With PHM solutions, all relevant patient data from various healthcare organizations is collected and analyzed to enhance both medical and financial results. Because of these solutions, healthcare professionals, insurers and public health groups can place patients into groups, find those most at risk, and arrange specific interventions for them. When using a mix of clinical, financial, and behavioral information, PHM promotes replacing fee-for-service care with models that value prevention, controlling chronic illnesses, and helping patients receive coordinated treatment.
Usually, a well-established PHM system consists of data integration, care management, risk grouping, predictive analysis, and patient involvement functions. It lets healthcare organizations track patients’ progress, lower the chance of patients coming back to the hospital, and make collaboration among hospitals and doctors easier. These advanced tools use AI and machine learning to give healthcare workers clear advice as they work and make decisions.
The U.S. Population Health Management Solution Market was valued at US$ 29.70 billion in 2023 and is anticipated to reach US$ 148.23 billion by the end of 2032 with a CAGR of 19.56% from 2024 to 2032.
PHM solutions are being adopted because medical costs continue to increase, more chronic diseases are appearing, and there is a worldwide drive for achieving goals measured by health outcomes. Investment in these tools is going up among governments and healthcare providers in the U.S. and developing countries to make healthcare more effective, meet regulations, and promote better health among all people.
Factors Driving the Growth of the U.S. Population Health Management Solution Market in the United States:
The transition from fee-for-service to value-based care is a primary driver of the U.S. PHM market. As healthcare providers and payers focus on improving patient outcomes while controlling costs, PHM solutions play a critical role in enabling care coordination, reducing hospital readmissions, and supporting outcome-based reimbursement models.
Another key factor is the rising prevalence of chronic diseases such as diabetes, hypertension, and cardiovascular conditions. Managing these conditions across large patient populations requires data-driven insights, risk stratification, and proactive care management, all of which are core capabilities of PHM platforms.
The increasing adoption of electronic health records (EHRs) and healthcare IT infrastructure also fuels market growth. PHM solutions rely heavily on interoperable data sources, and advancements in health information exchange (HIE) and data analytics technologies make it easier to integrate, analyze, and act upon large volumes of patient data.
Government initiatives and regulatory support, including programs like the Affordable Care Act (ACA), Medicare Shared Savings Program (MSSP), and MACRA (Medicare Access and CHIP Reauthorization Act), continue to incentivize providers to adopt PHM solutions. These policies encourage the use of digital tools to improve care quality and patient engagement.
Lastly, the growing focus on personalized and preventive care is accelerating PHM adoption. Providers are increasingly seeking tools that support early intervention, patient education, and behavioral health management. PHM solutions help target high-risk populations and deliver tailored care strategies, ultimately improving long-term health outcomes and reducing system-wide costs.
Competitive Insights:
Some of the key players of the U.S. Population Health Management Solution Market are as follows: Oracle Corporation, Conifer Health Solutions, eClinicalWorks, McKesson, Advisory Board, Philips, Athenahealth, Welltok, Cerner Corporation, Epic Systems Corporation, eClinicalWorks, etc.
In the U.S., there is strong competition for PHM, mostly driven by healthcare IT titans, EHR firms, and experts in data and analytics. Optum, Cerner (Oracle Health), Epic Systems, IBM Merative, and Philips Healthcare are top in this area, providing systems that combine analytics, coordination, categorization, and tools for engaging patients in care. They are favored in the market because their relationships with big healthcare organizations give them larger capabilities.
Sellers are using technology advancements and the ability to work with other brands to gain an edge. Being able to collect data from many EHRs, claims systems, and external sources helps a company succeed in the market. Companies that provide cloud-driven, AI solutions as well as real-time predictive analytics and customizable dashboards are being widely adopted by health systems that value live, actionable information.
Partnering with other companies and buying them are the main approaches to increasing competition. An example of this is Oracle purchasing Cerner, which now helps Oracle provide healthcare here and in the cloud. Just like Orion Group, IBM moved their PHM services into a new firm called Merative to give them greater focus on healthcare analytics and tools for handling large groups of patients. As a result, only a smaller number of firms are using new technology, teams and data resources to stay competitive.
Competition is also tough from mid-sized and niche businesses like eClinicalWorks, Health Catalyst, and Innovaccer, which supply simple, practical software to small and mid-sized practices. The fact that these companies can compete on speed, affordability, and being agile usually attracts healthcare providers with little IT infrastructure or funding. The popularity of PHM is rising because hospitals seek flexible systems designed for various clinical practices.
