Disease Management and Health Monitoring for ACOs 1Q 2013
This report examines new care delivery models such as patient-centered medical home (PCMH) and Accountable Care Organization (ACO). It analyzes how care management services and home health monitoring technologies will be deployed in these new care services, including revenues generated and growth potential.
“The recent Supreme Court ruling cleared the way for ACO implementation under ACA, and private sectors have already invested in PCMH and ACOs,” said Harry Wang, Director of Mobile & Health Research at Parks Associates. "As these care delivery models expand their presence and utilization, assist care coordination and monitoring will see an uptick in demand. Our report analyzes how ACO structure and operational models will influence adoption of care management service and health monitoring technologies.”
1 REPORT SUMMARY
1.1 Purpose and Scope of Report
1.2 Research Approach
1.3 Definitions and Acronyms
2 ACO AND PCMH: MARKET OVERVIEW
2.1 Background on PCMH and ACO
2.2 Private Sector’s ACO and PCMH Initiatives
2.2.1 ACO/PCMH Momentum and Growth
2.2.2 Organization Structure and Operation Models
2.2.3 Business Model Challenges
2.2.4 Growth of ACOs and PCMHs
2.3 Other Government Initiatives on Coordinated Care
2.3.1 Medicare
2.3.2 Medicaid
3 END-USER PERSPECTIVE: WILL CONSUMER EMBRACE COORDINATED CARE?
4 DISEASE MANAGEMENT AND HEALTH MONITORING: FUTURE WITH ACOS
4.1 Trends in the Disease Management Industry
4.2 Trends in Health Monitoring Technology Industry
4.3 Software and Service Innovations
4.4 The ACO Opportunity for DM and Health Monitoring Providers
5 MARKET FORECASTS
5.1 Market Drivers and Inhibitors
5.2 Forecast Methodology
5.3 Forecasts of PCMH- or ACO-Recognized Physicians and Patient Enrollment (2013-2017)
5.4 Forecast of Care Management Fee Revenue and Health Monitoring Hardware Revenues under ACOs (2013-2017)
6 MARKET IMPLICATIONS AND RECOMMENDATIONS
Appendix: Company INDEX
1.1 Purpose and Scope of Report
1.2 Research Approach
1.3 Definitions and Acronyms
2 ACO AND PCMH: MARKET OVERVIEW
2.1 Background on PCMH and ACO
2.2 Private Sector’s ACO and PCMH Initiatives
2.2.1 ACO/PCMH Momentum and Growth
2.2.2 Organization Structure and Operation Models
2.2.3 Business Model Challenges
2.2.4 Growth of ACOs and PCMHs
2.3 Other Government Initiatives on Coordinated Care
2.3.1 Medicare
2.3.2 Medicaid
3 END-USER PERSPECTIVE: WILL CONSUMER EMBRACE COORDINATED CARE?
4 DISEASE MANAGEMENT AND HEALTH MONITORING: FUTURE WITH ACOS
4.1 Trends in the Disease Management Industry
4.2 Trends in Health Monitoring Technology Industry
4.3 Software and Service Innovations
4.4 The ACO Opportunity for DM and Health Monitoring Providers
5 MARKET FORECASTS
5.1 Market Drivers and Inhibitors
5.2 Forecast Methodology
5.3 Forecasts of PCMH- or ACO-Recognized Physicians and Patient Enrollment (2013-2017)
5.4 Forecast of Care Management Fee Revenue and Health Monitoring Hardware Revenues under ACOs (2013-2017)
6 MARKET IMPLICATIONS AND RECOMMENDATIONS
Appendix: Company INDEX
LIST OF FIGURES
Companies Interviewed for this Report
Value Chain of ACO-led Healthcare Industry
Definitions and Acronyms
Comparison between PCMH and Medicare ACO
Private Health Insurers’ PCMH Initiatives
Types of Medicare ACOs and Examples
Impact of PCMH Requirements on Provider Operation Model
Impact of NCQA-ACO Standards on Care Provider Operation Model
Other Medicare Coordinated Care Initiatives
State Medicaid PCMH Initiatives
Desired Care Services from Consumers (2/2)
Consumer Interest in a Free Care Navigator Service
Consumer Confidence in Provider’s Capability to Offer a Care Navigator Service
Consumer Perception of Care Navigator Service’s Ability to Improve Level of Service
Consumer’s Likelihood to Pay for Care Navigator Service
Private Payer and Integrated Health System’s Disease Management Initiatives
Traditional DM Companies Transformation to Population Health Management
New Care Management Service Providers
Incumbent and Emerging Health Monitoring Technology Providers
Health Monitoring Software and Data Integration Solution Providers
Online Care Software and Service Providers
EMR Software Vendors Enter Population Health IT Market
Report Forecast Methodology
Projected Number of Primary Care Practices to Become a PCMH-Recognized Practice (2012-2017)
Projected Number of Primary Care Physicians to Become either a PCMH-or ACO-Recognized Doctor (2012-2017)
Projected Number of Patients Managed by PCMH or ACO-recognized Practices (2012-2017)
Health Monitoring Hardware Revenues and Care Management Fee Revenues from Managing PCMH or ACO Patients (2012-2017)
Companies Interviewed for this Report
Value Chain of ACO-led Healthcare Industry
Definitions and Acronyms
Comparison between PCMH and Medicare ACO
Private Health Insurers’ PCMH Initiatives
Types of Medicare ACOs and Examples
Impact of PCMH Requirements on Provider Operation Model
Impact of NCQA-ACO Standards on Care Provider Operation Model
Other Medicare Coordinated Care Initiatives
State Medicaid PCMH Initiatives
Desired Care Services from Consumers (2/2)
Consumer Interest in a Free Care Navigator Service
Consumer Confidence in Provider’s Capability to Offer a Care Navigator Service
Consumer Perception of Care Navigator Service’s Ability to Improve Level of Service
Consumer’s Likelihood to Pay for Care Navigator Service
Private Payer and Integrated Health System’s Disease Management Initiatives
Traditional DM Companies Transformation to Population Health Management
New Care Management Service Providers
Incumbent and Emerging Health Monitoring Technology Providers
Health Monitoring Software and Data Integration Solution Providers
Online Care Software and Service Providers
EMR Software Vendors Enter Population Health IT Market
Report Forecast Methodology
Projected Number of Primary Care Practices to Become a PCMH-Recognized Practice (2012-2017)
Projected Number of Primary Care Physicians to Become either a PCMH-or ACO-Recognized Doctor (2012-2017)
Projected Number of Patients Managed by PCMH or ACO-recognized Practices (2012-2017)
Health Monitoring Hardware Revenues and Care Management Fee Revenues from Managing PCMH or ACO Patients (2012-2017)
