Clinical Risk Grouping Solution Market

Clinical Risk Grouping Solution Market Size

Clinical Risk Grouping Solution Market size was valued at USD 673.4 million in 2023 growing at a CAGR of 11.5% between 2024 and 2032. Clinical risk grouping solutions help in identifying high-risk patients and managing the care more efficiently. Therefore, one of the primary drivers is the increasing healthcare cost, as healthcare costs continue to rise, there is a greater need for solutions that can effectively manage and mitigate the expenses of treatment.

Additionally, the rise in prevalence of chronic diseases such as diabetes, cardiovascular diseases, and cancer increases the need for effective population health management solutions. For instance, as per the report published by World Health Organization it has been reported that noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 74% of all deaths globally. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), chronic respiratory diseases (4.1 million), and diabetes (2.0 million including kidney disease deaths caused by diabetes).

Thus, the rapid increase in the prevalence of chronic disease globally is the major factor that is expanding the demand for clinical risk grouping solution for better risk stratification and to manage patient populations and improve healthcare outcomes, thereby driving the market growth. A clinical risk grouping solution (CRGS) is a sophisticated tool or system used in healthcare to categorize patients based on their clinical risk. The main purpose of CRGS is to predict and manage healthcare outcomes, optimize resource utilization, and improve patient care by identifying individuals at varying levels of health risk.

Clinical Risk Grouping Solution Market Trends

The increase in adoption of electronic health records (EHR) system at healthcare facilities such as hospitals, clinics, and ambulatory care centers, has been a key driver for clinical risk grouping solution industry. Also, innovations in data analytics, artificial intelligence, and machine learning enhance the capabilities of clinical risk grouping solutions such as EHRs software. These advancements enable more accurate risk prediction and better patient management.

• For instance, in March 2024, Health Information Management Systems (HiMS) launched AxiomEHR, an all-new, AI-powered electronic health record (EHR) solution that supports data-based decision-making, flexible care coordination, and overall resilience to drive quality-based care. Thus, technological advancements in clinical risk grouping solution and the growing reliance on data-driven decision-making in healthcare for improving clinical outcomes and operational efficiency will boost the market for clinical risk grouping solution.
  

Clinical Risk Grouping Solution Market Analysis

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Based on the component, the market is classified into software and services. The software segment dominated the market with revenue of USD 526.1 million in 2023.

• The software’s ability to be customized according to the specific needs of different healthcare providers including the customization of risk models to fit populations or conditions is driving the market growth.
  
• Also, the availability of advanced software that offers analytical capabilities such as predictive modeling and machine learning algorithms can provide more accurate risk assessments and predictions, which are valuable in clinical risk grouping, thereby boosting the segmental growth for clinical risk grouping solution.
  
• Further, software offers clinical decision support tools based on risk assessments and can help healthcare providers make informed decisions about patient care and resource allocation.
  

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Based on the application, the global clinical risk grouping solution market is classified into population health management, chronic disease management, clinical decision support, fraud detection and prevention, and other applications. The population health management segment dominated the market with market share of 33.2% in 2023.

• With a growing prevalence of chronic diseases, population health management (PHM) solutions help in proactive management and prevention strategies, reducing complications and hospitalizations. Also, population health management solutions facilitate better coordination among healthcare providers across different settings such as primary care, specialists, and department, ensuring continuity of care and reducing duplication of services.
  
• Furthermore, government regulations and policies such as those promoting accountable care organizations (ACOs) and bundled payment programs encourage healthcare providers to adopt population health management strategies. Therefore, clinical risk grouping solutions help organizations meet regulatory requirements, thereby fuelling market growth.
  

Based on end-use, the clinical risk grouping solution market is classified into hospitals & clinics, ambulatory surgical centers, long term care centers, and other end-users. The hospitals & clinics segment is expected to exhibit 11.8% CAGR between 2024 - 2032.

• Hospitals and clinics benefit from clinical risk grouping solutions by improving the efficiency of patient care delivery. These solutions help in identifying high-risk patients early, allowing healthcare providers to intervene proactively and manage resources effectively.
  
• Moreover, implementing clinical risk grouping solutions can lead to cost savings for hospitals and clinics. By identifying high-risk patients and providing targeted interventions, healthcare facilities can potentially reduce hospital readmissions, emergency room visits, and overall healthcare costs.
  
• Furthermore, hospitals and clinics are increasingly focused to support quality improvement initiatives by enabling better care coordination, patient stratification, and personalized treatment plans based on risk profiles.
  

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In 2023, North America secured a substantial market share of 45.2% in the global clinical risk grouping solution market and is expected to dominate throughout the forecast period.

• North America has a strong technological structure with continuous innovation in healthcare. The adoption of advanced analytics, artificial intelligence (AI), and machine learning (ML) algorithms in clinical risk grouping solutions enhances the effectiveness in predicting and managing patient risks.
  
• Moreover, regulatory frameworks in North America, including HIPAA in the U.S. and similar privacy laws in Canada emphasize the importance of patient data security and confidentiality. Therefore, the healthcare system in the region is increasingly moving towards value-based care models where providers are incentivized based on patient outcomes rather than the volume of services provided.
  
• In addition, collaboration between healthcare providers and payers (insurers) in managing patient populations has increased. Thus, clinical risk grouping solutions facilitate this collaboration by providing a common framework for assessing and managing patient risk across different stakeholders.
  
• Thus, aforementioned factors associated with clinical risk group solution will accelerate the market demand in the region.
  

Germany to experience the highest growth rate in the Europe market.

• The country's emphasis on digital health infrastructure and interoperability enhances the adoption of clinical risk grouping solutions. Integrated health data enables more accurate risk assessments and predictive modeling for patient care.
  
• Also, ongoing healthcare reforms in Germany emphasize cost-effectiveness, quality improvement, and patient outcomes. Thus, clinical risk grouping solutions assist healthcare providers in optimizing resource allocation and improving care coordination, aligning with these reform goals, thereby fostering country level market growth.
  

The Asia Pacific clinical risk grouping solution market is expected to grow with a significant CAGR of 11.9% during the forecast period.

• The rising prevalence of chronic diseases such as diabetes, cardiovascular diseases, and cancer in Asia-Pacific is the major factor that increase the demand for clinical risk grouping solutions that help in identifying high-risk patient groups, enabling proactive management and preventive care strategies.
  
• Moreover, the increase in investments in healthcare IT infrastructure development in emerging economies such as China, India, and Southeast Asian countries facilitate the adoption of clinical risk grouping solutions to streamline healthcare delivery and improve outcomes, thereby boosting the growth of the market.
  

Clinical Risk Grouping Solution Market Share

The clinical risk grouping solution industry is characterized by intense competition among key players aiming to expand their market presence. Leading companies are focusing on strategic initiatives such as mergers, acquisitions, and partnerships to strengthen their market position. These efforts are aimed at enhancing their service offerings, expanding their geographic reach, and investing in advanced technologies. The market also witnesses the entry of new players, intensifying the competitive landscape further.

Clinical Risk Grouping Solution Market Companies

Prominent players operating in the clinical risk grouping solution industry are as mentioned below:

• 3M Corporation
• 4S Dawn Clinical Software
• Apixio
• Cotiviti Inc.
• Evolent
• HBI Solutions
• Health Catalyst, Inc.
• HealthEC LLC
• Lightbeam Health Solutions
• MedeAnalytics, Inc.
• Nuance Communications, Inc.
• Optum, Inc.
• RELX (LexisNexis Risk Solution)
• ZeOmega
  

Clinical Risk Grouping Solution Industry News:

• In April 2022, Tata Consultancy Services (TCS) launched TCS ADD suite, the new risk-based monitoring solution enables biopharmaceutical and Contract Research Organizations (CROs) to identify study and site risks through advanced statistical algorithms and drive intelligent data driven decisions. This helped the company to expand its services offerings.
  

The clinical risk grouping solution market research report includes an in-depth coverage of the industry with estimates & forecast in terms of revenue in USD Million from 2021 - 2032 for the following segments:

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Market, By Component

• Software
  • Private cloud
  • Public cloud
  • Hybrid cloud
• Services

Market, By Application

• Population health management
• Chronic disease management
• Clinical decision support
• Fraud detection and prevention
• Other applications

Market, By End-use

• Hospitals & clinics
• Ambulatory surgical centers
• Long term care centers
• Other end-users

The above information is provided for the following regions and countries:

• North America
  • U.S.
  • Canada
• Europe
  • Germany
  • UK
  • France
  • Italy
  • Spain
  • Netherlands
  • Rest of Europe
• Asia Pacific
  • Japan
  • China
  • India
  • Australia
  • South Korea
  • Rest of Asia Pacific
• Latin America
  • Brazil
  • Mexico
  • Rest of Latin America
• Middle East and Africa
  • South Africa
  • Saudia Arabia
  • UAE
  • Rest of Middle East and Africa