The healthcare industry is undergoing a major transformation as a result of the growing pressure to provide more cost-effective personalized care. The push towards predictable outcomes and higher quality of care is resulting in the convergence of information technologies. In this regard, accountable care solutions facilitate innovation and coordination, and help improve the cost-efficacy, quality, and safety of medical care delivery systems.
The overall global accountable care solutions market is expected to grow from USD 8.75 billion in 2016 to USD 18.85 billion by 2021 at a CAGR of 16.6%. Furthermore, these solutions help in maintaining patient-provider communications, clinical data repositories, HIE interoperability, terminology mapping and EHR integration, and patient engagement. The base year considered for the study is 2015, and the forecast has been provided for the period between 2016 and 2021.
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Market Dynamics
Drivers
Implementation of government regulations and initiatives to promote patient-centric care
Implementation of incentives to shift the burden of risk from healthcare payers to providers
Increasing number of accountable care organizations
Rising need to curtail healthcare costs
Advancing It and Big Data Capabilities
Rising Geriatric Population and Subsequent Growth in the Burden of Chronic Diseases
Restraints
Lack of interoperability
High investments required for supporting infrastructure
Data security concerns
Opportunities
Increasing focus on value-based medicine
Emerging markets
Growing adoption of cloud-based models
Challenges
Reluctance of providers to adopt accountable care solutions
Lower reimbursement rates within the value-based care model
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Increasing number of accountable care organizations drives the global accountable care solutions market
There has been a steady rise in the number of ACOs in the US since 2010. In 2015, the total number of private and Medicare ACOs exceeded 700, covering ~20 million Americans (Source: Department of Healthcare Policy and Research). In addition, according to the CMS, the number of ACOs has been growing by about 100 organizations each year. According to the Centers for Medicare & Medicaid Services (CMS), the number of ACOs participating in Medicare programs is now 477. This includes 21 NGACOs, 434 MSSP ACOs, 9 Pioneer ACOs, and 13 Comprehensive ESRD Care Model (CEC) ACOs. Medicare ACOs are now responsible for 8.9 million beneficiaries, up from 7.3 million in April 2015. Approximately 180,000 physicians and practitioners are now involved in Medicare ACOs. To achieve their specific standards, ACOs are increasingly adopting accountable care solutions.
Major Market Developments
In September 2016, McKesson launched McKesson Intelligence Hub, a new technology platform for enabling interoperability and sharing business intelligence among healthcare applications. This will help the company to provide automated reimbursement solutions and help streamline payment by making interoperability easy for customers, partners, and vendors across the healthcare ecosystem.
In August 2016, Aetna expanded its accountable care collaboration with Duke Health (U.S.) and WakeMed Health & Hospitals (U.S.). This collaboration would help the company to deliver better value through quality, cost-effective care, and improved population health management.
In July 2016, McKesson acquired HealthQX (U.S.). This acquisition helped the company to expand its value-based care portfolio with HealthQX’s value-based payment technology solution, ClarityQx.
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The reluctance of providers in terms of adopting accountable care solutions, coupled with the limited infrastructure & capabilities to support these solutions, is restraining the growth of the accountable care solutions market. Cooperation of providers is very important for the implementation of accountable care software and services; providers may be reluctant due to lack of infrastructure to support these solutions or lack of skills or training to implement these solutions. To ensure the use of accountable care solutions to their full potential, healthcare providers should be engaged in collecting and integrating data, involving their staff in accountable care efforts, counselling and engaging patients in the care process, and streamlining workflows. However, due to financial or time-related constraints, providers display reluctance to employ accountable care solutions.
Critical questions the report answers:
Where will all these developments take the industry in the mid to long term?
What are the upcoming industry trends for accountable care organization solutions?
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