Value-based care good for population health management
As healthcare increasingly adopts tools supporting value-based care delivery, the potential multi-billion dollar market for population health management is getting a big boost, according to new analysis from research firm Frost & Sullivan.
The report US Population Health Management Market – Analysis and Competitive Landscape Assessment 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.
Payers are aligning reimbursements to the quality of healthcare, driving providers to adopt outcome-based healthcare delivery models. PHM tools can help achieve the elusive Triple Aim, which offers quality care at optimized costs with improved access. Frost & Sullivan figure population health management 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 platforms, analysts asserted. Additionally, they said PHM is the biggest opportunity in health information technology in the post-electronic health records era. It's expected to enable providers to reduce readmissions, expand preventive care, encourage wellness program and embrace cost reduction strategies to meet payer targets and realize shared savings.
“The Centers for Medicare & Medicaid Services aims to link almost 50 percent of Medicare fee-for-service to alternative payment models by 2018,” Frost & Sullivan Transformational Health Industry Analyst Koustav Chatterjee noted. “Commercial payers are seeking support to improve performances around member cost containment, engagement and supervision. 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, payers and providers may take a wait-and-see-approach before investing in population health management.
"Although PHM requires heavy, long-term investment, payers and providers need to focus on the benefits of quality compliance, patient loyalty and consistent profitability," Chatterjee noted. "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 tools. 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. Chatterjee expects the market to experience fierce competition as small, modular PHM firms compete against large, platform providers.