Accountable care solutions play a vital role in the transition of the healthcare industry into a data-driven and patient-centered healthcare model. These solutions aid in creating care pathways and managing transitions from hospital to community-based home care settings. Accountable care solutions are proved efficient in proactively identifying chronic condition patients also termed as “rising risk” to reduce hospital stays and healthcare utilization. Groups of doctors, physicians, hospitals, and other healthcare providers have come together willingly to offer high-quality coordinated care to Medicare patients. The only goal of coordinated care is to make sure that patients receive enhanced care at the right time while preventing medical errors and eliminating unnecessary duplication of services. Accountable care solutions are extensively adopted among self-insuring employers, insurance companies, and several healthcare organizations. While insurers have a history of early adoption of these services to predict risks and costs, healthcare providers and employers are still catching up in their adoption.
The healthcare payment models have been witnessing dramatic transformation as the majority of healthcare providers and payers are shifting from volume to value-based care. Though stakeholders are currently adopting different value-based care delivery models, accountable care has proved to be the most successful strategy to date. However, various healthcare critics argue that accountable care and other value-based care delivery programs aid in reducing competition within the healthcare sector, thereby resulting in higher service costs for consumers. Moreover, The Affordable Care Act (ACA) enabled in 2010 has officially introduced Accountable Care Organizations (ACOs) to support the ambient goal of the healthcare industry to achieve the Triple Aim which covers improving care quality, decreasing healthcare costs, and enhancing the patient experience. In 2019, since the enactment of ACA, healthcare providers and payers in the U.S. have formed more than 1,000 ACOs covering approximately 32.7 million patients throughout the country. These ACOs are likely to witness an increase in their number as value-based reimbursement participation exceeded fee-for-service.
An increase in the number of ACOs offering quality care at reduced costs is expected to positively impact the accountable care solutions market in near future. For instance, as of January 2021, nearly 512 Medicare ACOs have been registered serving more than 12.0 million beneficiaries. Moreover, since 2010, over 1,200 organizations have undergone an ACO contract in Medicaid, Medicare, or the commercial sector and serve additional patients. In addition, major insurance companies and healthcare providers are adopting strategies, such as partnerships and joint ventures with ACOs, for enhancing revenue flow and offering healthcare services at low cost by adopting accountable care solutions. For instance, in 2020, two large-sized health systems based in Philadelphia entered into a joint venture with an ACO. This joint venture led to the development of collaborative post-acute care (PAC) strategy, which offered quality improvement, covering an 83.0% reduction in the readmission penalties. New software solutions for accountable care services are developed, globally. In November 2020, Blue Cross and Blue Shield of North Carolina entered into collaboration with Caravan Health to launch a new accountable care organization (ACO). The ACO was expected to be launched in January 2021 and is designed to work with community providers and rural hospitals.
Moreover, with the ongoing COVID-19 pandemic, various healthcare organizations have proactively come together for data sharing to optimize healthcare delivery. The market has been witnessing a new trend of cross-collaboration between government agencies, health systems, insurance providers, and academia, thereby aiding data-driven insights for improved financial outcomes, resource allocation, disease prevention, and cost containment. COVID-19 has further created new risks for the ACOs. The majority of the ACOs witnessed a potential increase in risk-sharing losses, however, there are some ACOs who believe that these COVID-19 associated risk-sharing losses can be mitigated by optimized financial benchmarking and contract protections.
For this study, Grand View Research, Inc. has segmented the global accountable care solutions market report based on component, application, delivery mode, end user, and region:
Component Outlook (Revenue, USD Million, 2016 - 2028)
Application Outlook (Revenue, USD Million, 2016 - 2028)
Electronic Health/Medical Records
Revenue Cycle Management Solutions (RCM)
Patient Engagement Solutions
Population Health Management (PHM) Solutions
Claims Management Solutions
Payment Management Solutions
Healthcare Information Exchange (HIE)
Delivery Mode Outlook (Revenue, USD Million, 2016 - 2028)
Web & Cloud-Based
End-user Outlook (Revenue, USD Million, 2016 - 2028)
Regional Outlook (Revenue, USD Million, 2016 - 2028)
List of Key Players in the Global Accountable Care Solutions Market
Allscripts Healthcare Solutions, Inc.
Epic Systems Corporation
Verisk Health, Inc.
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