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AI-Powered Care Coordination Software Gives Vendors Competitive Edge in the Era of Personalized Healthcare

Business Models Around Transitional Care Management Offer Tangible Growth Opportunities, Finds Frost & Sullivan

Every year, across the United States (US), close to 50 percent of patients fail to understand treatment plans and care management guidelines, and approximately 20 percent of them switch providers due to a lack of trust in their care teams. Next-generation patients prefer having access to personalized clinical information on the go, requiring caregivers to coordinate medical insight across the care continuum more efficiently than ever. Almost 70 percent of patients reported feeling fully satisfied when they received coordinated care from a provider-designated team that appears confident in identifying the right intervention strategies and delivering episodic medical support compassionately. However, such services cannot be scaled without the contribution of progressive digital health solutions. As a result, the care coordination software market is poised to witness significant traction from payers, hospitals and physician practices across the US. This is expected to drive the $1.55 billion care coordination software market toward $3.18 billion by 2022 at a compound annual growth rate of 15.4 percent.

“The care coordination software market is embracing large-scale innovation, aided by advanced technologies such as AIand blockchain, which support data interoperability and normalization within a defined clinical network,” said Koustav Chatterjee, Industry Analyst, Transformational Health. “The growing need to auto-trigger worklists and personalize intervention plans for complex patient populations will further drive investments in care coordination IT (CCIT).”

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Frost & Sullivan’s recent analysis, US Care Coordination Software Market, Forecast to 2023, examines the adoption drivers across a variety of settings. It also presents the challenges impacting the market and the outlook for the adoption of care coordination software among three key customer segments. It presents forecasts for the overall market growth over a six-year period and opportunities within the total market.

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“While regulatory hurdles had hindered the adoption of CCIT in the past, the latest US policies advocating thePromoting Interoperability initiative by Centers of Medicare and Medicaid Services (CMS), the cross-continuum interoperability, are expected to accelerate the adoption of both software and service solutions,” noted Chatterjee. “Business models will remain largely centered on transitional care management, and chronic condition management is highly regulated under various value-based reimbursement programs. Legacy electronic health record (EHR) platforms, which allow third-party integration with CCIT to remain interoperable in the front end, will thrive. Collaboration with traditional ICT vendors such as Microsoft, Apple, and Salesforce is also expected by both payers and providers.”

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For additional growth opportunities, CCIT vendors are likely to:

  • Encourage the integration of disparate medical workflows by demonstrating accrued revenue, saved costs, and improved outcomes.
  • Automate the process of matching patients with their care teams. Care managers need to employ IT enablers so that they can proactively reach out to patients’ caretakers and provide insights to help make more informed, data-driven decisions.
  • Manage patients’ clinical and financial experience through IT, enabling the sharing or exchanging of information required to make favorable decisions.
  • Deliver robust care coordination software products that offer end-to-end referral management capabilities.
  • Highlight financial gaps in the network and identify patients who can generate incremental revenue for caregivers.
  • Introduce a digital command center to auto-attribute care managers, who will be responsible for delivering, monitoring, and benchmarking care plan adherence both manually and digitally for patients.

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