Value-Based Healthcare Drives Growth Opportunity in Population Health Management

The desire to offer quality care at optimized costs with improved access spurs investments in PHM, says Frost & Sullivan Transformational Health Team

MOUNTAIN VIEW, California, June 16, 2016 /PRNewswire/ -- As healthcare stakeholders in the U.S. adopt solutions supporting value-based care delivery, the potential multi-billion dollar market for population health management (PHM) is set to thrive. Payers are aligning reimbursements to the quality of healthcare, driving providers to adopt outcome-based healthcare delivery models. PHM solutions can help achieve the elusive Triple Aim, which offers quality care at optimized costs with improved access. Essentially, PHM will account for the entire patient population in a coordinated and cost-effective manner. It goes beyond healthcare analytics to data management, risk management, care management and performance management solutions. As such, PHM is the biggest opportunity in health information technology (IT) in the post-electronic health records (EHR) era.

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New analysis from Frost & Sullivan, US Population Health Management Market—Analysis and Competitive Landscape Assessment (http://utm.io/256681), finds the market will expand by 284 percent during the next five years, increasing at a compound annual growth rate of 30.9 percent until 2020. The majority of U.S.-based payers and providers are poised to progressively embrace health IT solutions and services facilitating PHM goals.

For complimentary access to more information on this research, please visit: http://frost.ly/h7.

PHM is expected to:

• Enable providers to reduce readmissions
• Expand preventive care
• Encourage wellness programs
• Embrace cost reduction strategies to meet payer targets and realize shared savings

"The Centers for Medicare & Medicaid Services (CMS) aims to link almost 50 percent of Medicare fee-for-service (FFS) to alternative payment models by 2018. Commercial payers are seeking support to improve performances around member cost containment, engagement and supervision," explained Frost & Sullivan Transformational Health Industry Analyst Koustav Chatterjee. "This shift from volume to value-based healthcare delivery is accelerating adoption of PHM technology and service solutions helping providers effectively manage chronic conditions and prevent unnecessary system utilization."

However, the market lacks a defined implementation approach. Payers and providers may wait to invest in PHM due to the following challenges hindering adoption:

• Lack of value-based contracting capability
• Negative Affordable Care Act (ACA) profitability
• Poor supply outlook
• Slow regulatory policy evolution

"Although PHM requires heavy, long-term investment, payers and providers need to focus on the benefits of quality compliance, patient loyalty and consistent profitability," stressed Chatterjee. "Providers must initiate customized intervention based on patients' primary conditions and potential risk profiles to drive positive outcomes."

PHM vendors are already investing through research and collaboration to build robust solutions. Training care managers for effective coordination, building pioneering capabilities through partnerships, streamlining patient engagement through preventive outreach and working towards patient risk stratification will be the top PHM priorities.

"The market will experience fierce competition as small, modular PHM firms compete against large, platform providers," added Chatterjee. "Winners will successfully weigh in market needs and offer secured, interoperable and highly customized PHM solutions that achieve the triple aim."

US Population Health Management Market—Analysis and Competitive Landscape Assessment is part of the Connected Health (http://ww2.frost.com/research/industry/transformational-health/connected-health) Growth Partnership Service program. Frost & Sullivan's related studies include: US Healthcare Cybersecurity Market, US Telehealth Virtual Visits Market, Visible Light (VL) Imaging Informatics & OR Integration Market, Top Trends in Health IT from HIMSS16, Health Insurance Information Technology: US Overview and Outlook, 2014–2020, North American Market for Remote Patient Monitoring, Care Coordination Software - US Overview and Outlook, 2014 - 2020, The US Ambulatory EHR Market: 2015–2020, among others. All studies included in subscriptions provide detailed market opportunities and industry trends evaluated following extensive interviews with market participants.

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US Population Health Management Market—Analysis and Competitive Landscape Assessment
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SOURCE Frost & Sullivan