Industry Outlook

Value-Based Care service market accounted for USD 3.48 billion in 2024 and is expected to reach USD 7.2 Billion by 2035, growing at a CAGR of around 6.85% between 2025 and 2035. The value-based care services market is focused on medical systems that reward vendors for offering high-quality care rather than the quantity of services provided. This market aims to improve the quality of care and reduce the cost. The increasing demand for strengthening patient satisfaction, and reducing nonessential medical expenditure are important motivators. The transition from fee-for-service to outcome-based healthcare models is driving market growth.

Report Scope:

Market Dynamics

Improved Care for Individuals with Long-Term Medical Conditions

Improvement of care for people with chronic illness is the main factor driving the value-based care services market growth. The value-based care market focuses on patient-centered methods which result in fragmented treatment. Value-based care services ensure that patients with long-term illness receive constant and complete treatment. Value-based care services focus on better patient care and treatment plans, which ultimately lead to lower costs of treatment by improving health outcomes. Enabling the health care system to provide greater value for patients is the aim of the value-based care transformation.

Uncertainty in Regulations and Changing Health Care Policies

One of the major obstacles to the value-based care services market is the uncertainty of the regulations and changing healthcare policies. Definite, constant regulations are required for the value-based care model to work properly. The payer and the providers also get confused and unpredictable due to the increasing changes in regulations and healthcare policies. Value-based care systems are hard to settle and maintain due to changing regulations. The firms need to adjust constantly to these changes. The changing regulations may affect the performance measures and reporting requirements, making it more difficult to combine with value-based care services. Therefore, healthcare providers may be cautious to completely shift to value-based care models.

Development of Remote Care and Telehealth Solutions.

The value-based care services market has a significant opportunity in the development of telehealth and remote caring solutions. Telehealth and remote care technologies allow healthcare providers to offer treatments outside the clinics to improve patient accessibility and convenience. These solutions facilitate the patient's involvement and make it easier to monitor chronic illness. Telehealth can improve care delivery efficiency by reducing the need for in-person visits. Treatment programs can be customized by healthcare professionals with the use of remote monitoring devices.

Industry Experts Opinion

“Value-based care is really a care-delivery system that rewards for patient outcomes and quality of care, managing a population rather than transactional care,”

• Marie Ansari CEO and executive director of The Permanente Medical Group, and president and CEO of Mid-Atlantic Permanente Medical Group."

Segment Analysis

The Value-Based Care Services Market is segmented based on Model, Providers, Payers, End-User, and Regions.

Based on the model, the Value-Based Care Services Market has been classified into pay-for-performance, Patient-centered Medical Home, Shared Savings, Shared Risk, Bundled Payment, and Capitation. The shared savings model is dominant in the market. It is mostly used because of a combination of risk and reward. Providers can split the savings and are encouraged to cut expenses while preserving or raising quality. Commercial insurers and Medicare are among the payers who frequently use this mode.

Based on the providers, The Value-Based Care Services Market has been classified into Home Health Care, Institutional Care, and Hospital Therapy. Home healthcare is dominant among providers. They provide a wide range of services, such as emotional support, therapy sessions, and skilled medical care. The industry is growing due to personalized and cost-effective care.

Regional Analysis

Based on regional analysis, North America is the largest and is leading in the value-based care market. North America has an advanced infrastructure and substantial investments in innovative care models. The region is categorized by a high adoption rate for technological solutions such as electronic health records and data analytics, which support integrated care for chronic diseases. The payers and providers strongly collaborate, and this collaboration helps to improve the efficiency of this model.

Asia-Pacific is the second largest market. In Asia Pacific, the value-based care market is expanding in this region as a result of rapid urbanization, rising healthcare expenditures, and growing awareness about the importance of efficient care management. Countries like China and India are adopting value-based care strategies to improve patient outcomes.

Competitive Landscape

The value-based care services market is highly competitive. It concentrates on how businesses are personally determined by improving patient outcomes while controlling expenditures. Organizations are battling for their abilities to implement statistical analysis, integrate medical services, and utilize modern payment models such as bundled payments and shared savings. Leading companies in the market include Humana, Cigna, UnitedHealth Group, CVS Health (Aetna), Kaiser Permanente, and others. Human excels in Medicare Advantage and savings programs. United Health Group offers analytical-driven care management. There are three main areas where rivalry exists for companies' public health management, vendor evolution to value-based models, and quality of care promotions. Furthermore, gathering a competitive edge involves implementing cutting-edge healthcare technologies such as electronic health records (EHR) and data-driven solutions. In September 2023, leading provider enablement companies Pearl Health and Walgreens announced that they would be working together to hasten the rollout of value-based care via community-based primary care physicians.

Value-Based Care Service Market, Company Shares Analysis, 2024

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Recent Developments:

• In May 2024, CityblockA's partnership with Sunshine Health was announced as a value-based healthcare provider for adult Medicaid recipients to offer primary care and care coordination services to high-need, difficult-to-reach Medicaid enrollees in 11 Central Florida counties.
• In April 2023, Kaiser Foundation Hospitals and Geisinger Health formed the new non-profit organization Risant Health with the intention of hastening the implementation of value-based care in a range of varied, multi-payer, multi-provider, community-based health system environments.
• In February 2023, Blue Cross and Blue Shield of Minnesota, and Homeward signed a full-risk value-based care agreement to increase access in rural Minnesota.

Report Coverage:

By Model

• Pay for Performance
• Patient-centered Medical Home
• Shared Savings
• Shared Risk
• Bundled Payment
• Capitation Models

By Providers

• Home Health Care
  • Frontloading Skilled Nursing Visits
  • Specialized Frontloading Therapy Visits
• Institutional Care
• Hospital Therapy
• Others

By Payers

• Medicare
• Medicaid
• Commercial
• Others

By End-Users

• Hospital and Clinics
• Insurance Companies
• Government
• Others

By Region

North America

• U.S.
• Canada

Europe

• U.K.
• France
• Germany
• Italy
• Spain
• Rest of Europe

Asia Pacific

• China
• Japan
• India
• Australia
• South Korea
• Singapore
• Rest of Asia Pacific

Latin America

• Brazil
• Argentina
• Mexico
• Rest of Latin America

Middle East & Africa

• GCC Countries
• South Africa
• Rest of the Middle East & Africa

List of Companies:

• UnitedHealth Group
• CVS Health
• Cigna
• Humana
• Anthem
• Molina Healthcare
• Kaiser Permanente
• Medica
• Magellan Health
• Evolent Health
• MediSprout
• NextGen Healthcare
• Allscripts Healthcare Solutions
• Cerner Corporation

Frequently Asked Questions (FAQs)