2018
North America is expected to account for the largest share of the care management solutions market in 2018, followed by Europe. The large share of North America can be attributed to the increased adoption of care management solutions by healthcare providers and payers to meet the healthcare goals of better quality care and lower healthcare costs. Also, several major global players are based in the US, owing to which the US has become a center for innovation in the care management solutions market.
The care management market is rapidly emerging with many regional as well as international players. In 2017, the care management solutions market was dominated by a few large players, namely, EXL Service Holdings, Inc. (US), Casenet, LLC (US), Medecision Inc. (US), ZeOmega Inc. (US), Cognizant Technology Solutions (US), Cerner Corporation (US), Allscripts Healthcare Solutions, Inc. (US), and TCS Healthcare Technologies (US).
Product deployments and launches, acquisitions, partnerships, agreements, and collaborations were strategies adopted by key players between 2015 and 2018 to enhance their share in the care management market. Important players that adopted these strategies include EXL Service Holdings, Inc. (US), Casenet, LLC (US), Medecision Inc. (US), ZeOmega Inc. (US), Cognizant Technology Solutions (US), Cerner Corporation (US), Allscripts Healthcare Solutions, Inc. (US), and TCS Healthcare Technologies (US).
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