Population Health Management Market

[146 Pages Report] The population health management market is expected to reach $42.54 billion by 2021 from $13.85 billion in 2016, at a CAGR of 25.2% in the next five years. Implementation of the Affordable Care Act (ACA) in the U.S., government support for the prevention of diseases and adoption of HCIT, growing geriatric population and the subsequent increase in the prevalence of chronic diseases, need for affordable treatment options due to the rising healthcare costs, and advancing IT and big data capabilities can grow global market growth.

In the coming years, the market is expected to witness the highest growth in the Asia-Pacific region due to the implementation of a number of PHM programs to improve population health in Australia, growing medical tourism in Asia, rapidly growing healthcare industry in India, efforts taken to digitalize the healthcare system in China, investments and reforms to modernize China’s healthcare infrastructure, and new outline by Japan’s information and communication technology fund.

North America is expected to account for the largest share of the market. In the U.S. market for population health management is driven by the rising healthcare costs, growth in geriatric population, the implementation of the Affordable Care Act (ACA), increasing funding for population health management, rising prevalence of chronic diseases, and increasing number of awareness campaigns. In Canada, the market growth for population health management is driven by the rising healthcare spending, the implementation of the population health approach by the Canadian government, and rising prevalence of chronic diseases in the country.

The report segments PHM market based on component, mode of delivery, end user, and region.

On the basis of mode of delivery, the PHM market is segmented into web-based, cloud-based, and on-premise.

In 2016, the web-based segment is expected to account for the largest share of market. This can be attributed to the minimal software and hardware requirements for using web-based PHM solutions (which reduces upfront installation costs) and increasing adoption of web-based services by healthcare providers. However, the cloud-based segment is expected to register the highest during the forecast period. A cloud-based solution is sold on demand, is flexible, and is fully managed by the provider; these characteristics differentiate it from traditional methods of delivery. Cloud-based solutions help healthcare organizations share and integrate information from disparate locations or systems in real time, and in the generation of database registries. In addition, these services help curtail costs incurred in the purchase of hardware and licensing of software. Such advantages have led to the growth of the cloud-based solutions segment.

Cerner Corporation (U.S.), McKesson Corporation (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Healthagen, LLC. (U.S.), OptumHealth (U.S.), IBM Corporation (U.S.), Epic Corporation, Inc. (U.S.), Conifer Health Solutions, LLC (U.S.), Health Catalyst, LLC (U.S.), Wellcentive, Inc. (U.S.), i2i Population Health (U.S.), and Verscend Technologies, Inc. (U.S.) are some of the key players in the population health management market.

Stakeholders

• Healthcare IT Service Providers
• Healthcare Insurance Companies/Payers
• Healthcare Institutions/Providers (Hospitals, Medical Groups, Physician Practices, Diagnostic Centers, and Outpatient Clinics)
• Venture Capitalists
• Government Bodies
• Corporate Entities
• Market Research and Consulting Firms
• Accountable Care Organizations
• Community Centers

To know about the assumptions considered for the study, download the pdf brochure

Scope of the Report:

This research report categorizes the global population health management market into the following segments:

By Component

• Software
• Services

By Mode of Delivery

• Web-based
• Cloud-based
• On-premise

By End User

• Healthcare Providers
• Healthcare Payers
• Employer Groups
• Government Bodies

By Region

• North America
  • U.S.
  • Canada
• Europe
  • U.K.
  • Germany
  • France
  • Italy
  • Rest of Europe (RoE)
• Asia-Pacific
• Rest of the World (RoW)

Available Customizations

With the given market data, MarketsandMarkets offers customizations as per the company’s specific needs. The following customization option is available for the report:

Portfolio Assessment

Product Matrix, which gives a detailed comparison of the product portfolios of the top three companies in the market.

Software segment to grow at the highest CAGR during the forecast period for PHM Market

On the basis of component, the population health management market is segmented into software and services. In 2016, the software segment is expected to account for the largest share of the global market. PHM software includes web-based and cloud-based solutions. The advantage of these solutions is that the service provider maintains and upgrades the software and eliminates the buyer’s responsibility of server support and maintenance, which enables the buyers to focus on their core business.

The PHM market is expected to reach USD 42.54 billion by 2021. Factors such as implementation of the Affordable Care Act (ACA) in the US, government support for the prevention of diseases and adoption of HCIT, growth in geriatric population and the subsequent increase in the prevalence of chronic diseases, need for affordable treatment options due to the rising healthcare costs, and advancing IT and big data capabilities are driving the growth of the market.

Lack of data management capabilities and skilled analysts, reluctance to migrate from legacy systems, and safety concerns with regard to patient information, are the major restraints for the population health management market.

A major concern with cloud-based population health management solutions is that data hosted by vendors is not as secure as its on-premise counterparts. Patient information is highly sensitive, and a high degree of privacy needs to be maintained so that this information is accessible only to authorized users.

Patient information across countries has been under the scanner of various legal frameworks; for instance, stringent data privacy requirements were legislated through HIPAA (Health Insurance Portability and Accountability Act) in the U.S. Similarly, the European Union has several directives pertaining to data protection. Moreover, in many countries, a patient's Protected Health Information (PHI) cannot be transferred out of the country of origin. Patients themselves are concerned about the security of their personal data, which adds to the necessity of maintaining necessary security standards for data protection. Public clouds face similar security issues as traditional IT systems and are thus not preferred. Although private clouds offer more secure access protocols and systems, the healthcare industry is still skeptical about the effectiveness of private cloud-based population health management solutions.

However, the increasing focus on value-based medicine, expansion in emerging economies, and rising focus on personalized medicine based on analytics are likely to offer lucrative growth opportunities for players in the global PHM market.

Minimal software and hardware requirements for using web-based PHM solutions (which reduces upfront installation costs) and increasing adoption of web-based services by healthcare providers are driving the web-based segment.

Web-based population health management

A web-based population health management system eliminates the buyer’s responsibility for server support and maintenance. Concurrently, control of the server also transfers from the healthcare provider to the vendor. The healthcare provider is dependent on the vendor for reliability, uptime, and functionality of the server. The vendor also takes responsibility of all external interfaces such as labs and imaging, making it beneficial for the healthcare provider. In the web-based delivery mode, a monthly fee per provider is charged; other relevant costs such as extra internet connection might also be applicable.

Cloud-based population health management

Cloud-based solutions are based on SaaS (Software-as-a-Solution), which utilizes a group of servers to spread data processing tasks across healthcare organizations. This process requires a shared IT infrastructure, which contains a large pool of data that is integrated from disparate locations. This technology is flexible, scalable, and affordable.

A cloud-based solution is sold on demand and is fully managed by the provider; these characteristics differentiate it from the traditional delivery models. Cloud-based services help healthcare organizations share and integrate information from disparate locations or systems in real time. Cloud services also help curtail costs incurred in the purchase of hardware and licensing of software.

Many healthcare providers manage and optimize their complex IT systems. In doing so, they strive to meet the requirements of the Affordable Care Act of improving the quality of care, reducing the rate of readmissions, reducing healthcare costs, and transforming themselves into Accountable Care Organizations (ACOs). All these requirements have driven healthcare providers to adopt cloud-based services.

On-premise population health management

The on-premise mode of delivery is a traditional method to deploy population health management solutions. In this delivery mode, a licensed software is installed which runs on computers in the hospital/clinic premises. Healthcare providers are responsible for purchasing, installing, and maintaining the server, through its in-house IT staff or local IT support vendors. Decision makers in healthcare organizations prefer to maintain access to these solutions due to issues like control, the safety of patient data, and cost benefits.

Implementation of the Affordable Care Act and Hospital Readmissions Reduction Program in the US, high demand for PHM solutions among healthcare providers owing to various benefits offered by these solutions, and Medicare initiative to penalize hospitals for unnecessary readmissions are driving the growth of the healthcare providers segment.

Healthcare Providers

Healthcare providers adopt population health management solutions to curtail the rising costs of healthcare, offer quality care, and improve financial outcomes. A number of provisions in the Affordable Care Act (ACA) have resulted in an increase in the number of population health management programs being implemented in the U.S. The ACA stresses on value-based reimbursement and quality of treatment rather than the traditional fee for reimbursement systems based on volume. At the same time, the ACA also aims to lower the number of uninsured people to reduce the cost of healthcare for the government as well as for individuals.

Healthcare Payers

The healthcare payer industry is undergoing changes in terms of legislation, competition, and market segments, which have played a significant role in changing the outlook of the industry. Payers in the healthcare market include various private as well as public insurance bodies like the Centers for Medicare & Medicaid Services in the U.S. The new Medicare initiatives include penalizing hospitals for unnecessary readmissions and correlating their reimbursements to the quality of care provided. Payers aim to offer financial rewards to healthcare providers that deliver quality care in a cost-effective manner. Through a unified population health management solution, costs can be decreased by avoiding expenses related to pharmacies, readmissions, and length of stay. This, in turn, would help healthcare providers to maximize their reimbursements. In addition, payers can provide healthcare providers with a client database to integrate into their registries, thereby increasing the size of the population to be covered for assessing health.

Other End Users

Employer Groups

Many employers have initiated wellness programs to assess the health of their employees. The Affordable Care Act offers incentives for wellness programs at workplaces in the form of insurance discounts for participating employees and grants to develop wellness programs. Many companies use health risk assessments (HRAs) as an element to track the health of their employees. Employees in many of the large, self-insured companies are asked to fill these HRAs (questionnaires) as a part of their wellness programs. In addition, financial incentives are offered to increase the number of enrollments. These HRAs are uploaded online to make it easy for healthcare providers to access data.

Government Bodies

The rising costs of healthcare have compelled government bodies to implement various mandates on healthcare providers and payers to improve the quality of care. Apart from healthcare providers, payers, and corporate entities, government bodies like the Ministry of Health are also engaged in population health management.

Key questions

• How does PHM relate to the industry transition to Value based Care & Reimbursement (VBC&R)?
• What will be the impact on utilization and the provision of healthcare?
• What will be the impact of PHM on revenue cycle management?

The population health management market is projected to reach USD 42.54 Billion by 2021 from USD 13.85 Billion in 2016, at a CAGR of 25.2% in the next five years (2016 to 2021).

The implementation of the Affordable Care Act (ACA) in the U.S., government support for the prevention of diseases and adoption of HCIT, rising geriatric population and the subsequent increase in the prevalence of chronic diseases, need for affordable treatment options due to the rising healthcare costs, and advancing IT and big data capabilities are expected to drive the growth of the market in the coming years.

The PHM market is segmented on the basis of component, mode of delivery, end user, and region. Based on component, the market is categorized into software and services. The software segment is expected to command the largest share of the global market in 2016. PHM software includes web-based and cloud-based solutions. The advantage of these solutions is that the service provider maintains and upgrades the software and eliminates the buyer’s responsibility of server support and maintenance, which enables the buyer to focus on their core business.

On the basis of region, the market is categorized into North America, Europe, Asia-Pacific, and the Rest of the World (RoW). North America is expected to account for the largest share of the market in 2016. The U.S. is the largest market in North America, owing to the rising healthcare costs, growing geriatric population, the implementation of the Affordable Care Act (ACA), increasing funding for population health management, rising prevalence of chronic diseases, and increasing number of awareness campaigns. In Canada, the growth of the market is driven by the rising healthcare spending, the implementation of the population health approach by the Canadian government, and rising prevalence of chronic diseases in the country.

However, the Asia-Pacific region is expected to grow at the highest CAGR during the forecast period. This can be attributed to the implementation of a number of PHM programs to improve population health in Australia, growing medical tourism in Asia, rapidly growing healthcare industry in India, efforts taken to digitalize the healthcare system in China, investments and reforms to modernize China’s healthcare infrastructure, and new outline by Japan’s information and communication technology fund.

The population health management market is expected to be dominated by North America, followed by Europe, Asia-Pacific, and the Rest of the World (RoW). Asia-Pacific is expected to grow at the highest rate during the forecast period.

Agreements, collaborations, partnerships, joint ventures, and strategic alliances was the major growth strategy adopted by players operating in the global population health management market

Agreements, collaborations, partnerships, joint ventures, and strategic alliances; product launches; marketing and promotional activities; and acquisitions were the major strategies adopted by key players to achieve growth in this market.

Agreements, collaborations, partnerships, joint ventures, and strategic alliances accounted for 41.2% of the total strategies adopted by the players in this market. Players adopted these strategies to expand their product portfolios and customer base, and fortify their sales channels. The key players that adopted this strategy include Cerner Corporation (U.S.), McKesson Corporation (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Healthagen, LLC. (U.S.), OptumHealth (U.S.), IBM Corporation (U.S.), Epic Corporation, Inc. (U.S.), Conifer Health Solutions, LLC. (U.S.), and Health Catalyst, LLC. (U.S.). For instance, in October 2016, IBM Watson entered into a 5-year population health management alliance with Siemens Healthineers (Germany), a medical technology company. The alliance enabled Siemens Healthineers to offer PHM solutions and services from IBM Watson Health, and bundle these services with Siemens instruments and machines in order to provide better quality care.

Product launches accounted for 16% of the total number of growth strategies adopted by players in the population health management market from 2013 to 2016. Players adopted this strategy to strengthen their networks, increase their global presence, enhance customer experience, and improve relationships with customers. In January 2016, Conifer Health Solutions launched ConiferCore Outcomes Optimization, a care coordination software. The solution enabled the entire cross-functional care teams- ranging from primary care physicians to care managers seamlessly access the complete record of a member, provide customization to support the needs of care managers, and improve outcomes. The key players that adopted this strategy are McKesson Corporation (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Conifer Health Solutions, LLC. (U.S.), IBM Corporation (U.S.), Verscend Technologies, Inc. (U.S.), and i2i Population Health (U.S.).

Acquisitions accounted for 11.9% of the total key growth strategies adopted by players in the population health management market from 2013 to 2016. Players adopted this strategy to strengthen their existing product portfolios. In December 2016, Allscripts Healthcare Solutions, Inc. acquired Core Medical Solutions (Australia), a healthcare IT software leader. The acquisition aimed to integrate Allscripts’ Sunrise PAS and EMR module and EMR-agnostic population health solutions including dbMotion with the product offerings of Core Medical Solutions to improve health outcomes. Key players that adopted this strategy are Cerner Corporation (U.S.), McKesson Corporation (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Epic Corporation, Inc. (U.S.), Conifer Health Solutions, LLC. (U.S.), IBM Corporation (U.S.), and Wellcentive, Inc. (U.S.).

Marketing and promotional activities accounted for 6.2% of the total number of strategic developments adopted by players operating in the population health management market between 2013 and 2016. In November 2015, i2i Systems hosted the “Leverage Big Data to boost value-based care and incentives” webinar. The webinar empowered healthcare organizations leverage Big Data with i2i Systems’ PopIQ to improve quality, revenue growth, and business optimization. The key players that adopted this strategy are i2i Population Health (U.S.) and IBM Corporation (U.S.).

Lucrative Asia-Pacific Markets to Offer Significant Growth Opportunities for the Population Health Management Market in the Coming Years

Growth in the population health management market is likely to be centered on the Asia-Pacific region. This can be attributed to the implementation of a number of PHM programs to improve population health in Australia, growing medical tourism in Asia, rapidly growing healthcare industry in India, efforts taken to digitalize the healthcare system in China, investments and reforms to modernize China’s healthcare infrastructure, and new outline by Japan’s information and communication technology fund.

The new outline on the healthcare sector by Japan’s information and communication technology fund has mandated the use of electronic medical records, development of HCIT and PHM platforms, and the creation of platforms (that can monitor pharmaceutical prescriptions and adverse events in real time) & claims databases. These changes indicate that Japan is now pursuing a PHM-based approach to enhance its healthcare system. To achieve these goals, the Japanese government invested USD 3.29 billion (JPY 367 billion) in 2007. It has also taken various initiatives such as the “e-Japan policy,” the “New IT Reform Strategy,” and the “iJapan Strategy 2015,” which encourage hospitals to adopt healthcare information technology and effectively manage the inflow of patients, lower hospital operational expenditure, and improve the quality of services.

The Indian healthcare industry is expected to reach USD 280 billion by 2020 (according to the Federation of Indian Chambers of Commerce and Industry). Factors such as changing demographics (such as the increase in aging population), rising healthcare awareness, and greater access to healthcare facilities are driving this growth. According to a report by the U.N., in India, the number of people aged 60 years and above is projected to reach around 300 million by 2050.

The Australian government has initiated the implementation of population health management programs. The “Get Healthy Service” is one such program that is offered to about 10 million people across five Australian states and territories. The aim of this program is to reduce the prevalence of chronic diseases in the country through changes in the lifestyle of citizens. Moreover, the NSW Ministry of Health through its NSW Population Health and Health Services Research Support (PHHSRS) Program provided funding to research organizations that undertake population health and health services research.

Cerner Corporation (U.S.), McKesson Corporation (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Healthagen, LLC. (U.S.), OptumHealth (U.S.), IBM Corporation (U.S.), Epic Corporation, Inc. (U.S.), Conifer Health Solutions, LLC (U.S.), Health Catalyst, LLC (U.S.), Wellcentive, Inc. (U.S.), i2i Population Health (U.S.), and Verscend Technologies, Inc. (U.S.) are some of the key players in the population health management market.

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