Market Challenges And Opportunities
Global Value-Based Healthcare Market- Drivers
- Shift from fee-for-service to value-based payment models: The healthcare payment system across many countries is gradually shifting from traditional fee-for-service models to value-based payment models where the focus is more on health outcomes rather than service volume. This transition is a key driver for the growing global value-based healthcare market. Under the fee-for-service system, healthcare providers are paid for each test and procedure, which encourages increased volume of services but does not consider quality and health outcomes of patients. However, value-based models link payments to quality metrics and overall care of patients. For example, providers may be paid based on preventing complications, readmissions, managing chronic illnesses, patient satisfaction rather than on a per-visit basis. This promotes higher value and affordable care over time.
- Government initiatives: Government initiatives are playing a major role in driving the growth of the global value-based healthcare market. Many governments around the world are pushing for healthcare models that improve patient outcomes and lower costs. For instance, on December 31, 2021, the Center for Medicare and Medicaid Innovation adopted the initial home health value-based purchasing model. The concept was created to help medicare-certified home health agencies across the country improve the quality and efficiency of their treatment.
- Adoption of advanced technologies: The healthcare industry worldwide has witnessed a dramatic shift towards value-based models of care delivery over forecast years. Advanced technologies are playing a key role in enabling this transition by improving outcomes and lowering costs. For instance, artificial intelligence and machine learning (ML) are being utilized for personalized treatment recommendations, predictive analytics, and precision medicine. Healthcare providers can gain deeper insights into individual patients through analysis of their vast EHR and genomic data. This helps deliver more proactive, preventive, and coordinated care.
Global Value-Based Healthcare Market- Opportunities
- Big data integration: Big data integration presents a great opportunity for value-based healthcare globally by helping move from volume to value-driven care. As healthcare systems generate immense datasets from clinical, financial, operational, and patient-reported sources, integrating these disparate sources can provide invaluable insights to optimize value-based care models. By analyzing patterns and making connections across large volumes of patient data, providers can gain a more comprehensive view of health outcomes, costs, and experiences. This enables more precise risk stratification, early detection of high-risk patients, and targeted intervention strategies. Care teams can be better informed to improve quality of care and patient satisfaction, while controlling unnecessary costs for both providers and payers.
- Increase in healthcare IT expenditure: Increasing healthcare IT expenditure presents a great opportunity for the global value-based healthcare market to grow exponentially in the near future. As the whole world is battling the ongoing pandemic, the fundamental importance of investing in healthcare infrastructure and digitizing healthcare services has become abundantly clear. Governments across the world are allocating higher budgets for modernizing their existing healthcare systems by using digital and technological tools.
Global Value-Based Healthcare Market - Restraints
- Resistance from healthcare providers: Healthcare providers are facing significant resistance to adopt value-based care models due to concerns over financial risks and changing care delivery processes. There is a deeply ingrained fee-for-service mindset among many physicians and healthcare systems who have practiced and operated under that model for decades. Switching to value-based arrangements that requires taking on new forms of risk that many providers are uncomfortable with, such as being accountable for the overall costs and quality of care for a population of patients rather than getting paid for each individual service. It also necessitates care coordination across settings and specialties, increased data tracking and reporting, and new focus on outcomes and preventative care rather than episodic sick visits. Making such fundamental changes to long-established clinical and business practices poses organizational, cultural and operational challenges.
- Counterbalance: To overcome this restraint, the key market players need to take initiatives in making the healthcare providers aware about the merits of adopting value-based healthcare and its advantages in the long run thereby aiding in the market growth.
- Lack of interoperability: Lack of interoperability between different healthcare systems and technologies is one of the major barriers restraining the growth of global value-based healthcare market. When medical information cannot be easily and securely accessed and exchanged between healthcare providers, payers and patients, it undermines the fundamental principle of delivering coordinated and high-value care. In a value-based model, cares providers are reimbursed that are based on patient health outcomes instead of traditional fee-for-service model. This requires accurate, comprehensive, and longitudinal data on individual patients that capture their medical history, treatments, outcomes and costs of care across multiple providers over time.
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