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市場調查報告書

美國的社群健康管理 (PHM) 市場:分析及競爭情形的評估

US Population Health Management Market - Analysis and Competitive Landscape Assessment

出版商 Frost & Sullivan 商品編碼 359411
出版日期 內容資訊 英文 181 Pages
商品交期: 最快1-2個工作天內
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美國的社群健康管理 (PHM) 市場:分析及競爭情形的評估 US Population Health Management Market - Analysis and Competitive Landscape Assessment
出版日期: 2016年05月20日 內容資訊: 英文 181 Pages
簡介

本報告提供美國的社群健康管理 (PHM) 市場定義,提供您PHM市場管理,一般認為將影響今後5年市場的主要促進要素·抑制因素,競爭上的特徵,費用模式,契約模式及參與度模式等調查分析。

第2章 市場概要

  • PHM的市場範圍·定義
  • 市場背景
  • 主要的醫療產業責任和義務:美國
  • 轉換為責任醫療:遵從4個根本階段
  • 為了促進PHM所要求的基本特徵
  • PHM的目標
  • 責任醫療的未來:美國的PHM市場
  • 美國的PHM市場上類別區分
  • 美國的PHM市場上客戶區分
  • 主要客戶的市場區隔定義
  • PHM的商務目的:主要客戶類別

第3章 促進社群健康管理 (PHM) 的宏觀環境

  • 傳統醫療制度的非效率性
  • 社會經濟指標
  • 醫療需求的增加
  • 慢性疾病的增加
  • 慢性疾病管理的莫大成本負擔
  • 國家醫療費用的增加
  • 推進責任醫療的醫療費給付組成架構的發展

第4章 社群健康管理 (PHM)的簡介

  • 社群健康管理 (PHM) :定義
  • 社群健康管理 (PHM) :概要
  • PHM解決方案的種類
  • PHM的演進
  • PHM:市場成熟度指標
  • PHM的演進:技術藍圖
  • 市場成長的促進要素
  • 市場阻礙成長要素

第5章 PHM部門level分析

  • 市場區隔
  • 建議:主要的目標
  • 建議
  • 資料聚合·經營管理:主要的目標
  • 資料聚合·經營管理:發展的服務模式
  • 資料聚合·經營管理:主要市場觀測
  • 風險層級:主要的目標
  • 風險層級·建模:實現PHM的組成架構
  • 照護協調:主要的目標
  • 照護協調
  • 病人參與:主要的目標
  • 病人參與:所有相關利益者的主要重點領域
  • 成功的病人參與需要患者及其供應商的行為變化
  • 病人參與過去和未來的方法
  • 基本到高級的病人參與指南
  • 不同的患者參與解決方案的採用展望
  • 效能管理:主要的目標
  • 效能管理

第6章 PHM的實行

第7章 PHM服務的採購

第8章 PHM解決方案的費用模式

第9章 預測·趨勢:PHM整體市場

第10章 預測·趨勢:市場區隔

第11章 需求分析

第12章 競爭環境

第13章 主要供應商簡介

第14章 附錄

圖表清單

目錄
Product Code: K00B-01-00-00-00

This Frost & Sullivan research service presents a comprehensive analysis of the market potential and dynamics of the population health management (PHM) market in the United States (US). The study provides a strategic PHM road map to progressive health entities that aspire to practice proactive care monitoring at a community level and synthesize clinical, administrative, and financial information to improve the well-being of the patient population while taking responsibility of a value-driven reimbursement relationship.

It includes market drivers, challenges, forecasts, and trends. This research examines the following market segments:

Services

  • Advisory: Clinical & Financial Consulting
  • Data Analysis: Data Aggregation & Management, Risk Stratification & Modeling
  • Care Management: Care Coordination, Patient Engagement
  • Performance Management: Clinical Performance Management, Financial Performance Management

Customers

  • Accountable Care Organizations (ACO)
  • Payers & Payer-Providers
  • Hospitals outside of ACO contracts
  • Physician practices outside of ACO contracts

Market Overview

Population health hanagement is the leading growth opportunity in a post-EHR healthcare era.

The rising cost burden of chronic disease management coupled with evolving value-based payment programs supports the requirement of individualized digital interventions that aim to transform care delivery and improve chronic conditions at a population level.

The adoption of PHM solutions that demonstrate meaningful use of IT applications is expected to accelerate in 2016 through 2020. Patient care is moving into a broader but coordinated environment where routine, manual tasks are automated by PHM solutions that unify siloed systems, stratify comorbidities, empower patients through engagement, and benchmark outcomes at network, practice, and patient level.

Health systems, on the road to accountable care, are striving to identify appropriate care workflows, control readmissions, and promote self-care so that incoming patients heal quickl, transitioning patients avoid readmitting, and healthy populations stay healthy.

Payer, payer-provider, and ACO communities are the top promoters of PHM in the United States. Best-in-class solutions are sought to help track, monitor, analyze, and manage provider/member performance. These groups are expected to invest in technologies that support value-based contracts, set provider-specific quality goals, initiate member engagement, and minimize financial risk through episodic care management.

Additionally, the need to coordinate care departments, meet payer targets, and engage patients during, pre-, and post-care is expected to strongly accelerate investment in the non-ACO hospital segment. Non-ACO physician practices are challenged by growing competition, imposing regulations, and limited investment capabilities. However, as CMS drives new MU objectives that consider physician preferences, the adoption of PHM solutions across this segment is expected to be substantial during 2018-2020.

The US PHM supply market is at a nascent stage and a select few companies have managed to better patient outcomes and minimize financial risk for their clients. Many providers and payers are in dire need of a suite of healthcare technology solutions and services that improve care delivery efficiency and enable transitions toward various value- or risk-based healthcare ecosystems. The market is likely to observe fierce competitive rivalry as small modular PHM firms compete against large, platform providers. Winners will successfully weigh in market needs and offer secure, interoperable, and highly customized PHM solutions that achieve the coveted triple aim around cost, quality, and access.

Key Questions this Study will Answer

  • How to define the population health management (PHM) market? How to functionally represent the PHM ecosystem?
  • How is the PHM ecosystem being implemented and optimized by different healthcare entities (payer and provider communities)?
  • How to migrate from a traditional fee-for-service (FFS) operating model to a PHM-enabled value-based reimbursement (VBR) one? How should the roles and responsibilities be disseminated strategically to ensure success? What can be learned from recent PHM implementations?
  • What are the key drivers and restraints that will affect the US PHM market over the next 5 years?
  • What are the competitive characteristics of the US PHM market? Which are the key participants in the market? How are the different price models, contract models, and engagement models placed in the market?
  • What is the value of the US PHM market? How is it expected to grow in the next 5 years?

Table of Contents

1. EXECUTIVE SUMMARY

  • 1. Key Findings-The US PHM Market
  • 2. Key Findings-The US PHM Market (continued)
  • 3. Key Findings-The US PHM Market (continued)
  • 4. Key Findings-The US PHM Market (continued)
  • 5. Scope and Segmentation
  • 6. Measurements
  • 7. Measurements (continued)
  • 8. Key Questions this Study will Answer
  • 9. CEO's Perspective
  • 10. Executive Summary-3 Big Predictions

2. MARKET OVERVIEW

  • 1. Market Scope and Definition for PHM
  • 2. Market Background
  • 3. Top Healthcare Industry Imperatives-The United States
  • 4. Transition to Accountable Care-4 Essential Steps to Follow
  • 5. Fundamental Characteristics Required to Facilitate PHM
  • 6. Goal of PHM-Shifting Emphasis from Immediate Care to Prevention
  • 7. The Road to Accountable Care-US PHM Market
  • 8. Category Segmentation of the US PHM Market
  • 9. Customer Segmentation of the US PHM Market
  • 10. Definition of Key Customer Market Segments
  • 11. PHM Business Objectives by Key Customer Segments

3. MACRO CONDITIONS PROMPTING POPULATION HEALTH MANAGEMENT

  • 1. Inefficiency in Traditional Healthcare Systems
  • 2. Socioeconomic Indicators
  • 3. Rising Demand for Healthcare
  • 4. Growth of Chronic Diseases
  • 5. Massive Cost Burden of Chronic Disease Management
  • 6. Rising National Health Expenditure
  • 7. Evolving Reimbursement Frameworks Drive Accountable Care
  • 8. Risk-Based Reimbursements Tie Provider Revenue with Performance

4. INTRODUCTION TO POPULATION HEALTH MANAGEMENT

  • 1. Population Health Management-Definition
  • 2. Population Health Management-Overview
  • 3. Type of PHM Solutions-Market Has a Technology for Every Health System
  • 4. Evolution of PHM
  • 5. PHM-Market Maturity Indicator
  • 6. Evolution of PHM-Technology Roadmap
  • 7. Market Drivers
  • 8. Market Restraints

5. PHM SEGMENT LEVEL ANALYSIS

  • 1. Market Segmentation
  • 2. Advisory-Key Goals
  • 3. Advisory
  • 4. Data Aggregation and Management-Key Goals
  • 5. Data Aggregation and Management-Evolving Service Models
  • 6. Data Aggregation and Management-Key Market Observations
  • 7. Risk Stratification-Key Goals
  • 8. Risk Stratification and Modeling-Framework that Enables PHM
  • 9. Care Coordination-Key Goals
  • 10. Care Coordination
  • 11. Care Coordination (continued)
  • 12. Patient Engagement-Key Goals
  • 13. Patient Engagement-A Key Focus Area across All Stakeholders
  • 14. Successful Patient Engagement Requires Behavioral Change for Patients and Their Providers
  • 15. Past and Future Approaches to Patient Engagement
  • 16. Basic-to-Advanced Patient Engagement Guidelines
  • 17. Adoption Outlook of Different Patient Engagement Solutions
  • 18. Performance Management-Key Goals
  • 19. Performance Management

6. IMPLEMENTATION OF PHM

  • 1. PHM Value Chain Analysis
  • 2. Payers Triggered PHM to Support Implementation of Value-based Reimbursement Programs
  • 3. Traditional vs. PHM-enabled Care Delivery-Comparative Ecosystem
  • 4. Patient Condition Management through Analytics-Contextual Framework
  • 5. PHM Technology Ecosystem Aid Patient-Centered Care Delivery
  • 6. Population Health Management-Functional Architecture
  • 7. Progressive PHM Approach by Care Settings
  • 8. PHM IT Solutions Interface with Various Clinical and Administrative Solutions to Address Program Objectives
  • 9. Top PHM Investment Areas
  • 10. Incremental Growth Potential for Leading Healthcare Information Technologies that aid PHM

7. PROCUREMENT OF PHM SERVICES

  • 1. PHM Procurement-Snapshot
  • 2. Supply-Demand Dynamics
  • 3. Engagement Strategy
  • 4. Contract Strategy
  • 5. Sourcing Strategy
  • 6. Cost Structure-Vendors
  • 7. Cost Structure-Vendors (continued)
  • 8. Cost Structure-Providers
  • 9. Cost Structure-Providers (continued)
  • 10. Procurement Quick Wins

8. PRICING MODELS FOR PHM SOLUTIONS

  • 1. Pricing Strategy for Specific PHM Applications
  • 2. PHM Pricing Models
  • 3. Software-license-based Pricing Tied to Coverage
  • 4. Software-license-based Pricing Tied to Coverage (continued)
  • 5. Risk-based Pricing Tied to Outcomes
  • 6. Risk-based Pricing Tied to Outcomes (continued)

9. FORECASTS AND TRENDS-TOTAL POPULATION HEALTH MANAGEMENT MARKET

  • 1. Measurements
  • 2. Forecast Assumptions and Definitions
  • 3. Forecast Assumptions and Definitions (continued)
  • 4. Revenue Forecast
  • 5. Revenue Forecast Discussion
  • 6. Percent Revenue Forecast by Customer Segment
  • 7. Revenue Forecast by Segment
  • 8. Revenue Forecast by Segment Discussion
  • 9. Revenue Forecast by Segment Discussion (continued)
  • 10. Pricing Analysis-Projected Unit Price Variance
  • 11. Pricing Analysis by PHM Customer Segment-ACOs
  • 12. Pricing Analysis by PHM Customer Segment-Payers & Payer-Providers
  • 13. Pricing Analysis by PHM Customer Segment-Non-ACO Hospitals
  • 14. Pricing Analysis by PHM Customer Segment-Non-ACO Physician Practices

10. FORECASTS AND TRENDS-MARKET SEGMENTS

  • 1. Measurements-ACOs Segment
  • 2. Revenue Forecast-ACOs Segment
  • 3. Measurements-Payers & Payer-Providers Segment
  • 4. Revenue Forecast-Payers & Payer-Providers Segment
  • 5. Measurements-Non-ACO Hospitals Segment
  • 6. Revenue Forecast-Non-ACO Hospitals Segment
  • 7. Measurements-Non-ACO Physician Practices Segment
  • 8. Revenue Forecast-Non-ACO Physician Practices Segment

11. DEMAND ANALYSIS

  • 1. Penetration Analysis-ACOs
  • 2. Penetration Analysis-Payers & Payer-Providers
  • 3. Penetration Analysis-Non-ACO Hospitals
  • 4. Penetration Analysis-Non-ACO Physician Practices

12. COMPETITIVE ENVIRONMENT

  • 1. Market Gaps in the United States
  • 2. Recommendations for the US Market
  • 3. Changes in the Supply Market Landscape-Analyst Perspective
  • 4. PHM Vendors Capability Matrix-Definitions
  • 5. PHM Vendors Capability Matrix-Snapshot
  • 6. PHM Vendors Capability Matrix-Key Observations
  • 7. Mapping of Leading Ecosystem Players
  • 8. Complex Supply Dynamics of the US PHM Market
  • 9. Select PHM Companies and Products
  • 10. Select PHM Companies and Products (continued)
  • 11. Competitive Market Structure
  • 12. Competitive Market Structure (continued)
  • 13. Competitive Market Structure (continued)
  • 14. Competitive Market Structure (continued)
  • 15. Competitive Market Structure (continued)
  • 16. Competitive Market Structure (continued)
  • 17. Competitive Market Structure (continued)
  • 18. Recent Notable M&As-Investment and Withdrawals
  • 19. Recent Notable M&As-Investment and Withdrawals (continued)
  • 20. Recent Notable M&As-Investment and Withdrawals (continued)
  • 21. Top Companies to Watch

13. SELECTED VENDOR PROFILES

  • 1. Optum-Corporate Background
  • 2. Optum-PHM Value Chain
  • 3. Optum-SWOT Analysis
  • 4. Caradigm-Corporate Background
  • 5. Caradigm-PHM Value Chain
  • 6. Caradigm-SWOT Analysis
  • 7. Healthagen-Corporate Background
  • 8. Healthagen-PHM Value Chain
  • 9. Healthagen-SWOT Analysis
  • 10. Evolent Health-Corporate Background
  • 11. Evolent Health-PHM Value Chain
  • 12. Evolent Health-SWOT Analysis
  • 13. IBM Watson Health-Corporate Background
  • 14. IBM Watson Health-Platform solutions for the PHM Value Chain
  • 15. IBM Watson Health-SWOT Analysis
  • 16. Health Catalyst-Corporate Background
  • 17. Health Catalyst-PHM Value Chain
  • 18. Health Catalyst-SWOT Analysis
  • 19. ENLI-Corporate Background
  • 20. ENLI-PHM Value Chain
  • 21. ENLI-SWOT Analysis
  • 22. ZeOmega-Corporate Background
  • 23. ZeOmega-PHM Value Chain
  • 24. ZeOmega-SWOT Analysis
  • 25. Future Perspectives
  • 26. Future Perspectives-3 Big Predictions
  • 27. The Last Word-Discussion
  • 28. Legal Disclaimer

14. APPENDIX

  • 1. Additional Frost & Sullivan Sources of Information on Healthcare
  • 2. Methodology
  • 3. Learn More-Next Steps

List of Exhibits

  • Population Health Management Market: Patient-Centered Care Delivery Ecosystem, US, 2015
  • Total Population Health Management Market: Market Engineering Measurements, US, 2015
  • Population Health Management Market: Top Healthcare Industry Imperatives, US, 2015
  • Population Health Management Market: Category Segmentation, US, 2015
  • Population Health Management Market: Customer Segmentation, US, 2015
  • Population Health Management Market: Mortality Rates, US, 2000-2010
  • Population Health Management Market: Growth of Chronic Diseases, US, 2000-2025
  • Population Health Management Market: Cost of Chronic Disease Management, US, 2011
  • Projected Average Annual Growth for GDP and Select NHE Categories, US, 2014-2020
  • Population Health Management Market: Evolving Payment Programs, US, 2016
  • Population Health Management Market: Advanced PHM Solutions, US, 2014-2020
  • Population Health Management Market: Market Drivers, US, 2016-2020
  • Population Health Management Market: Market Restraints, US, 2016-2020
  • Population Health Management Market: Category Segmentation, US, 2015
  • Population Health Management Market: Patient Engagement Strategy Outlook, US, 2005-2025+
  • Population Health Management Market: Payer-Provider Collaboration to Pursue PHM, US, 2015
  • Population Health Management Market: Typical Patient Composition within a Hospital System, US, 2015
  • Population Health Management Market: PHM by Type of Healthcare Facility, US,
  • 2016-2020
  • Population Health Management Market: Technology Architecture, US, 2016
  • Population Health Management Market: Top Investment Areas, US, 2015
  • Population Health Management Market: Adoption of Major PHM Enablers among Survey Respondents, US, 2014
  • Population Health Management Market: Supply-Demand Dynamics, US, 2015
  • Total Population Health Management Market: Market Engineering Measurements, US, 2015
  • Total Population Health Management Market: Revenue Forecast, US, 2015-2020
  • Population Health Management Market: Market Summary, US, 2015-2020
  • Total Population Health Management Market: Percent Revenue Forecast by Segment, US, 2015-2020
  • Total Population Health Management Market: Revenue Forecast by Segment, US, 2015-2020
  • Total Population Health Management Market: Pricing Analysis, US, 2015-2020
  • ACOs Segment: Market Engineering Measurements, US, 2015
  • ACOs Segment: Revenue Forecast, US, 2015-2020
  • Payers & Payer-Providers Segment: Market Engineering Measurements, US, 2015
  • Payers & Payer-Providers Segment: Revenue Forecast, US, 2015-2020
  • Non-ACO Hospital Segment: Market Engineering Measurements, US, 2015
  • Non-ACO Hospitals Segment: Revenue Forecast, US, 2015-2020
  • Non-ACO Physician Practice Segment: Market Engineering Measurements, US, 2015
  • Non-ACO Physician Practices Segment: Revenue Forecast, US, 2015-2020
  • ACOs Segment: Penetration Analysis, US, 2015
  • Payers & Payer-Providers Segment: Penetration Analysis, US, 2015
  • Non-ACO Hospitals Segment: Penetration Analysis, US, 2015
  • Non-ACO Physician Practices Segment: Penetration Analysis, US, 2015
  • Total Population Health Management Market: Top Vendors, US, 2015
  • Total Population Health Management Market: Types of Vendors, US, 2015
  • Total PHM Market: Select Market Participants by Tiers of Competition, US, 2015
  • Total PHM Market: Competitive Market Structure, US, 2015
  • Total Population Health Management Market: Notable Industry Deals, US, 2014-2015
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