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U.S. Value-based Healthcare Service Market Size, Share & Trends Analysis Report by Models (Pay For Performance, Patient-centered Medical Home), by Payer, by Providers Utilization Category, and Segment Forecasts, 2022-2030

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    Report

  • 150 Pages
  • October 2022
  • Region: United States
  • Grand View Research
  • ID: 5681782
The U.S. value-based healthcare service market size is anticipated to reach USD 6.16 trillion by 2030. The market is expected to expand at a CAGR of 7.5% from 2022 to 2030. Increased adoption of value-based care beyond primary care, increase in healthcare spending as a percentage of GDP, and continued growth in home and virtual-based models are the major growth drivers for the industry.

The Centers for Medicare & Medicaid Services' objective is to transition all Medicare providers to two-sided risk arrangements and half of its commercial and Medicaid contracts to value-based models by 2025; currently, fewer than 20% of Medicare expenditure is value-based. The increase of consumerism in health care, the development of new technology, the need to fulfilling the Quadruple Aim, and prioritizing preventative care while decreasing unsustainable healthcare expenditures are the primary drivers of the shift to value-based care.

Healthcare reforms in recent years have highlighted the need for electronic health information, which has raised interest in digital solutions. Furthermore, the COVID-19 pandemic has accelerated business expansion by highlighting the benefits of using electronic health information to help improve patient care and scheduling. Several countries are implementing value-based care systems. This increases the demand for high-acuity IT solutions that boost clinical efficacy and workflow, thus supporting market growth.

The rapid evolution of value-based healthcare services is one of the factors driving this market's rapid growth. Due to value-based healthcare services, the healthcare cost curve and excessive health spending have decreased. According to "UnitedHealth Group," a US-based health insurance firm that delivers value-based payments to healthcare providers, this industry's development increased by more than 15% in 2019. It supports the delivery of high-quality treatment while improving the efficient use of healthcare resources.

Furthermore, "Cigna" acquired Bright Health in December 2021, bringing additional skills and resources to continue their development toward a value-based healthcare setting. Collaborations in value-based care are becoming increasingly popular among providers because they enable partners such as medical device makers, payers, and provider groups to build programs, solutions, and initiatives that benefit both patients and healthcare systems. For instance, in June 2021, “Humana’’ acquired League, a digital health company, to create a new digital platform for Humana employer group and specialty insurance members.

To take advantage of the various types of services and technology capabilities required for future success, forward-thinking payers are broadening their options and moving beyond traditional providers. These firms have employed several techniques to improve their position in the value-based healthcare services industry in the U.S., including partnerships, collaborations, joint ventures, and mergers and acquisitions. For instance, in February 2021, Optum, a healthcare provider, completed the acquisition of Leadmark Health, a home healthcare company. It will create the first of its home-based care health system and would accelerate home health care’s move toward value-based care.

U.S. Value-based Healthcare Service Market Report Highlights

  • Pay for performance accounted for the largest revenue share of 28.35% in 2021 due to the growing shift away from traditional fee-for-service toward payment for value-based healthcare programs
  • The medicare and medicare advantage segment was the largest revenue-generating segment in 2021. Medicare is gradually shifting away from fee-for-service compensation toward value-based models that promote cost-cutting and quality improvement
  • The industry is competitive as major players are focusing on investment, partnership, collaboration, mergers & acquisitions, and expansion strategies to improve their market penetration
  • In October 2021, Walgreens Boots Alliance, a holding company, made an investment of USD 5.2 billion in VillageMD, a primary care platform and value-based primary care service provider. The partnership between Walgreens and VillageMD will significantly enhance primary care access in underserved rural and urban regions; more than 75% of Americans reside within 5 miles of Walgreens. The investment increases WBA’s ownership stake in VillageMD to 63% from 30%


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Frequently Asked Questions about the U.S. Value-based Healthcare Service Market

What is the estimated value of the U.S. Value-based Healthcare Service Market?

The U.S. Value-based Healthcare Service Market was estimated to be valued at $3.46 trillion in 2022.

What is the growth rate of the U.S. Value-based Healthcare Service Market?

The growth rate of the U.S. Value-based Healthcare Service Market is 7.5%, with an estimated value of $6.16 trillion by 2030.

What is the forecasted size of the U.S. Value-based Healthcare Service Market?

The U.S. Value-based Healthcare Service Market is estimated to be worth $6.16 trillion by 2030.

Who are the key companies in the U.S. Value-based Healthcare Service Market?

Key companies in the U.S. Value-based Healthcare Service Market include Baker Tilly Us, Llp, Deloitte, Siemens Medical Solutions Usa, Inc., Boston Consulting Group, Change Healthcare, Athena Healthcare, Veritas Capital Fund Management, L.L.C., Unitedhealth Group., Nxgn Management, LLC. and Mckesson Corporation.

Table of Contents

Chapter 1 Research Methodology & Scope
1.1 Market Segmentation & Scope
1.1.1 Estimates And Forecast Timeline
1.2 Research Methodology
1.3 Information Procurement
1.3.1 Purchased Database:
1.3.2 Internal Database
1.3.3 Secondary Sources
1.3.4 Primary Research:
1.3.5 Details Of Primary Research
1.4 Information Or Data Analysis
1.4.1 Data Analysis Models
1.5 Market Formulation & Validation
1.6 Model Details
1.6.1 Mixed Approach Analysis (Model 1)
1.6.1.1 Approach 1: Mixed Approach
1.7 List Of Secondary Sources
1.8 List Of Primary Sources
1.9 Report Objectives
Chapter 2 Executive Summary
2.1 Market Outlook
2.1.1 U.S. Value-Based Healthcare Service Market Outlook, 2017 - 2030 (Billion)
2.2 Segment Outlook
2.3 U.S. Value-Based Healthcare Service Market Summary, 2021
Chapter 3 U.S. Value-Based Healthcare Service Market Variables, Trends & Scope
3.1 Penetration & Growth Prospect Mapping
3.2 U.S. Value-Based Healthcare Service Market Dynamics
3.2.1 Market Driver Analysis
3.2.1.1 Improved Chronic Health Condition Patient Management
3.2.1.2 Higher Incidence Of Chronic Non-Communicable Diseases
3.2.1.3 Rising Demand For More Integrated Care Delivery Models
3.2.1.4 Rising Organizational Restructuring Efforts
3.2.1.5 Rising Government Initiatives
3.2.2 Market Restraints Analysis
3.2.3 Unmet Needs/Opportunity Analysis
3.3 U.S. Value-Based Healthcare Service Market Analysis Tools: Porter’s Five Forces Analysis
3.3.1 Supplier Power: Moderate-High
3.3.2 Buyer Power: Moderate-High
3.3.3 Threat Of Substitutes: Low-Moderate
3.3.4 Threat Of New Entrants: Moderate- High
3.3.5 Competitive Rivalry: High
3.4 Pestel Analysis
3.4.1 Political & Legal Landscape
3.4.2 Social Landscape
3.4.3 Technology Landscape
3.5 Regulatory Framework
3.6 Covid-19 Impact Analysis
3.6.1 Current And Future Impact Analysis
3.6.2 Impact Of Covid-19 On Market Players
Chapter 4 U.S. Value-Based Healthcare Service Market: Models Estimates & Trend Analysis
4.1 Models Movement Analysis, 2021 & 2030
4.1.1 Pay For Performance
4.1.1.1 Pay For Performance Market Estimates And Forecasts, 2017 - 2030 (Billion)
4.1.2 Pay For Performance
4.1.2.1 Pay For Performance Market Estimates And Forecasts, 2017 - 2030 (Billion)
4.1.3 Patient-Centered Medical Home
4.1.3.1 Patient-Centered Medical Home Market Estimates And Forecasts, 2017 - 2030 (Billion)
4.1.4 Shared Savings
4.1.4.1 Shared Savings Market Estimates And Forecasts, 2017 - 2030 (Billion)
4.1.5 Shared Risk
4.1.5.1 Shared Risk Market Estimates And Forecasts, 2017 - 2030 (Billion)
4.1.6 Bundled Payment
4.1.6.1 Bundled Payment Market Estimates And Forecasts, 2017 - 2030 (Billion)
4.1.7 Capitation Models
4.1.7.1 Capitation Models Market Estimates And Forecasts, 2017 - 2030 (Billion)
Chapter 5 U.S. Value-Based Healthcare Service Market: Payer Category Estimates & Trend Analysis
5.1 Payer Category Movement Analysis, 2021 & 2030
5.1.1 Medicare And Medicare Advantage
5.1.1.1 Medicare And Medicare Advantage Market Estimates And Forecasts, 2017 - 2030 (Billion)
5.1.2 Medicaid
5.1.2.1 Medicaid Market Estimates And Forecasts, 2017 - 2030 (Billion)
5.1.3 Commercial
5.1.3.1 Commercial Medical Home Market Estimates And Forecasts, 2017 - 2030 (Billion)
Chapter 6 U.S. Value-Based Healthcare Service Market: Providers Utilization Category Estimates & Trend Analysis
6.1 Providers Utilization Category Movement Analysis, 2021 & 2030
6.1.1 Home Health Care
6.1.1.1 Home Health Care Market Estimates And Forecasts, 2017 - 2030 (Billion)
6.1.2 Institutional Care
6.1.2.1 Institutional Care Market Estimates And Forecasts, 2017 - 2030 (Billion)
6.1.3 Self-Care
6.1.3.1 Self-Care Market Estimates And Forecasts, 2017 - 2030 (Billion)
6.1.4 Hospital Therapy
6.1.4.1 Hospital Therapy Market Estimates And Forecasts, 2017 - 2030 (Billion)
Chapter 7 U.S. Value-Based Healthcare Service Market: Home Health Care Providers Utilization Category Estimates & Trend Analysis
7.1 Home Health Care Providers Utilization Category Movement Analysis, 2021 & 2030
7.1.1 Frontloading Skilled Nursing Visits
7.1.1.1 Frontloading Skilled Nursing Visits Market Estimates And Forecasts, 2017 - 2030 (Billion)
7.1.2 Specialized Frontloading Therapy Visits
7.1.2.1 Specialized Frontloading Therapy Visits Market Estimates And Forecasts, 2017 - 2030 (Billion)
Chapter 8 U.S. Value-Based Healthcare Service Market: Hospital Therapy Category Estimates & Trend Analysis
8.1 Hospital Therapy Category Movement Analysis, 2021 & 2030
8.1.1 Inpatient
8.1.1.1 Inpatient Market Estimates And Forecasts, 2017 - 2030 (Billion)
8.1.2 Outpatient
8.1.2.1 Outpatient Market Estimates And Forecasts, 2017 - 2030 (Billion)
Chapter 9 Competitive Landscape
9.1 Market Participation Categorization
9.2 Companies
9.2.1 Company Market Position Analysis
9.2.2 Major Deals & Strategic Alliances
9.2.3 Detailed List Of Players
Chapter 10 Company Profile
10.1 Baker Tilly US, LLP
10.1.1 Company Overview
10.1.2 Financial Performance
10.1.3 Product Benchmarking
10.1.4 Strategic Initiatives
10.2 Deloitte
10.2.1 Company Overview
10.2.2 Financial Performance
10.2.3 Product Benchmarking
10.2.4 Strategic Initiatives
10.3 Siemens Medical Solutions USA, Inc.
10.3.1 Company Overview
10.3.2 Financial Performance
10.3.3 Product Benchmarking
10.4 Boston Consulting Group
10.4.1 Company Overview
10.4.2 Financial Performance
10.4.3 Product Benchmarking
10.4.4 Strategic Initiatives
10.5 Change Healthcare
10.5.1 Company Overview
10.5.2 Financial Performance
10.5.3 Product Benchmarking
10.5.4 Strategic Initiatives
10.6 Athena Healthcare
10.6.1 Company Overview
10.6.2 Financial Performance
10.6.3 Product Benchmarking
10.6.4 Strategic Initiatives
10.7 Veritas Capital Fund Management, L.L.C.
10.7.1 Company Overview
10.7.2 Financial Performance
10.7.3 Product Benchmarking
10.7.4 Strategic Initiatives
10.8 UnitedHealth Group.
10.8.1 Company Overview
10.8.2 Financial Performance
10.8.3 Product Benchmarking
10.8.4 Strategic Initiatives
10.9 NXGN Management, LLC.
10.9.1 Company Overview
10.9.2 Product Benchmarking
10.9.3 Strategic Initiatives
10.10 McKesson Corporation
10.10.1 Company Overview
10.10.2 Financial Performance
10.10.3 Product Benchmarking
10.10.4 Strategic Initiatives
10.11 Genpact
10.11.1 Company Overview
10.11.2 Financial Performance
10.11.3 Product Benchmarking
10.11.4 Strategic Initiatives
10.12 Unlimited Technology Systems, LLC
10.12.1 Company Overview
10.12.2 Financial Performance
10.12.3 Product Benchmarking
10.12.4 Strategic Initiatives
10.13 ForeSee Medical, Inc.
10.13.1 Company Overview
10.13.2 Financial Performance
10.13.3 Product Benchmarking
10.13.4 Strategic Initiatives
10.14 Signify Health, Inc. (Sentara Healthcare)
10.14.1 Company Overview
10.14.2 Financial Performance
10.14.3 Product Benchmarking
10.14.4 Strategic Initiatives
10.15 Curation Health
10.15.1 Company Overview
10.15.2 Financial Performance
10.15.3 Product Benchmarking
10.15.4 Strategic Initiatives
10.16 Koninklijke Philips N.V.
10.16.1 Company Overview
10.16.2 Financial Performance
10.16.3 Product Benchmarking
10.16.4 Strategic Initiatives
List of Tables
Table 1 List of secondary sources
TABLE 2 Major Deals & Strategic Alliances
TABLE 3 Detailed List of players
TABLE 4 U.S. Value-based Healthcare Service Market estimates and forecasts, by Models, 2017-2030 (Billion)
TABLE 5 U.S. Value-based Healthcare Service Market estimates and forecasts, by Payer Category, 2017-2030 (Billion)
TABLE 6 U.S. Value-based Healthcare Service Market estimates and forecasts, by Providers Utilization Category, 2017-2030 (Billion)
TABLE 7 U.S. Value-based Healthcare Service Market estimates and forecasts, by Home Health Care Providers Utilization Category, 2017-2030 (Billion)
TABLE 8 U.S. Value-based Healthcare Service Market estimates and forecasts, by Hospital Therapy Category, 2017-2030 (Billion)
List of Figures
Fig. 1 Market segmentation
FIG. 2 Market research process
FIG. 3 Data triangulation techniques
FIG. 4 Primary research pattern
FIG. 5 Market research approaches
FIG. 6 Value-chain-based sizing & forecasting
FIG. 7 QFD Modeling for market share assessment
FIG. 8 Market formulation & validation
FIG. 9 Mixed approach analysis
FIG. 10 Segment-Based Penetration Model
FIG. 11 Market summary (2021, Billion)
FIG. 12 Segment outlook, by Models
FIG. 13 Segment outlook, by Payer Category
FIG. 14 Segment outlook, by Providers Utilization Category
FIG. 15 Segment outlook, by Home Health Care Providers Utilization Category
FIG. 16 Segment outlook, by Hospital Therapy Category
FIG. 17 Penetration & growth prospect mapping
FIG. 18 Market variable analysis
FIG. 19 Market driver relevance analysis (Current & future impact)
FIG. 20 Market restraint relevance analysis (Current & future impact)
FIG. 21 U.S. Value-based Healthcare Service Market: Models Movement Analysis
FIG. 22 Pay for performance market, 2017-2030 (Billion)
FIG. 23 Patient-centered medical home market, 2017-2030 (Billion)
FIG. 24 Shared savings market, 2017-2030 (Billion)
FIG. 25 Shared risk
FIG. 26 Bundled payment
FIG. 27 Capitation models
FIG. 28 U.S. Value-based Healthcare Service Market: Providers Utilization Category Movement Analysis
FIG. 29 Medicare and Medicare Advantage, 2017-2030 (Billion)
FIG. 30 Medicaid market, 2017-2030 (Billion)
FIG. 31 Commercial market, 2017-2030 (Billion)
FIG. 32 U.S. Value-based Healthcare Service Market: Providers Utilization Category Movement Analysis
FIG. 33 Home Health Care market, 2017-2030 (Billion)
FIG. 34 Institutional Care market, 2017-2030 (Billion)
FIG. 35 Self-Care market, 2017-2030 (Billion)
FIG. 36 Hospital Therapy market, 2017-2030 (Billion)
FIG. 37 U.S. Value-based Healthcare Service Market: Home Health Care Movement Analysis
FIG. 38 Frontloading Skilled Nursing Visits market, 2017-2030 (Billion)
FIG. 39 Specialized Frontloading Therapy Visits market, 2017-2030 (Billion)
FIG. 40 U.S. Value-based Healthcare Service Market: Hospital Therapy Movement Analysis
FIG. 41 InPatient market, 2017-2030 (Billion)
FIG. 42 Outpatient market, 2017-2030 (Billion)
FIG. 43 U.S. Value-based Healthcare Service Market, 2017-2030 (Billion)
FIG. 44 Market Participation Categorization
FIG. 45 Company market position analysis

Companies Mentioned

  • Baker Tilly Us, Llp
  • Deloitte
  • Siemens Medical Solutions Usa, Inc.
  • Boston Consulting Group
  • Change Healthcare
  • Athena Healthcare
  • Veritas Capital Fund Management, L.L.C.
  • Unitedhealth Group.
  • Nxgn Management, LLC.
  • Mckesson Corporation
  • Genpact
  • Unlimited Technology Systems, LLC
  • Foresee Medical, Inc.
  • Signify Health, Inc. (Sentara Healthcare)
  • Curation Health
  • Koninklijke Philips N.V.

Methodology

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