U.S. Care Management Solutions Market Size Report, 2030

Market Size & Trends

The U.S. care management solutions market size was valued at USD 6.63 billion in 2024 and is projected to grow at a CAGR of 14.1% from 2025 to 2030. The growing incidence of chronic conditions such as diabetes and cardiovascular diseases necessitates effective management strategies. Based on information from the CDC, in 2022, 702,880 people died from heart disease in the U.S. That’s the equivalent of 1 in every 5 deaths. In addition, as per an article published in the Journal of Cardiac Failure, about 6.7 million Americans aged 20 and older are affected by heart failure (HF), with the number projected to increase to 8.7 million by 2030, 10.3 million by 2040, and 11.4 million by 2050. Care management solutions provide tools for remote monitoring and personalized treatment plans, enabling healthcare providers to manage these conditions more effectively. This demand for better management solutions is contributing to the growth of the U.S. care management solutions industry.

Increasing product launches and approval is fostering market growth. For instance, in September 2024, Innovaccer Inc., a prominent company in healthcare AI, revealed the introduction of its Care Management Copilot. This innovative solution integrates Innovaccer’s healthcare-focused AI model, Sara, into its top care management offering, significantly decreasing the documentation workload for care managers, allowing them to save more than ten hours weekly, and empowering them to connect with 30-40% additional patients. Such growing launches of advanced solutions will foster the U.S. care management solutions industry growth.

In addition, the transition from fee-for-service (FFS) to value-based care (VBC) models has significantly influenced the adoption of care management solutions by shifting the focus from volume to patient outcomes and cost efficiency. This shift has driven healthcare organizations to invest in care management solutions that support population health analytics, remote patient monitoring, and predictive analytics. For instance , according to the American Hospital Association, approximately 61% of healthcare payments in the U.S. were linked to value and quality in 2022.

In addition, hospitals implementing care coordination programs have observed a reduction in readmission rates, demonstrating the effectiveness of these solutions in enhancing efficiency and reducing healthcare costs. As the healthcare sector continues to prioritize outcome-based care, the demand for comprehensive care management solutions is expected to rise.

Value-Based Care Models vs. Fee-for-Service Models

Fee-for-Service Care	Value-Based Care
Financial incentives encourage providers to perform a higher volume of procedures or treatments.	Financial incentives are tied to the quality of care provided and patient outcomes.
Providers are reimbursed for all procedures and treatments, regardless of necessity.	Reimbursement is based on achieving optimal patient health.
Operates in a siloed system where providers lack full visibility into a patient’s medical history.	Encourages a team-based approach where providers collaborate to reduce redundant tests and procedures.
Payment remains unchanged, irrespective of patient outcomes.	Focuses on wellness and preventive care to reduce the need for costly interventions.

 

Furthermore, the growing focus on continuous patient monitoring for acute and chronic conditions is driving growth for the U.S. care management solutions industry. In July 2024, CoachCare, a company specializing in remote patient monitoring and virtual care, obtained a strategic growth investment of USD 48 million. Integrity Growth Partners spearheaded the funding round, joined by Topmark Partners. CoachCare collaborates with individual healthcare practices and hospital systems to deliver a remote patient monitoring service for individuals with both acute and chronic conditions, and it provides connected devices that enable providers to gather patient data. The integration of RPM with care management solutions allows healthcare providers to track real-time patient data, optimize resource utilization, and support the industry’s shift toward value-based care, thereby escalating market growth.

Market Concentration & Characteristics

The degree of innovation in U.S. care management solutions is high, driven by advancements in digital health, artificial intelligence (AI), and value-based care models. Companies are leveraging AI-powered analytics, remote patient monitoring (RPM), and predictive modeling to enhance patient outcomes and reduce healthcare costs. The integration of electronic health records (EHRs) with care management platforms allows for real-time data sharing, improving care coordination and decision-making. In January 2025, Tempus AI, Inc., a pioneering technology company in the integration of AI to enhance precision medicine and patient care, announced the nationwide introduction of olivia. olivia is a personal health concierge application powered by AI, created to empower patients by consolidating their health-related information into a single, centralized platform and utilizing advanced AI to offer actionable insights.

The U.S. care management solutions market is characterized by a moderate level of merger and acquisition (M&A) activity by the leading players. This is due to several factors, including the desire to expand the business to cater to the growing demand for care management solutions. In  August 2024, Health Catalyst, Inc., a prominent provider of data and analytics solutions for healthcare organizations, purchased Lumeon Limited (“Lumeon”), a digital health firm operating in both the U.S. and the UK focused on assisting provider organizations in repairing ineffective care coordination systems through automated care orchestration.

Regulations play a crucial role in shaping the U.S. care management solutions market, impacting data security, interoperability, reimbursement policies, and innovation. The Health Insurance Portability and Accountability Act (HIPAA) enforces strict guidelines on patient data privacy, ensuring that care management platforms maintain high-security standards when handling electronic health records (EHRs) and remote patient monitoring (RPM) data.

Product substitutes for U.S. care management solutions come from alternative healthcare models, technologies, and service providers that offer similar functions in patient engagement, monitoring, and coordination. Traditional in-person case management by nurses and social workers can serve as a substitute, particularly in organizations that rely on direct human interaction rather than digital platforms.

Several market players are expanding their business by entering new geographical regions to strengthen their market position and expand their product portfolio. Rising product approvals create more opportunities for market players to enter new regions.

Component Insights

The software segment dominated the market and accounted for the largest revenue share of 58.41% in 2024. The increasing prevalence of chronic diseases necessitates advanced software solutions for effective patient management and care coordination. In October 2024, Inovalon, a provider of cloud-based software solutions that enhance data-driven healthcare, introduced its new product, the Eligibility Verification Pro solution. This tool simplifies accurate confirmation of a patient’s insurance coverage on the first attempt. It is a component of Inovalon’s front-end revenue cycle management software for providers, aimed at enhancing productivity, cash flow, patient outcomes and efficiency, by automatically filling in missing coverage information to minimize claims denials and delays in care for dependable reimbursements and access to services. Such increasing software launches are driving market growth.

The services segment in the U.S. care management solutions market is anticipated to witness significant growth over the forecast period owing to the increasing complexity of healthcare delivery and the requirement for specialized expertise to implement and manage care management systems. Healthcare organizations are increasingly relying on service providers for consulting, system integration, training, and support to effectively deploy and utilize care management solutions. In addition, the integration of advanced technologies such as AI and data analytics into care management requires specialized knowledge for implementation and optimization, further fueling the demand for professional services.

Type Insights

The integrated segment dominated the market and accounted for the largest revenue share of 69.32% in 2024. An integrated platform consolidates multiple functionalities-such as electronic health records (EHRs), patient engagement, care coordination, and analytics-into a unified system, enhancing efficiency and reducing fragmentation in care delivery. Moreover, the demand for such integrated solutions is further fueled by the increasing prevalence of chronic diseases in the U.S. According to a report from the Centers for Disease Control and Prevention released in 2024, 60% of Americans are living with at least one chronic condition, and 40% are affected by two or more chronic conditions. Such increasing cases of chronic disorders are fostering the U.S. care management solutions industry.

The standalone segment is expected to experience significant growth during the forecast period. These solutions offer targeted features such as chronic disease management, patient engagement tools, and care coordination capabilities that cater to particular patient populations or clinical requirements. Furthermore, healthcare providers often prefer standalone systems for their ability to address niche areas with greater depth and flexibility compared to broader integrated platforms. In addition, standalone systems often allow for immediate implementation and lower upfront costs, making them attractive to smaller practices or organizations. Such benefits associated with standalone care management solutions are fostering segmental growth. 

Mode of Delivery Insights

The web based segment dominated the market and accounted for the largest revenue share of 38.71% in 2024 due to their accessibility and ease of deployment. These platforms are accessible through standard web browsers, which eliminates the need for extensive local installations. Furthermore, the flexibility of web-based solutions allows for real-time updates and centralized data management, thereby accelerating market growth. For instance, IQVIA Inc. provides IQVIA Connection, a web-based Software-as-a-Service (SaaS) solution that delivers real-time patient data along with comprehensive analytics, enhancing patient engagement, retention, and exceptional insights and understanding. In addition, web-based systems often require lower upfront investments compared to traditional on-premises solutions, thereby driving segmental growth.

The cloud-based segment is expected to experience the fastest growth during the forecast period due to its scalability, flexibility, and enhanced data security features. These platforms allow healthcare organizations to store and access vast amounts of patient data securely, facilitating seamless information sharing across different care settings. The scalability of cloud-based solutions enables healthcare providers to adjust resources based on demand, making them suitable for organizations of all sizes. In addition, cloud-based solutions often come with advanced security measures to protect sensitive patient information, addressing concerns about data breaches and compliance with regulations such as the Health Insurance Portability and Accountability Act (HIPAA).

End Use Insights

The healthcare providers segment dominated the market and accounted for the largest revenue share of 54.84% in 2024. Healthcare providers in the U.S. are increasingly adopting care management solutions to enhance patient outcomes and operational efficiency, thereby supplementing the growth of the care management solution industry. Moreover, advancements in artificial intelligence (AI) and machine learning are enabling the development of predictive analytics tools within care management software, allowing for proactive patient care and efficient resource allocation. These technological innovations, coupled with supportive regulatory frameworks promoting digital health adoption, are propelling the demand for care management solutions among healthcare providers.

The healthcare payers segment is expected to experience the fastest growth during the forecast period. Healthcare payers, including insurance companies and managed care organizations, are increasingly investing in care management solutions to control costs and improve member health outcomes. For instance, according to the report published in McKinsey Insights in 2021, payers often allocate 10% or more of their administrative budgets to care management programs. Furthermore, the escalating costs associated with chronic disease management and hospital readmissions have prompted payers to seek proactive strategies to manage patient care. By leveraging care management solutions, payers can identify high-risk members, coordinate care interventions, and monitor adherence to treatment plans, ultimately reducing healthcare expenditures.

Key U.S. Care Management Solutions Company Insights

Key participants in the U.S. care management solutions market are focusing on devising innovative business growth strategies in the form of product portfolio expansions, partnerships & collaborations, mergers & acquisitions, and business footprint expansions.

Recent Developments

• In January 2025, Innovaccer Inc., a leading company in healthcare AI, secured USD 275 million in its Series F funding round. This recent funding achievement increases Innovaccer’s total capital raised to USD 675 million and positions the company for substantial progress in healthcare technology. The capital will be used to enhance Innovaccer’s Healthcare Intelligence Cloud, grow its developer ecosystem, and strengthen partnerships with its current customers.

• In March 2024, Rimidi, a leading digital health firm that assists healthcare providers with remote patient monitoring and chronic disease management through EHR-integrated software, services, and connected devices, announced the introduction of The Rimidi Care Network, a collaborative program for clinical service providers focused on remote monitoring. This strategy positioned Rimidi as a key enabler of scalable, efficient, and value-based care delivery.

• In March 2023, Royal Philips launched Philips Virtual Care Management, an extensive range of adaptable solutions and services designed to assist health systems, payers, employer groups, and providers, in more effectively engaging and establishing deeper connections with patients from almost any location. 

U.S. Care Management Solutions Market Report Scope

Report Attribute	Details
Market size value in 2025	USD 7.48 billion
Revenue forecast in 2030	USD 14.50 billion
Growth rate	CAGR of 14.1% from 2025 to 2030
Actual data	2018 – 2024
Forecast data	2025 – 2030
Quantitative units	Revenue in USD million/billion and CAGR from 2025 to 2030
Report coverage	Revenue & Volume forecast, company ranking, competitive landscape, growth factors, and trends
Segments covered	Component, type, mode of delivery, end use
Country scope	U.S.
Key companies profiled	Veradigm LLC (Allscripts Healthcare, LLC), Epic Systems Corporation, Cognizant, Koninklijke Philips N.V., Oracle (Cerner Corp.), ZeOmega, Medecision, IBM, ExlService Holdings, Inc., HealthSnap, Inc..
Customization scope	Free report customization (equivalent up to 8 analysts working days) with purchase. Addition or alteration to country, regional & segment scope.
Pricing and purchase options	Avail customized purchase options to meet your exact research needs. Explore purchase options

U.S. Care Management Solutions Market Report Segmentation

This report forecasts revenue growth at the country level and provides an analysis of the latest industry trends in each of the sub segments from 2018 to 2030. For this study, Grand View Research, Inc. has segmented the U.S. care management solutions market report on the basis of component, type, mode of delivery, and end use:

• Component Outlook (Revenue USD Million, 2018 – 2030)




• Type Outlook (Revenue USD Million, 2018 – 2030)




• Mode of Delivery Outlook (Revenue USD Million, 2018 – 2030)

• Web based

• Cloud based

• On premise  

• End-Use Outlook (Revenue USD Million, 2018 – 2030)

• Healthcare Providers

• Healthcare Payers

• Others