醫療提供者網路管理的全球市場 - 成長，趨勢，預測(2018年∼2023年)
Global Healthcare Provider Network Management Market - Segmented by Component (Provider Network Management Services and Provider Network Management Software), and Geography - Growth, Trends, and Forecast (2018 - 2023)
The Global Healthcare Provider Network Management Market is expected to register a CAGR of nearly 10.5% during 2018-2023 (the forecast period). Healthcare Provider Network Management Market involves activities like contracting, service inquiry, documentation, and data management etc. to efficiently manage provider networks, reduce healthcare costs and improve patient outcomes.
Healthcare provisions such as Health Information Technology for Economic and Clinical Health (HITECH) Act (2009 ); Patient Protection and Affordable Care Act (ACA 2010); and key portions of the Medicare Access and CHIP Reauthorization Act (MACRA), are implemented to reduce medical costs and improve health outcomes. Healthcare provider networks management is helping insurers to expand their network by including low cost providers. A high value provide network with plan design feature enable to provide insurance at lower Provider network management. With decreasing margins of revenue for both providers and payers they are dependent on provider network management solutions that provide Payer's End-to-End Provider Lifecycle Management. Provider network management helps insurers to avoid penalty or fines charged by CMS through automation in data collection, expanding provider network that benefit in reducing costs and increase operational efficiency. Other factor which is driving the Healthcare Provider Network Management Market growth is strict government regulations in US for the implementation of such services.
Healthcare Provider network software solutions comprise automated provider network system, integration systems for internal and external sources and work flow management. Building a solution or outsourcing it to third party provider with respect to the need of payers and providers involves costs and additional maintenance expenses for maintaining databases and support staff of Developers, database administrators, data analysts, dashboard developers etc. The costs occur whenever a new software is upgraded or new applications are installed and integrated. The above factor may hinder the market growth as the healthcare facilities due to cost show little interest in deployment.
Provider network management helps providers the real time data of their patient status. The solution uses analytical dashboards that have access to patient care plan, medical and pharmacy claims data and diagnostic results. With Provider network management solutions providers are benefited with self-service tools that they can use for inquiry to check on patients care plan, eligibility, claim status etc. Provider network management services include: Provider data management, Payment Bundling, Provider network administration, Claims pricing, Product & contract management, and Network analysis & compliance reporting etc. Provider data management has become crucial as Centers for Medicare and Medicaid Services can fine up to USD 25,000 per error Medicare Advantage plan and USD 100 for error in per beneficiary for health plan sold through HealthCare. With the analytical support payers can design bundled payment schemes, Payment Bundling allows improve quality of care and reduce cost. Provider network administration is useful in member retention, stay competitive in market with new reimbursement models and new product implementation.
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