population health management – north america – 2019 · population health management – north...

Market Reports

Population Health Management – North America – 2019

‘2018 was by no means a ‘turnaround’ year for the North American PHM market, with even more uncertainty in relation to the future of VBC added into the mix. A lack of incentives for providers to go ‘at risk’ continues to limit the deployment of PHM solutions, with vendors targeting smaller IDNs and hospitals through managed service offerings to increase adoption. Whilst growth in the provider market remains lacklustre, opportunities are increasing from payers as they integrate themselves further with growing US health systems, driving demand for vendors able to adapt their portfolios.’

Published July 2019

Michael Liberty, Senior Market Analyst

2019 Edition

Report Author: Michael Liberty, Senior AnalystMichael joined Signify Research in 2018 as part of the Digital Health team focusing on PHM and EHR/EMR. He brings with him five years’ experience as a Senior Market Analyst.

www.signifyresearch.net | @signifyresearch


Table of ContentsChapter 1 Introduction, Scope and Methodology

Chapter 2 Key Trends & Analysis: Population Health Management2.0 Introduction2.1 Key Market Developments and Changes Since Last Report2.1.1 Top Takeaways: Growth Slows in 2018 and Growing Uncertainty2.1.2 Changes to 2018 Projections Since September 2018 Report2.1.3 Medium Term Forecast Update2.1.4 Forecast Risks and Issues to be Addressed 2.1.5 Headline Developments in the Competitive Environment2.2 Factors Driving Growth and Barrier to Growth2.2.1 Spiralling Healthcare Spending in North America2.2.2 The Affordable Care Act & Its Future2.2.3 Changes to the ACO Model Through MSSP2.2.4 MACRA Drive Outcome Measurements2.2.5 Market Maturity Driving Growth2.2.6 SDOH Still Underutilised in the Marketplace 2.2.7 Market Adoption of AI & Machine Learning 2.2.8 Pre-emptive VBC Adoption2.2.9 CMS Primary Care Payment Models & Financial Challenges2.2.10 Market Consolidation and ‘Payviders’2.2.11 Success in the Current VBC Reimbursement Models2.3 Market Trends and Key Assumptions2.3.1 Growth in Lives Managed2.3.2 Pricing Models2.3.3 Average Revenue per Life Managed Per Month 2.3.4 Development of the Market by Function2.3.5 SaaS & Hosted Services2.3.6 Services2.3.7 Product and Market Development by Risk Group2.4 North American PHM Market

Estimates and Forecasts2.4.1 North American Market for PHM IT by Scenario2.4.2 North American Market for PHM IT by Quarter 2.4.3 North American Market for PHM IT by Function 2.4.4 North American Market for PHM IT by Vertical2.4.5 North American Market for PHM IT – Software Versus Services2.4.6 North American Market for PHM IT – By Country2.5 Canada

Chapter 3 The Competitive Environment3.1 Top Level Market Shares3.1.1 Market Leaders3.2 Market Share by Vertical3.2.1 Market Leaders to the Provider Market3.2.2 Market Leaders to the Payer Market3.3 Competitive Landscape3.3.1 Payer/Provider Owned Vendors3.3.2 EHR Vendors3.3.3 PHM Specialists3.3.4 Healthcare IT Generalists3.4 Mergers and Acquisitions3.4.1 Notable Activity During 20183.4.2 Notable Developments in 2019 3.4.3 Significant Historic Activity

Chapter 4 Company Profiles4.1 3M4.2 Aetna/ CVS Health4.3 Allscripts, Inc.4.4 Arcadia.io4.5 athenahealth4.6 Cerner4.7 Change Healthcare4.8 Conifer Health Solutions4.9 Cotiviti4.10 CPSI4.11 DXC4.12 eClinicalWorks4.13 Enli Health Intelligence4.14 Epic4.15 Evolent Health4.16 EXL Service4.17 Forward Health Group4.18 GSI Health

4.19 Health Catalyst4.20 HealthEC4.21 HMS4.22 Humana4.23 i2i Population Health4.24 IBM Watson Health4.25 Innovaccer4.26 Insignia Health4.27 InterSystems4.28 LexisNexis Risk Solutions4.29 Lightbeam4.30 Livongo4.31 MedeAnalytics4.32 Medecision 4.32 Meditech 4.33 NextGen Health4.34 Optum4.35 Orion Health4.36 Philips4.37 Premier Inc.4.38 SPH Analytics4.39 Wolters Kluwer4.40 ZeOmega

Appendix 1 Research Scope and MethodAP1.1 IntroductionAP1.2 Report ContentAP1.3 ScopeAP1.3.1 Geographic Scope and DefinitionsAP1.4 Research MethodAP1.4.1 Information SourcesAP1.4.2 Market Sizing and Forecast MethodAP1.5 Exchange Rates

Appendix 2 Underlying Market Drivers AP2.1 Factors Driving Growth AP2.1.1 Spiralling Health Care Spending in North AmericaAP2.1.2 The Affordable Care ActAP2.1.3 Development of Accountable Care Organisations (ACOs)AP2.1.4 Transition to Value-based CareAP2.1.5 MACRA & The Quality Payment ProgramAP.2.2 Factors Restricting GrowthAP2.2.1 The Impact of the Trump Administration on the ACAAP2.2.2 Uncertainty over Future Legislation

Appendix 3 – Product List



Report Content

Report Features

Detailed analysis by product type, vertical, service v software, and by country

Primary research method ensures accuracy and reliability

Robust forecasts driven by proprietary database of hospital infrastructure

Direct access to the lead Analyst North American specific coverage, with country level analysis

Highly data-centric, with numerous market segmentations. New for 2019 - reporting tools market broken out

Actionable, jargon-free analyst insight and opinion

Expert commentary on the market trends

Historic data is presented for 2016, 2017 and 2018 with forecasts for the period 2019 to 2023.

The market is broken out by platform module into:

- Analytics/Data Aggregation- Care Management/Coordination- Patient Engagement- Reporting & Optimisation

Each market metric is presented in terms of:

- Revenues- Lives Managed- Average Revenue Per Life

Quarterly estimates provided for 2016, 2017 and 2018

The provider market is further segmented by installation type:

- Ambulatory Only- Independent Hospital- Enterprise Multi-site - Multi-provider Network/ACO

For each platform module the market is segmented by:

Product Type - Software - On Premise Software- Cloud-hosted Software

Product Type - Service- Implementation Services- Support Services

Country- US- Canada

Customer Type- Provider- Payer- Employer- Other

Market Share Estimates are provided by quarter for the following: - Analytics/Data Aggregation- Care Management/Coordination- Patient Engagement- Reporting & Optimisation

Note: a separate report covering the below countries will be available from September 2018:

EMEA- Benelux - DACH- France - Italy - Spain/Port. - Nordics- UK/Eire - E. Europe - Rest Europe - MEA

Asia- China - India- Japan - Rest of Asia- Australia/New Zealand

Latin America- Brazil - Mexico- Rest of Latin America

Vendor profiles are presented for 40 PHM vendors including SWOT analysis and product overview



Deliverables

Report Overview

Market DataEach PHM function segmented by product, vertical, and country with 5-year forecasts. Data presented in revenues, lives managed and revenue per life managed (PMPM).

Analyst CommentaryExpert insights on product, function, and vertical trends.Explanation of the assumptions behind the forecasts along with “Our Take” on key issues.

Competitive LandscapeVendor market shares for each product by year and quarter.40 profiles of international and local market players offering a deep-dive into SWOT, strategy and products.

Report ResourcesPDF report format and interactive Excel database that enables you to build your own views of the market data by selecting specific product, application and regional categories. Includes all static tables and figures.Accompanying Powerpoint executive summary.

Market

9 Identify the products and end-markets driving growth

9 Review the market drivers and barriers for growth

9 Quantitative analysis of market size and forecast growth

Competition

9 Market share estimates for the leading vendors

9 Detailed profiles of 40 vendors, with SWOT analysis for each

9 Identify potential partners and acquisition targets

Technology

9 Analysis of the market by product, vertical, customer size, software/service, service type and country

9 Aggregation/stratification, care management/care coordination and patient engagement module development

9 Impact of recent legislative uncertainty

Strategy

9 Review of go-to-market strategies 9 Analysis and insights to support your strategy

planning 9 Product pricing and software licensing strategies



Research Method

Scope research with industry stakeholdersTalk with industry stakeholders to understand their information needsIssue proposed research agenda and invite customers to take Advance Purchase option

Interview technology vendorsEvaluate supply to the market and the trends that will impact growth Strong focus on collecting sales, shipments and pricing data

Interview healthcare providersConduct in-depth interviews with healthcare professionals across the USStrong focus on open-ended and probing questions

Healthcare infrastructure database Leverage Signify Research’s proprietary database of key metrics on national healthcare systemsAllows for the impact of macro-economic and health infrastructure trends to be monitored

Collate secondary researchSupplement primary research with a variety of secondary research sourcesCompany news and financial information, economic data, conference proceedings, etc.

Review preliminary data with Advance PurchasersSend preliminary market data to customers for review, as quality control measureRefine market size estimates and growth forecasts based on feedback

Ongoing Analyst supportQ&A session to highlight the key findings of the research and to answer customer questionsOngoing support to help customers stay informed of latest market developments

Sample Tables and Figures



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population health management – north america – 2019 · population health management – north...

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