PUBLISHER: Grand View Research | PRODUCT CODE: 1609985
PUBLISHER: Grand View Research | PRODUCT CODE: 1609985
U.S. Value-based Healthcare Service Market Size, Share & Trends Analysis Report By Models (Pay For Performance, Patient-centered Medical Home), By Payer, By Providers Utilization Category, And Segment Forecasts, 2025 - 2030
U.S. Value-based Healthcare Service Market Growth & Trends:
The U.S. value-based healthcare service market size is anticipated to reach USD 6.16 trillion in 2030 and is expected to grow at a CAGR of 7.4% from 2025 to 2030. Increased adoption of value-based care beyond primary care, increase in healthcare spending as a percentage of GDP, and continued growth in home and virtual-based models are the major growth drivers for the industry.
The Centers for Medicare & Medicaid Services' objective is to transition all Medicare providers to two-sided risk arrangements and half of its commercial and Medicaid contracts to value-based models by 2025; currently, fewer than 20% of Medicare expenditure is value-based. The increase of consumerism in health care, the development of new technology, the need to fulfilling the Quadruple Aim, and prioritizing preventative care while decreasing unsustainable healthcare expenditures are the primary drivers of the shift to value-based care.
Healthcare reforms in recent years have highlighted the need for electronic health information, which has raised interest in digital solutions. Furthermore, the COVID-19 pandemic has accelerated business expansion by highlighting the benefits of using electronic health information to help improve patient care and scheduling. Several countries are implementing value-based care systems. This increases the demand for high-acuity IT solutions that boost clinical efficacy and workflow, thus supporting market growth.
The rapid evolution of value-based healthcare services is one of the factors driving this market's rapid growth. Due to value-based healthcare services, the healthcare cost curve and excessive health spending have decreased. According to "UnitedHealth Group," a US-based health insurance firm that delivers value-based payments to healthcare providers, this industry's development increased by more than 15% in 2019. It supports the delivery of high-quality treatment while improving the efficient use of healthcare resources.
Furthermore, "Cigna" acquired Bright Health in December 2021, bringing additional skills and resources to continue their development toward a value-based healthcare setting. Collaborations in value-based care are becoming increasingly popular among providers because they enable partners such as medical device makers, payers, and provider groups to build programs, solutions, and initiatives that benefit both patients and healthcare systems. For instance, in June 2021, "Humana'' acquired League, a digital health company, to create a new digital platform for Humana employer group and specialty insurance members.
To take advantage of the various types of services and technology capabilities required for future success, forward-thinking payers are broadening their options and moving beyond traditional providers. These firms have employed several techniques to improve their position in the value-based healthcare services industry in the U.S., including partnerships, collaborations, joint ventures, and mergers and acquisitions. For instance, in February 2021, Optum, a healthcare provider, completed the acquisition of Leadmark Health, a home healthcare company. It will create the first of its home-based care health system and would accelerate home health care's move toward value-based care.
U.S. Value-based Healthcare Service Market Report Highlights:
- On the basis of models, the patient-centred medical homes segment held the largest revenue share of 31.69% in 2024 and is expected to grow at a fastest CAGR over the forecast period
- The shared savings segment is expected to grow at the lucrative rate over the forecast period due to growing government initiatives aimed at introducing new models and programs
- On the basis of payer category, the medicare and medicare advantage segment held the largest revenue share of 48.48% in 2024 and is anticipated to grow at a fastest CAGR over the forecast period.
- On the basis of service, the self-care segment held the largest revenue share of 37.26% in 2024. Its dominance is due to increasing emphasis on patient-centered care, encouraging individuals to manage their health actively
Table of Contents
Chapter 1. Methodology and Scope
- 1.1. Market Segmentation & Scope
- 1.1.1. Segment Definitions
- 1.2. Estimates and Forecast Timeline
- 1.3. Research Methodology
- 1.4. Information Procurement
- 1.4.1. Purchased Database
- 1.4.2. GVR's Internal Database
- 1.4.3. Secondary Sources
- 1.4.4. Primary Research
- 1.4.5. Details of Primary Research
- 1.4.6. Research Assumption
- 1.5. Information or Data Analysis
- 1.5.1. Data Analysis Models
- 1.6. Market Formulation & Data Visualization
- 1.7. Model Details
- 1.7.1. Commodity Flow Analysis
- 1.8. Objectives
- 1.8.1. Objective - 1
- 1.8.2. Objective - 2
- 1.8.3. Objective - 3
- 1.9. List of Secondary Sources
- 1.10. List of Secondary Sources
Chapter 2. Executive Summary
- 2.1. U.S. Value-based Healthcare Service Market
- 2.1.1. Market Snapshot
- 2.1.2. Segment Snapshot
- 2.1.2.1. Model segment outlook
- 2.1.2.2. Payer category segment outlook
- 2.1.2.3. Providers utilization category outlook
- 2.1.3. Competitive Landscape Snapshot
Chapter 3. Market Variables, Trends, & Scope
- 3.1. Market Lineage Outlook
- 3.1.1. Parent Market Outlook
- 3.1.2. Related/Ancillary Market Outlook
- 3.2. Market Trends and Outlook
- 3.3. Market Dynamics
- 3.3.1. Market Driver Analysis
- 3.3.1.1. Rising Incidence of Chronic Diseases and Increasing Government Initiatives
- 3.3.1.2. Growing Demand for More Integrated Care Delivery Models
- 3.3.2. Market Restraint Analysis
- 3.3.2.1. Challenges in Balancing Two Reimbursement Types and Payment
- 3.3.1. Market Driver Analysis
- 3.4. Regulatory Framework
- 3.5. Business Environment Analysis Tools
- 3.5.1. Industry Analysis - Porter's Five Forces Analysis
- 3.5.1.1. Supplier power
- 3.5.1.2. Buyer power
- 3.5.1.3. Substitution threat
- 3.5.1.4. Threat of new entrant
- 3.5.1.5. Competitive rivalry
- 3.5.2. PESTEL Analysis
- 3.5.1. Industry Analysis - Porter's Five Forces Analysis
Chapter 4. Models Business Analysis
- 4.1. U.S. Value-based Healthcare Service Market: Models Movement Analysis
- 4.2. U.S. Value-based Healthcare Service Market: Models Segment Dashboard
- 4.3. Models Movement & Market Share Analysis, 2023 & 2030
- 4.4. U.S. Value-based Healthcare Service Market Estimates & Forecast, by Models
- 4.5. Pay For Performance
- 4.5.1. Pay for performance market, 2018 - 2030 (USD Billion)
- 4.6. Patient-Centered Medical Home
- 4.6.1. Patient-centered medical home market, 2018 - 2030 (USD Billion)
- 4.7. Shared Savings
- 4.7.1. Shared savings market, 2018 - 2030 (USD Billion)
- 4.8. Shared Risk
- 4.8.1. Shared risk market, 2018 - 2030 (USD Billion)
- 4.9. Bundled Payment
- 4.9.1. Bundled payment market, 2018 - 2030 (USD Billion)
- 4.10. Capitation Models
- 4.10.1. Capitation models market, 2018 - 2030 (USD Billion)
Chapter 5. Payer Category Business Analysis
- 5.1. U.S. Value-based Healthcare Service Market: Payer Category Movement Analysis
- 5.2. U.S. Value-based Healthcare Service Market: Payer Category Segment Dashboard
- 5.3. Payer Category Movement & Market Share Analysis, 2023 & 2030
- 5.4. U.S. Value-based Healthcare Service Market Estimates & Forecast, by Payer Category
- 5.5. Medicare and Medicare Advantage
- 5.5.1. Medicare and medicare advantage market, 2018 - 2030 (USD Billion)
- 5.6. Medicaid
- 5.6.1. Medicaid market, 2018 - 2030 (USD Billion)
- 5.7. Commercial
- 5.7.1. Commercial market, 2018 - 2030 (USD Billion)
Chapter 6. Providers Utilization Category Business Analysis
- 6.1. U.S. Value-based Healthcare Service Market: Providers Utilization Category Movement Analysis
- 6.2. U.S. Value-based Healthcare Service Market: Providers Utilization Category Segment Dashboard
- 6.3. Providers Utilization Category Movement & Market Share Analysis, 2023 & 2030
- 6.4. U.S. Value-based Healthcare Service Market Estimates & Forecast, by Providers Utilization Category
- 6.5. Home Health Care
- 6.5.1. Home health care market, 2018 - 2030 (USD Billion)
- 6.5.2. Frontloading skilled nursing visits
- 6.5.2.1. Frontloading skilled nursing visits market, 2018 - 2030 (USD Billion)
- 6.5.3. Specialized frontloading therapy visits
- 6.5.3.1. Specialized frontloading therapy visits market, 2018 - 2030 (USD Billion)
- 6.6. Institutional Care
- 6.6.1. Institutional care market, 2018 - 2030 (USD Billion)
- 6.7. Self-Care
- 6.7.1. Self-care market, 2018 - 2030 (USD Billion)
- 6.8. Hospital Therapy
- 6.8.1. Hospital therapy market, 2018 - 2030 (USD Billion)
- 6.8.2. InPatient
- 6.8.2.1. InPatient market, 2018 - 2030 (USD Billion)
- 6.8.3. Outpatient
- 6.8.3.1. Outpatient market, 2018 - 2030 (USD Billion)
Chapter 7. Competitive Landscape
- 7.1. Company Categorization
- 7.2. Company Market Position Analysis
- 7.3. Strategy Mapping
- 7.3.1. Partnership/Collaboration/Alliance
- 7.3.2. New Product Launch
- 7.3.3. Mergers & Acquisitions
- 7.3.4. Others
- 7.4. Company Profiles/Listing
- 7.4.1. Baker Tilly US, LLP
- 7.4.1.1. Overview
- 7.4.1.2. Financial performance
- 7.4.1.3. Product benchmarking
- 7.4.1.4. Strategic initiatives
- 7.4.2. Deloitte
- 7.4.2.1. Overview
- 7.4.2.2. Financial performance
- 7.4.2.3. Product benchmarking
- 7.4.2.4. Strategic initiatives
- 7.4.3. Siemens Medical Solutions USA, Inc.
- 7.4.3.1. Overview
- 7.4.3.2. Financial performance
- 7.4.3.3. Product benchmarking
- 7.4.3.4. Strategic initiatives
- 7.4.4. Boston Consulting Group
- 7.4.4.1. Overview
- 7.4.4.2. Financial performance
- 7.4.4.3. Product benchmarking
- 7.4.4.4. Strategic initiatives
- 7.4.5. Change Healthcare
- 7.4.5.1. Overview
- 7.4.5.2. Financial performance
- 7.4.5.3. Product benchmarking
- 7.4.5.4. Strategic initiatives
- 7.4.6. Athena Healthcare
- 7.4.6.1. Overview
- 7.4.6.2. Financial performance
- 7.4.6.3. Product benchmarking
- 7.4.6.4. Strategic initiatives
- 7.4.7. Veritas Capital Fund Management, L.L.C.
- 7.4.7.1. Overview
- 7.4.7.2. Financial performance
- 7.4.7.3. Product benchmarking
- 7.4.7.4. Strategic initiatives
- 7.4.8. UnitedHealth Group.
- 7.4.8.1. Overview
- 7.4.8.2. Financial performance
- 7.4.8.3. Product benchmarking
- 7.4.8.4. Strategic initiatives
- 7.4.9. NXGN Management, LLC.
- 7.4.9.1. Overview
- 7.4.9.2. Financial performance
- 7.4.9.3. Product benchmarking
- 7.4.9.4. Strategic initiatives
- 7.4.10. McKesson Corporation
- 7.4.10.1. Overview
- 7.4.10.2. Financial performance
- 7.4.10.3. Product benchmarking
- 7.4.10.4. Strategic initiatives
- 7.4.11. Genpact
- 7.4.11.1. Overview
- 7.4.11.2. Financial performance
- 7.4.11.3. Product benchmarking
- 7.4.11.4. Strategic initiatives
- 7.4.12. Unlimited Technology Systems, LLC
- 7.4.12.1. Overview
- 7.4.12.2. Financial performance
- 7.4.12.3. Product benchmarking
- 7.4.12.4. Strategic initiatives
- 7.4.13. ForeSee Medical, Inc.
- 7.4.13.1. Overview
- 7.4.13.2. Financial performance
- 7.4.13.3. Product benchmarking
- 7.4.13.4. Strategic initiatives
- 7.4.14. Signify Health, Inc. (Sentara Healthcare)
- 7.4.14.1. Overview
- 7.4.14.2. Financial performance
- 7.4.14.3. Product benchmarking
- 7.4.14.4. Strategic initiatives
- 7.4.15. Curation Health
- 7.4.15.1. Overview
- 7.4.15.2. Financial performance
- 7.4.15.3. Product benchmarking
- 7.4.15.4. Strategic initiatives
- 7.4.16. Koninklijke Philips N.V.
- 7.4.16.1. Overview
- 7.4.16.2. Financial performance
- 7.4.16.3. Product benchmarking
- 7.4.16.4. Strategic initiatives
- 7.4.17. Humana
- 7.4.17.1. Overview
- 7.4.17.2. Financial performance
- 7.4.17.3. Product benchmarking
- 7.4.17.4. Strategic initiatives
- 7.4.18. The Commonwealth Fund.
- 7.4.18.1. Overview
- 7.4.18.2. Financial performance
- 7.4.18.3. Product benchmarking
- 7.4.18.4. Strategic initiatives
- 7.4.19. Stellar Health
- 7.4.19.1. Overview
- 7.4.19.2. Financial performance
- 7.4.19.3. Product benchmarking
- 7.4.19.4. Strategic initiatives
- 7.4.20. Privia Health
- 7.4.20.1. Overview
- 7.4.20.2. Financial performance
- 7.4.20.3. Product benchmarking
- 7.4.20.4. Strategic initiatives
- 7.4.1. Baker Tilly US, LLP
List of Tables
- Table 1. List of secondary sources
- Table 2. List of abbreviations
- Table 3. U.S. value-based healthcare service market revenu estimates and forecast, by models, 2018 - 2030 (USD Billion)
- Table 4. U.S. value-based healthcare service market revenue estimates and forecast, by payer category, 2018 - 2030 (USD Billion)
- Table 5. U.S. value-based healthcare service market revenue estimates and forecast, by providers utilization category, 2018 - 2030 (USD Billion)
List of Figures
- Fig 1. U.S. value-based healthcare service market segmentation
- Fig 2. Market research process
- Fig 3. Information procurement
- Fig 4. Primary research pattern
- Fig 5. Market research approaches
- Fig 6. Value chain based sizing & forecasting
- Fig 7. QFD modelling for market share assessment
- Fig 8. Market formulation & validation
- Fig 9. Market snapshot
- Fig 10. Type segment outlook
- Fig 11. Competitive landscape
- Fig 12. U.S. value-based healthcare service market: Market dynamics
- Fig 13. U.S. value-based healthcare service market: Porter's analysis
- Fig 14. U.S. value-based healthcare service market: PESTLE analysis
- Fig 15. U.S. value-based healthcare service market: models segment dashboard
- Fig 16. U.S. value-based healthcare service market: models movement share analysis
- Fig 17. Pay for performance market: models movement share analysis
- Fig 18. Patient-centred medical home market: models movement share analysis
- Fig 19. Shared savings market: models movement share analysis
- Fig 20. Shared risk market: models movement share analysis
- Fig 21. Bundled payment market: models movement share analysis
- Fig 22. Capitation models market, 2018 - 2030 (USD Million)
- Fig 23. U.S. value-based healthcare service market: payer category segment dashboard
- Fig 24. U.S. value-based healthcare service market: payer category movement share analysis
- Fig 25. Medicare and medicare advantage market, 2018 - 2030 (USD Million)
- Fig 26. Medicaid market, 2018 - 2030 (USD Million)
- Fig 27. Commercial market, 2018 - 2030 (USD Million)
- Fig 28. U.S. value-based healthcare service market: providers utilization category segment dashboard
- Fig 29. U.S. value-based healthcare service market: providers utilization category share analysis
- Fig 30. Home health care market, 2018 - 2030 (USD Billion)
- Fig 31. Frontloading skilled nursing visits market, 2018 - 2030 (USD Billion)
- Fig 32. Specialized frontloading therapy visits market, 2018 - 2030 (USD Billion)
- Fig 33. Institutional care market, 2018 - 2030 (USD Billion)
- Fig 34. Self-care market, 2018 - 2030 (USD Billion)
- Fig 35. Hospital therapymarket, 2018 - 2030 (USD Billion)
- Fig 36. InPatient market, 2018 - 2030 (USD Billion)
- Fig 37. Outpatient market, 2018 - 2030 (USD Billion)
- Fig 38. Company categorization
- Fig 39. Company market position analysis
- Fig 40. Strategic framework
