Frost Radar™: US Population Health Management Market, 2021
Published on: 01-Jun-2021 | SKU: HC03418-NA-MR_25473

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After pausing while the US healthcare industry struggled to contain COVID-19, the stringent audit process for value-based care (VBC) is back in full swing for 90% of Medicare reimbursement that is currently attributed to some form of quality or risk-based payment plan. Additionally, CMS has launched new guidance for value-based reimbursement among the Medicaid population, in which 67% of reimbursement remains fee-for-service (FFS).

The expanded scope of VBC will compel health systems to invest in a range of public health management (PHM) capabilities that cover all types of government-sponsored health insurance and demonstrate proven ability to meet quality performance criteria for specific insured populations (e.g., Medicare Advantage, Medicaid Advantage, and Long-Term Services and Supports).

Accountable care organizations (ACOs) are increasing their enrollment into risk-based payment plans (from 9% of all ACOs in 2017 to 74% in 2020) and driving adoption of PHM solutions that aid cross-continuum data interoperability and integrated care management.

However, next-generation ACOs (NGACOs) that pioneered adoption of VBC payment plans are failing to report the desired business outcomes. In fact, 50 such NGACOs reported additional spending of $93 million in the first 2 years of their program against savings of $86 million, which they reported in the first year of the same program. Consequently, they are devising PHM strategies that guarantee improved financial outcomes while being clinically result-oriented and operationally streamlined.

In a field of more than 50 industry participants, Frost & Sullivan independently plotted the top 11 companies in this Frost Radar™ analysis. The Radar™ reveals the market positioning of each company using its Growth and Innovation scores as highlighted in the Frost Radar™ methodology. The document presents competitive profiles on each company based on its strengths, opportunities, and market positioning. We discuss strategic market imperatives and the competitive environment that vendors operate in as well as make recommendations for each provider to spur growth.

Author: Koustav Chatterjee

Strategic Imperative

Strategic Imperative (continued)

Strategic Imperative (continued)

Growth Environment

Growth Environment (continued)

Frost Radar™: US Population Health Management Market, 2021

Frost Radar™: Competitive Environment

Frost Radar™: Competitive Environment (continued)

Allscripts

Cedar Gate Technologies

Cerner

Health Catalyst

Health EC

Innovaccer

Lightbeam Healthcare

Medeanalytics

Optum

Philips

ZeOmega

Strategic Insights

Significance of Being on the Frost Radar™

Frost Radar™ Empowers the CEO’s Growth Team

Frost Radar™ Empowers Investors

Frost Radar™ Empowers Customers

Frost Radar™ Empowers the Board of Directors

Frost Radar™: Benchmarking Future Growth Potential

Frost Radar™: Benchmarking Future Growth Potential

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Frost Radar™: Benchmarking Future Growth Potential 2 Major Indices, 10 Analytical Ingredients, 1 Platform

Growth Index

Growth Index (GI) is a measure of a company’s growth performance and track record, along with its ability to develop and execute a fully aligned growth strategy and vision; a robust growth pipeline system; and effective market, competitor, and end-user focused sales and marketing strategies.

  • Market Share (previous 3 years)
    This is a comparison of a company’s market share relative to its competitors in a given market space for the previous 3 years.
  • Revenue Growth (previous 3 years)
    This is a look at a company’s revenue growth rate for the previous 3 years in the market/industry/category that forms the context for the given Frost Radar™.
  • Growth Pipeline
    This is an evaluation of the strength and leverage of a company’s growth pipeline system to continuously capture, analyze, and prioritize its universe of growth opportunities.
  • Vision and Strategy
    This is an assessment of how well a company’s growth strategy is aligned with its vision. Are the investments that a company is making in new products and markets consistent with the stated vision?
  • Sales and Marketing
    This is a measure of the effectiveness of a company’s sales and marketing efforts in helping it drive demand and achieve its growth objectives.

Innovation Index

Innovation Index (II) is a measure of a company’s ability to develop products/ services/ solutions (with a clear understanding of disruptive Mega Trends) that are globally applicable, are able to evolve and expand to serve multiple markets and are aligned to customers’ changing needs.

  • INNOVATION SCALABILITY
    This determines whether an organization’s innovations are globally scalable and applicable in both developing and mature markets, and also in adjacent and non-adjacent industry verticals.
  • RESEARCH AND DEVELOPMENT
    This is a measure of the efficacy of a company’s R&D strategy, as determined by the size of its R&D investment and how it feeds the innovation pipeline.
  • PRODUCT PORTFOLIO
    This is a measure of a company’s product portfolio, focusing on the relative contribution of new products to its annual revenue.
  • MEGATRENDS LEVERAGE
    This is an assessment of a company’s proactive leverage of evolving, long-term opportunities and new business models, as the foundation of its innovation pipeline.
  • CUSTOMER ALIGNMENT
    This evaluates the applicability of a company’s products/services/solutions to current and potential customers, as well as how its innovation strategy is influenced by evolving customer needs.

Significance of Being on the Frost Radar™

Companies plotted on the Frost RadarTM are the leaders in the industry for growth, innovation, or both. They are instrumental in advancing the industry into the future.

  • GROWTH POTENTIAL
    Your organization has significant future growth potential, which makes it a Company to Action.
  • BEST PRACTICES
    Your organization is well positioned to shape Growth Pipeline™ best practices in your industry.
  • COMPETITIVE INTENSITY
    Your organization is one of the key drivers of competitive intensity in the growth environment.
  • CUSTOMER VALUE
    Your organization has demonstrated the ability to significantly enhance its customer value proposition.
  • PARTNER POTENTIAL
    Your organization is top of mind for customers, investors, value chain partners, and future talent as a significant value provider.

Have questions about this research or need deeper insights?
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Impacting your company's future growth potential.

After pausing while the US healthcare industry struggled to contain COVID-19, the stringent audit process for value-based care (VBC) is back in full swing for 90% of Medicare reimbursement that is currently attributed to some form of quality or risk-based payment plan. Additionally, CMS has launched new guidance for value-based reimbursement among the Medicaid population, in which 67% of reimbursement remains fee-for-service (FFS). The expanded scope of VBC will compel health systems to invest in a range of public health management (PHM) capabilities that cover all types of government-sponsored health insurance and demonstrate proven ability to meet quality performance criteria for specific insured populations (e.g., Medicare Advantage, Medicaid Advantage, and Long-Term Services and Supports). Accountable care organizations (ACOs) are increasing their enrollment into risk-based payment plans (from 9% of all ACOs in 2017 to 74% in 2020) and driving adoption of PHM solutions that aid cross-continuum data interoperability and integrated care management. However, next-generation ACOs (NGACOs) that pioneered adoption of VBC payment plans are failing to report the desired business outcomes. In fact, 50 such NGACOs reported additional spending of $93 million in the first 2 years of their program against savings of $86 million, which they reported in the first year of the same program. Consequently, they are devising PHM strategies that guarantee improved financial outcomes while being clinically result-oriented and operationally streamlined. In a field of more than 50 industry participants, Frost & Sullivan independently plotted the top 11 companies in this Frost Radar™ analysis. The Radar™ reveals the market positioning of each company using its Growth and Innovation scores as highlighted in the Frost Radar™ methodology. The document presents competitive profiles on each company based on its strengths, opportunities, and market positioning. We discuss strategic market imperatives and the competitive environment that vendors operate in as well as make recommendations for each provider to spur growth. Author: Koustav Chatterjee
More Information
Deliverable Type Frost Radar
No Index No
Podcast No
Author Koustav Chatterjee
Industries Healthcare
WIP Number K606-01-00-00-00
Is Prebook No
GPS Codes 9564-B1,9600-B1,9612-B1

Frost Radar™: US Population Health Management Market, 2021

HealthcareFrost Radar™: US Population Health Management Market, 2021

A Benchmarking System to Spark Companies to Action - Innovation That Fuels New Deal Flow and Growth Pipelines

RELEASE DATE
01-Jun-2021
REGION
North America
Deliverable Type
Frost Radar
Research Code: K606-01-00-00-00
SKU: HC03418-NA-MR_25473
AvailableYesPDF Download
$4,950.00
In stock
SKU
HC03418-NA-MR_25473