Medical Case Management Market Drivers and Forecasts by 2028

The medical case management market is projected to reach US$ 5,228.35 million in 2028 from US$ 4,109.20 million in 2021; it is estimated to grow at a CAGR of 3.5% during 2021–2028.

Medical case management is a combined process of assessing, recommending, planning, coordinating, and implementing various medical services through case managers or patient advocates to promote as well as ensure quality and cost-effective outcomes along with the best possible treatment and rehabilitation. The medical case management services are delivered through web-based, telephonic, and person-to-person modes at hospitals as well as in home care settings. Cases covered under these services can range from catastrophic to short-term disabilities and independent medical examinations. Companies involved in the ` generally establish collaborations and partnerships with hospitals, specialty clinics, and other healthcare facilities on one end and with employers, organizations, events, and individuals on the other to create a chain of services that can be provided to the latter.

The medical case management market is analyzed on the basis of the mode of service, the severity of case, end user, and geography. The market, by geography, is broadly segmented into North America, Europe, Asia Pacific, the Middle East & Africa, and South & Central America. The medical case management market report offers insights and in-depth analysis of the market, emphasizing parameters such as medical case management market size, medical case management market trends, and market dynamics; technological advancements in the market; and the analysis of the competitive landscape of the leading market players in the medical case management market.

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Medical Case Management Market: Strategic Insights

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The medical case management market growth is attributed to the rising prevalence of chronic diseases and increasing adoption of technological advancements that are expected to have a significant short-, mid-, and long-term impact on the medical case management market in the coming years. However, ineffective collaboration, and security and privacy concerns hamper the medical case management market growth. The medical case management market report also identifies opportunities and future medical case management market trends that can have possible impacts on the market growth.

Market Insights

Rising Prevalence of Chronic Diseases Fuels Case Management Market Growth

There is an increase in the number of cases of chronic pain, long-term and short-term disability, and catastrophic cases. To treat these cases and increase the recovery rate of the patients, it has become essential to maintain adequate patient and care management. Chronic pain is linked with numerous physical and mental conditions, and it contributes to high healthcare costs and lost productivity. Several studies estimate that the prevalence of chronic pain ranges from 11% to 40%. Chronic pain results in restricted mobility and hamper daily activities; trigger dependence on opioids, and anxiety and depression; poor perceived health or reduced life quality. According to the Centers for Disease Control and Prevention (CDC), in 2019, the prevalence of chronic pain was 20.4%, and the prevalence of high-impact chronic pain was 7.4%. Chronic pain cases are highest among women (21.7%), non-Hispanic white adults (23.6%) and people aged 65 and above (30.8%). High impact chronic pain was highest among women (8.5%) and those aged 65 and above (11.8%). This type of pain is one of the most common conditions for which adults seek medical care. Therefore, the growing cases of chronic pain propels the demand for medical case management services.

Chronic diseases, such as heart disease, diabetes, stroke, and obesity, are among the leading causes of death across the world, and these diseases hold the largest share of most country's healthcare costs. According to the CDC, 37.3 million people are affected by diabetes, and it is the major cause of lower-limb amputation and kidney failure in the US. The report also estimates that more than 2 million people are diagnosed with diabetes in the US every year. A similar scenario of a high prevalence of diabetes is observed in other regions, such as Europe, Asia Pacific, and the Middle East & Africa. According to International Diabetes Federation's IDF Diabetes Atlas, published in 2021, Southeast Asia had 1 in 11 adults (90 million) suffer from diabetes. Moreover, according to the American College of Cardiology Foundation, in 2018, coronary heart disease (CHD) (43.8%) is the leading cause of deaths due to cardiovascular diseases (CVDs) in the US, followed by stroke (16.8%), high BP (9.4%), heart failure (HF) (9.0%), and other CVDs (17.9%). By 2035, more than 130 million adults in the US population (45.1%) are projected to have some form of CVD, and total costs of CVD are expected to reach US$ 1.1 trillion in 2035. Thus, the rising geriatric population and related chronic disorders create a need for medical case management services for support, treatment, and rehabilitation.

Further, the rate of obesity is growing rapidly among populations of developed and developing countries across the world. Unhealthy and sedentary lifestyles are among the major factors increasing the number of cases of obesity. According to the Organization for Economic Co-operation (OECD), in 2020, more than 1.9 billion adults were overweight. The overweight population has grown rapidly in Canada, Australia, Chile, the UK, and South Africa. The obese population is expected to be high in the US, Mexico, and England, consisting of ~47%, 39%, and 35%, respectively, by the next two decades. According to the data gathered from the National Safety Council (NSC), 48.3 million injuries were reported in the US in 2019. The treatment of these injuries amounted to an estimated US$ 1.0979 trillion. Also, there were 173,040 preventable injury-related deaths during 2019. The preventable deaths can primarily be attributed to a 5% increase in both poisoning deaths (including opioid overdoses) and fall fatalities. Hence, the rising incidence of catastrophic injuries and increasing prevalence of obesity across the world are driving the demand for medical case management services.

Mode of Service-Based Insights

The global medical case management market, based on the mode of service, is segmented into web-based case management, telephonic case management, field case management, and bilingual case management. The telephonic case management segment held the largest share of the market in 2021 It is also is expected to register the highest CAGR during the forecast period.

Severity of Case-Based Insights

Based on the severity of case, the medical case management market is segmented into catastrophic cases, chronic pain, independent medical examinations, long-term disability, and short-term disability. The long-term disability segment held the largest share of the market in 2021 and is expected to hold a significant share of the market during the forecast period. However, the chronic pain segment is expected to register the highest CAGR from 2021 to 2028.

End User-Based Insights

Based on end user, the medical case management market is bifurcated into hospitals and home care settings. The hospitals segment held a larger share of the market and is expected to register a higher CAGR during the forecast period.

Various companies operating in the medical case management market adopt strategies such as product launches, mergers and acquisitions, collaborations, product innovations, and product portfolio expansions to expand their footprint worldwide, maintain a brand name, and meet growing consumer demands.

Medical Case Management Market Regional Insights

The regional trends and factors influencing the Medical Case Management Market throughout the forecast period have been thoroughly explained by the analysts at Insight Partners. This section also discusses Medical Case Management Market segments and geography across North America, Europe, Asia Pacific, Middle East and Africa, and South and Central America.

Medical Case Management Market Report Scope

Medical Case Management Market Players Density: Understanding Its Impact on Business Dynamics

The Medical Case Management Market market is growing rapidly, driven by increasing end-user demand due to factors such as evolving consumer preferences, technological advancements, and greater awareness of the product's benefits. As demand rises, businesses are expanding their offerings, innovating to meet consumer needs, and capitalizing on emerging trends, which further fuels market growth.

Market players density refers to the distribution of firms or companies operating within a particular market or industry. It indicates how many competitors (market players) are present in a given market space relative to its size or total market value.

Major Companies operating in the Medical Case Management Market are:

1. EagleOne Case Management
2. EK Health Services Inc
3. Genex Services, LLC.
4. MMRO INC.
5. TRIUNE Health Group

Disclaimer: The companies listed above are not ranked in any particular order.

Company Profiles

• EagleOne Case Management
• EK Health Services Inc
• Genex Services, LLC
• MMRO INC
• TRIUNE Health Group
• PayerFusion Holdings LLC.
• GMMI, Inc.
• Sierra Nevada Administrators
• AXIOM MEDICAL CONSULTING, LLC
• Medical Case Management Group