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Care Management Procedures Market Dynamics
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.
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.
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Restraint: High cost of deployment
Healthcare IT systems are high-priced software solutions. Moreover, the maintenance and software update costs of these systems may be more than the price of the software. Support and maintenance services (which include software upgrades as per changing user requirements) form a recurring expenditure, which amounts to almost 30% of the total cost of ownership. Lack of internal IT expertise in the healthcare industry necessitates training for end users in order to maximize the efficiency of various healthcare IT solutions, thereby adding to the cost of ownership of the systems.
Hospitals often prefer investing in core technologies directly linked to the quality of care for patients than investing in technologies for allied departments of healthcare organizations. Thus, the high cost of deployment and maintenance restricts smaller healthcare organizations from investing in healthcare IT solutions, especially in the emerging markets across the APAC and Latin American regions.
Recent Developments:
# 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.
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 Care Management Solutions 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.
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Global Leaders:
The Care Management Procedures 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).
Different Growth Strategies Adopted:
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 solutions 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).
Key questions addressed by the report:
# Which end user segment will dominate the care management solutions market in the future?
# Emerging countries have immense opportunities for the growth and adoption care management solutions, therefore will this scenario continue in the next five years?
# What are the upcoming growth geographies for care management solutions?
# Where will all the advancements in technology offered by various companies take the industry in the mid to long term?
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