U.S. Population Health Management Market Size, Share & Trends Analysis Report by Product (Software, Services), By End Use (Providers, Payers, Employer Groups), And Segment Forecasts, 2023 - 2030

Market Segmentation

• U.S. Population Health Management Product Outlook (Revenue, USD Billion, 2017 - 2030)
  • Software
  • Services
• U.S. Population Health Management End Use Outlook (Revenue, USD Billion, 2017 - 2030)
  • Providers
  • Payers
  • Employer Groups

U.S. Population Health Management Market Dynamics

Driver: Growing demand for value-based healthcare delivery

The U.S. healthcare industry is shifting toward the adoption of healthcare IT solutions including electronic health record (EHR) and population health management (PHM) for value-based compensation. Healthcare providers can obtain benefits from PHM solutions that can result in financial savings under the new care models. Healthcare information technology (IT) segment has witnessed a steady growth rate since the last decade. The American Recovery and Reinvestment Act of 2009 (ARRA), also known as the stimulus bill, provided a huge boost to the adoption of healthcare IT solutions. The HITECH Act was enacted as a part of the stimulus bill/ARRA. The HITECH Act offers financial incentives to hospitals and physicians for the adoption of electronic health record (EHR) systems. Hospitals and physicians are eligible to receive up to USD 2 million and USD 64,000, respectively. Healthcare IT solutions focus on the conversion of clinical information to electronic format. As the EHR adoption in the U.S. healthcare industry has almost approached the saturation level, the PHM market has been moving beyond the initial phase.

Driver: Rising healthcare expenditure

In 2017, the healthcare expenditure in the U.S. reached USD 3.5 trillion and is increasing continuously. The adoption of PHM is a cost-effective option for the reducing overall healthcare costs. The healthcare expenditure by the state and local governments has been rising by around 4% each year. This growth is majorly driven by the rising Medicaid expenditure, which accounted for around 35% of the total healthcare expenditure in 2017. The rising prevalence of chronic diseases drives the need for advanced healthcare IT solutions. Private healthcare spending in the U.S. is almost five times that of Canada, which is the second-highest spending country. However, about 34% of the citizens are covered under Medicaid and Medicare. The per capita expenditure in the country in 2017 was USD 10,739. The healthcare expenditure as a percentage of the GDP can be estimated at 17.9%. In the U.S., 5% of patients account for half of the national healthcare expenditure. Detailed analyses of spending patterns; how they affect different payers, such as Medicare, Medicaid, employers, private insurers, and consumers; and how they change over time can help limit the rapidly rising healthcare costs & improve healthcare delivery.

Restraint: Lack of proper regulatory framework for PHM

The traditional patterns of healthcare practice need to be changed for successful implementation of PHM solutions across care portals. It has become essential to collect and aggregate the patient data to understand PHM. Constantly changing regulations is one of the major threats to this market. A shift in healthcare reimbursement models is required, as the current models are based on Fee-for-Service principle, which dates back to the 1950s. The models are based on managing sickness, not health. The PHM model encourages patients to take charge of their health and engages them. The lack of a regulatory framework affects the market growth. The absence of a well-defined and organized reimbursement policy at a global level, especially for the software solutions restricts the market for these solutions, as their cost remains high, which burdens the customers. Moreover, the healthcare industry is subject to changing economic, regulatory, and political influences that could negatively affect the purchasing capacity of the healthcare providers.

What Does This Report Include?

This section will provide insights into the contents included in this U.S. population health management market report and help gain clarity on the structure of the report to assist readers in navigating smoothly.

U.S. population health management market qualitative analysis

• Industry overview

• Industry trends

• Market drivers and restraints

• Market size

• Growth prospects

• Porter’s analysis

• PESTEL analysis

• Key market opportunities prioritized

• Competitive landscape

  • Company overview

  • Financial performance

  • Product benchmarking

  • Latest strategic developments

U.S. population health management market quantitative analysis

• Market size, estimates, and forecast from 2017 to 2030

• Market estimates and forecast for product segments up to 2030

• Regional market size and forecast for product segments up to 2030

• Market estimates and forecast for application segments up to 2030

• Regional market size and forecast for application segments up to 2030

• Company financial performance