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Growth Opportunities in US Digital Health Solutions as an Enabler for Value-based Care

Publisher Frost & Sullivan
Published Dec 19, 2023
SKU # MC18395889

Description

Growth Opportunities in US Digital Health Solutions as an Enabler for Value-based Care



According to the Centers for Medicare and Medicaid Services (CMS), value-based care (VBC) programs reward healthcare providers with incentive payments for the quality of care they provide Medicare patients.

These programs are part of its larger CMS quality strategy to reform healthcare delivery and payment. Value-based programs support 3 aims: better care for individuals, better health for populations, and lower cost of care. This study analyzes digital health solutions for payers and providers (including physician practices and hospitals) that enable VBC programs. It excludes solutions targeting life sciences, pharmaceutical companies, and the public sector. Evaluations are exclusive to the United States, with concept considerations based on the CMS.

The study addresses the current status of value-based programs and payment incentives by CMS, such as ACO REACH, MSSP, MCP, and AHEAD models, alongside regulatory updates and growth opportunities for the next five years. It additionally assesses the role of digital health providers and payers in digital quality measurements and performance gaps, showcasing best practices from established US companies and start-ups enabling VBC through digital health solutions.

Table of Contents

Strategic Imperatives
Why is it Increasingly Difficult to Grow?
The Strategic Imperative 8™
The Impact of the Top 3 Strategic Imperatives on the US Value-based Care (VBC) Industry
Growth Opportunities Fuel the Growth Pipeline Engine™
Growth Opportunity Analysis
Scope of Analysis
Market Segmentation
Payment Incentives—CMS VBC Models
Payment Incentives—Accountable Care Models
Payment Incentives—Accountable Care Models
Payment Incentives—Accountable Care Models: Medicare Shared Savings Program (MSSP)
Payment Incentives—Accountable Care Models: Medicare Shared Savings Program (MSSP)
Payment Incentives—Accountable Care Models: ACO Realizing Equity, Access, and Community Health (ACO REACH) Model
Payment Incentives—Accountable Care Models
Payment Incentives—Disease-specific and Episode-based Models
Payment Incentives—Disease-specific and Episode-based Models
Payment Incentives—Disease-specific and Episode-based Models
Payment Incentives—Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): Merit-based Incentive Payment System (MIPS)
Payment Incentives—MACRA: Alternative Payment Models (APMs)
VBC Programs and Legislation
VBC Programs and Legislation
How to Measure Quality?
How to Measure Quality?—The 6 Healthcare Quality Priorities
How to Measure Quality?—Digital Health’s Role
How to Measure Quality?—Payer’s Role
Addressing Gaps in Performance Measurement
Addressing Gaps in Performance Measurement
Addressing Gaps in Performance Measurement
Addressing Gaps in Performance Measurement
Addressing Gaps in Performance Measurement
Addressing Gaps in Performance Measurement
Established US Companies and Start-ups Enabling VBC through Digital Health Solutions
Established US Companies and Start-ups Enabling VBC through Digital Health Solutions
Established US Companies and Start-ups Enabling VBC through Digital Health Solutions
Established US Companies and Start-ups Enabling VBC through Digital Health Solutions
Growth Drivers
Growth Restraints
Growth Opportunity Universe
Growth Opportunity 1: Standardization of Digital Quality Measures (dQMs)
Growth Opportunity 1: Standardization of Digital Quality Measures (dQMs)
Growth Opportunity 2: Behavioral Health and Telehealth Investment
Growth Opportunity 2: Behavioral Health and Telehealth Investment
Growth Opportunity 3: Small and Medium Practices Demand
Growth Opportunity 3: Small and Medium Practices Demand
Growth Opportunity 4: Generative AI for Physician Burnout
Growth Opportunity 4: Generative AI for Physician Burnout
List of Exhibits
Legal Disclaimer

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