Innovation in clinical and care management during the pandemic has permanently impacted how care is delivered. Remote care support and productivity improvement solutions are key to better clinical services and care management outcomes. Service providers are enhancing their care management capabilities and incorporating various services, such as remote delivery, preventive care, and clinical decision support, to address the growing enterprise demand for clinical services in UM, care coordination, and PHM. Also, organizations are focusing on developing and investing in the capabilities that help them deliver value-based care, reduce costs, and deliver high-quality services. Therefore, they increasingly rely on clinical service providers’ expertise through outsourcing. This is evident from a 28% increase in the number of enterprises outsourcing.
Both demand-side and supply-side trends are covered in our Clinical Services Business Process Transformation 2023 Market Insights™ and Clinical Services Business Process Transformation 2023 RadarView™, respectively.
These reports present a comprehensive study of clinical services service providers and closely examine market leaders, innovators, disruptors, and challengers.
Avasant evaluated 43 service providers across three dimensions: practice maturity, domain ecosystem, and investments and innovation. Of the 43 providers, we recognized 18 that brought the most value to the market during the past 12 months.
The RadarView recognizes service providers in four categories:
- Leaders: Accenture, Cognizant, EXL, Optum, and Sagility
- Innovators: Accolade, Conduent, Shearwater Health, and Wipro
- Disruptors: CareCentrix, Health Advocate, HealthHelp, Kepro, and Quantum Health
- Challengers: AllMed Healthcare, Health Dialog, Telligen, and eviCore
Figure 1 below from the full report illustrates these categories:
“Enterprises are increasingly looking for solutions that can help them drive patient-centricity,” said Avasant Partner Matthew Barlow. “They need to enable the above through digitalization and health data analytics and by leveraging advanced technologies such as AI and automation to provide patient-focused care through real-time insights.”
The reports provide several findings, including the following:
- Digitally enabled virtual/remote care has expanded care access to many. For instance, telehealth claims contribute to more than 5% of medical claims, allowing patients to receive care from the comfort of their homes
- The enterprises outsourcing clinical services grew by 28% YOY. Next-generation clinical services, that is, nurse advice/concierge and telehealth, behavioral health, and care coordination have seen a 59% growth in resources compared to traditional clinical services, that is, UM, CM, and PHM, which grew at 12%.
- Service providers plan to invest significantly in product growth, inorganic expansion, and human capital. These investments include developing platforms with automation capabilities, creating new offerings by leveraging advanced technology and data, and training resources to meet the required clinical skill sets, especially registered nurses.
- With healthcare expenditure in the US expected to reach 19.6% of GDP by 2030, care organizations are adopting technology-based solutions such as AI-powered automation and analytics, virtual care, and remote monitoring to streamline care delivery processes and optimize costs.
“The shift toward personalized preventive care is being achieved through innovative solutions,” said Aditya Jain, principal analyst with Avasant. “Enterprises must leverage digitally enabled, data-driven, and cost-efficient solutions to transform patient outcomes and optimize end-to-end clinical services through proactive and personalized intervention.”
The RadarView also features detailed profiles of 18 service providers, along with their solutions, offerings, and experience in assisting enterprises in their clinical services journeys.
This Research Byte is a brief overview of the Clinical Services Business Process Transformation 2023 Market Insights™ and Clinical Services Business Process Transformation 2023 RadarView™. (click for pricing).