The healthcare industry is shifting towards a more coordinated and patient-centered approach. The global population is aging, raising the nurse demand and creating a nursing shortage. Due to rising healthcare costs, healthcare payers and providers are seeking ways to manage costs. These factors have led to a surge in demand for clinical and care management services, as evidenced by a 13% revenue increase and a 23% active client growth for clinical and care management service providers from December 2022 to December 2023.
Both demand- and supply-side trends are covered in Avasant’s Clinical and Care Management Services Business Process Transformation 2024 Market Insights™ and Clinical and Care Management Services Business Process Transformation 2024 RadarView™ respectively. These reports present a comprehensive study of clinical and care management business process transformation service providers and closely examine the market leaders, innovators, disruptors, and challengers. They also provide a view into key market trends and developments impacting the clinical and care management services space.
We evaluated 34 service providers across three dimensions: practice maturity, domain ecosystem, and investments and innovation. Of the 34 providers, we recognized 18 that brought the most value to the market during the past 12 months.
The report recognizes service providers in four categories:
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- Leaders: Accenture, Cognizant, EXL, Optum, and Wipro
- Innovators: Accolade, Conduent, Omega Healthcare, Sagility, and Shearwater Health
- Disruptors: Acentra Health, Carenet Health, Health Advocate, Quantum Health, and WNS HealthHelp
- Challengers: CareCentrix, eviCore, and Telligen
Figure 1 below from the full report illustrates these categories:
“As the healthcare industry evolves, the demand for clinical and care management services is likely to grow,” said Avasant Partner Matthew Barlow. “Success factors include effective workforce management, integration of emerging technologies, and adoption of value-based care models focused on patient engagement and population health.”
The reports provide a number of findings, including the following:
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- Time-based and PEPM (per employee per month) pricing models account for 65% of clinical and care management services due to their subjective nature.
- Utilization management resources account for 62% of the total clinical and care management workforce as healthcare payers and providers prioritize cost reduction due to rising healthcare costs.
- Service providers are relying on strategic acquisitions to quickly expand their service offerings, increase their revenue, and grow their client base.
- Healthcare organizations are facing higher cyberattack incidents as healthcare data is more valuable on the black market than any other kind of data.
“The clinical and care management services market is witnessing a transformation,” said Aditya Jain, research leader with Avasant. “Service providers need to integrate emerging technologies, such as generative AI, AI/ML, automation, and data analytics, with their offerings like prior authorization and telehealth, to adapt to the evolving market.”
This RadarView™ features detailed profiles of 18 service providers, along with their solutions, offerings, and experience in assisting enterprises and individuals in their clinical and care management journey.
This Research Byte is a brief overview of the Clinical and Care Management Services Business Process Transformation 2024 Market Insights™ and Clinical and Care Management Services Business Process Transformation 2024 RadarView™ (click for pricing).