基於價值的醫療保健市場－全球產業規模、佔有率、趨勢、機會和預測：按模式、部署方式、最終用戶、地區和競爭對手分類，2021-2031年

全球基於價值的醫療保健市場預計將從 2025 年的 1.89 兆美元成長到 2031 年的 2.94 兆美元，複合年成長率為 7.64%。

這種醫療服務模式根據醫療品質和病人健康結果而非服務數量來支付醫療服務提供者的報酬。推動這一市場發展的主要因素是遏制醫療成本飆升的必要性以及對日益增多的慢性病進行協調管理的迫切需求。這些因素要求醫療服務從追求短暫的技術趨勢轉向提高財務效率和改善患者療效，從而實現根本性的轉變。為了反映這一轉變，美國醫療機構協會（ACO）報告稱，64%的醫療機構預計到2025年，其基於價值的醫療合約收入將比上一年有所成長。

阻礙市場擴張的主要障礙之一是傳統報銷模式轉型帶來的巨大財務風險。由於資金儲備不足和資料基礎設施不完善，醫療服務提供者常常面臨基於價值的合約中固有的潛在虧損風險。這種財務風險使得小規模的機構不願放棄按次計量型的固定報銷收入模式，導致全球市場對責任制醫療框架的接受度緩慢。

市場促進因素

法律義務和政府主導的、旨在推廣基於價值的醫療模式的舉措，正成為市場成長的關鍵催化劑。聯邦政府正積極推動醫療產業擺脫以服務量為導向的模式，透過設立獎勵成本效益、懲罰低效率行為的計畫來實現這一目標。這些法律規範減輕了不斷上漲的國民醫療成本負擔，並鼓勵醫療服務提供者採用責任制醫療框架。這些措施的成功案例也增強了參與其中的商業價值。例如，2025年9月，美國醫療保險和醫療補助服務中心（CMS）報告稱，醫療保險共用節約計劃在2024會計年度為政府節省了24億美元，證明了政府主導的干涉措施在財務上的可行性。

支付方和醫療服務提供者之間獎勵的策略性協調，正在有效地加速從計量型到績效付費的轉變。支付方越來越傾向於設計能夠為那些能夠證明其臨床療效和社區健康管理能力更優的醫療服務提供者提供更大潛在收益的合約。這種經濟上的協調促使醫生將預防保健和慢性病管理置於短期治療之上。 Humana 於 2025 年 2 月發布的《基於價值的醫療保健報告》支持了這種獎勵機制的盈利，報告顯示，在基於價值的 Medicare Advantage 合約下，醫療服務提供方的收入比在標準 Medicare 補償結構下高出 241%。此外，這種結構性轉變正在加速發展。 Optum 的 2025 年數據顯示，約 14% 的美國醫療保健支付將與固定費率風險模型掛鉤，比 2021 年加倍。

市場挑戰

從傳統報銷模式轉向基於價值的醫療保健模式所帶來的巨大財務風險，對全球基於價值的醫療保健市場的擴張構成了重大障礙。基於價值的合約通常要求醫療服務提供者承擔損失責任，即如果醫療成本超過既定基準值，則需承擔相應的財務責任。這種模式需要大量的領先資本儲備來吸收潛在損失，以及高成本的基礎設施來準確追蹤患者的治療效果。對於許多醫療機構，尤其是小規模獨立診所和地方醫院而言，向支付方償還款項的潛在風險是無法控制的，其影響甚至超過了共用節約帶來的潛在收益。

不願直接承擔這種財務風險阻礙了醫療機構廣泛參與責任制醫療框架，並直接減緩了市場成長勢頭。只要醫療服務提供者仍受制於計量型模式以確保收入可預測性，基本契約就會停滯不前。這一障礙的影響在近期的行業研究中顯而易見。根據美國責任制醫療組織協會 (NAACO) 2025 年的調查，87% 的醫療機構表示，財務風險是阻止他們採用基於價值的醫療合約的主要障礙。如此高的擔憂程度表明，除非財務責任得到更有效的緩解，否則市場將難以實現預期的成長率。

市場趨勢

將人工智慧驅動的預測分析應用於風險分層，從根本上改變了醫療機構管理人群健康的方式，使其能夠在代價高昂的併發症發生之前及早識別高風險患者。與簡單的資料聚合不同，這些複雜的演算法會分析歷史計費資料和臨床模式，從而預測諸如再入院和慢性病進展等不利事件，使醫療團隊能夠主動介入。這種技術能力正逐漸成為最大限度共用成本的標準作業要求。根據美國國家衛生資訊科技協調辦公室 (ONC) 2025 年 9 月發布的報告《醫院預測性人工智慧的使用、評估和管治趨勢》，71% 的醫院報告稱，到 2024 年，他們將把預測性人工智慧整合到電子健康記錄 (EHR) 系統中，以改善臨床決策。

同時，將社會健康決定因素納入醫療報銷體系標誌著價值評估的重大變革。此舉承認住宅保障和食品安全等非醫療因素會影響大多數臨床結果。支付方正逐步修訂合約條款，將社會介入措施的獎勵納入傳統醫療報銷代碼之外的範疇。這正朝著一個重視全面病患支持、減少長期醫療資源使用的體系轉變。儘管存在這一戰略轉變，但準確收集社會風險數據仍然是一個至關重要的成長領域。根據Net Health於2025年4月發布的報告《利用ICD-10 Z代碼識別社會健康決定因素》，僅有1.9%的住院患者記錄了社會健康決定因素（SDOH）的Z代碼，這表明各機構可以透過系統化這些關鍵數據要素來顯著提高收入。

目錄

第1章概述

第2章：調查方法

第3章執行摘要

第4章：客戶心聲

第5章：全球價值醫療市場展望

• 市場規模及預測
  • 按金額
• 市佔率及預測
  • 具體模式（責任醫療組織、以病人為中心的醫療之家、績效薪酬、一次性付款）
  • 部署方式（雲端/本地）
  • 依最終用戶（醫院、診所、保險公司、政府機構等）分類
  • 按地區
  • 按公司（2025 年）
• 市場地圖

第6章：北美基於價值的醫療保健市場展望

• 市場規模及預測
• 市佔率及預測
• 北美洲：國別分析
  • 美國
  • 加拿大
  • 墨西哥

第7章：歐洲基於價值的醫療保健市場展望

• 市場規模及預測
• 市佔率及預測
• 歐洲：國別分析
  • 德國
  • 法國
  • 英國
  • 義大利
  • 西班牙

第8章：亞太地區基於價值的醫療保健市場展望

• 市場規模及預測
• 市佔率及預測
• 亞太地區：國別分析
  • 中國
  • 印度
  • 日本
  • 韓國
  • 澳洲

第9章：中東和非洲基於價值的醫療保健市場展望

• 市場規模及預測
• 市佔率及預測
• 中東與非洲：國別分析
  • 沙烏地阿拉伯
  • 阿拉伯聯合大公國
  • 南非

第10章：南美洲基於價值的醫療保健市場展望

• 市場規模及預測
• 市佔率及預測
• 南美洲：國別分析
  • 巴西
  • 哥倫比亞
  • 阿根廷

第11章 市場動態

• 促進因素
• 任務

第12章 市場趨勢與發展

• 併購
• 產品發布
• 近期趨勢

第13章：全球價值醫療市場：SWOT分析

第14章：波特五力分析

• 產業競爭
• 新進入者的潛力
• 供應商的議價能力
• 顧客權力
• 替代品的威脅

第15章 競爭格局

• UnitedHealth Group
• Kaiser Permanente
• Aetna Inc.
• Optum
• Cleveland Clinic
• Mayo Clinic
• Cigna
• Humana
• BCBS
• DaVita

第16章 策略建議

第17章：關於研究公司及免責聲明

The Global Value Based Healthcare Market is projected to expand from USD 1.89 Trillion in 2025 to USD 2.94 Trillion by 2031, reflecting a CAGR of 7.64%. This delivery model functions by compensating providers based on the quality of care and patient health outcomes achieved, rather than the quantity of services performed. The market is primarily driven by the critical need to curb rising healthcare costs and the increasing incidence of chronic diseases demanding coordinated management. These factors demand a fundamental transition toward financial efficiency and superior patient outcomes, moving beyond fleeting technological trends. Reflecting this shift, the National Association of ACOs noted that in 2025, 64% of healthcare organizations anticipated increased revenue from value-based care arrangements compared to the prior year.

One major obstacle hindering wider market expansion is the significant financial risk involved in shifting away from traditional reimbursement structures. Providers frequently struggle with the potential downside liabilities found in value-based contracts due to insufficient capital reserves or inadequate data infrastructure. This financial exposure causes smaller organizations to hesitate in abandoning guaranteed fee-for-service revenue streams, thereby slowing the widespread adoption of accountable care frameworks across the global market.

Market Driver

Legislative mandates and government initiatives promoting value-based models act as the primary catalyst for market growth. Federal authorities are actively directing the industry away from volume-based care by establishing programs that penalize underperformance while rewarding cost efficiency. These regulatory structures alleviate the strain of rising national health expenditures and compel healthcare institutions to implement accountable care frameworks. The demonstrated success of these mandates strengthens the business case for participation; for instance, the Centers for Medicare & Medicaid Services reported in September 2025 that the 'Medicare Shared Savings Program' generated $2.4 billion in net savings for the government during the 2024 performance year, confirming the financial viability of state-led interventions.

The strategic alignment of incentives between payers and providers is effectively hastening the shift from fee-for-service to pay-for-performance reimbursement. Payers are increasingly designing contracts that provide significant upside potential for providers who can demonstrate superior clinical outcomes and population health management. This financial alignment motivates physicians to prioritize preventive care and chronic disease management rather than episodic treatment. According to Humana Inc.'s 'Value-Based Care Report' from February 2025, providers in value-based Medicare Advantage arrangements earned up to 241% above the standard Medicare fee schedule, underscoring the profitability of these aligned incentives. Furthermore, this structural shift is gaining momentum; Optum data from 2025 indicates that approximately 14% of United States healthcare payments were linked to capitated risk models, marking a twofold increase since 2021.

Market Challenge

The considerable financial risk associated with moving from traditional reimbursement models to value-based care constitutes a critical impediment to the expansion of the Global Value Based Healthcare Market. Under value-based agreements, providers must often assume downside liability, meaning they are financially accountable if care costs surpass established benchmarks. This model demands substantial upfront capital reserves to absorb potential losses and requires costly infrastructure to track patient outcomes precisely. For many healthcare entities, especially smaller independent practices and rural hospitals, the possibility of owing funds back to payers presents an unmanageable hazard that outweighs the potential for shared savings.

This reluctance to accept financial exposure directly slows the market's growth momentum by discouraging broad participation in accountable care frameworks. When providers remain tethered to fee-for-service models to secure predictable revenue, the scalable adoption of value-based contracts stalls globally. The impact of this barrier is highlighted by recent industry findings; according to the National Association of ACOs in 2025, 87% of healthcare organizations identified financial risk as the primary barrier preventing the adoption of value-based care arrangements. Such elevated levels of apprehension suggest that until financial liabilities are more effectively mitigated, the market will struggle to achieve its projected growth rates.

Market Trends

The Integration of AI-Driven Predictive Analytics for Risk Stratification is fundamentally transforming how providers handle population health by facilitating the early detection of high-risk patients before expensive complications occur. Distinct from simple data aggregation, these sophisticated algorithms examine historical claims and clinical patterns to predict adverse events, such as hospital readmissions or the progression of chronic diseases, enabling care teams to intervene proactively. This technological capacity is becoming a standard operational necessity for maximizing shared savings; according to the Office of the National Coordinator for Health Information Technology's September 2025 report, 'Hospital Trends in the Use, Evaluation, and Governance of Predictive AI,' 71% of hospitals reported integrating predictive AI into their electronic health records in 2024 to improve clinical decision-making.

Concurrently, the Incorporation of Social Determinants of Health into Reimbursement Frameworks marks a crucial evolution in value assessment, recognizing that non-medical factors such as housing stability and food security influence the majority of clinical outcomes. Payers are progressively modifying contract terms to reimburse for social interventions, moving beyond traditional fee-for-service codes to reward holistic patient support that lowers long-term utilization. Despite this strategic pivot, accurately capturing social risk data remains a significant growth area; according to Net Health's April 2025 report, 'Using ICD-10 Z Codes to Identify Social Determinants of Health,' only 1.9% of inpatient hospital admissions documented SDOH Z codes, underscoring the vast opportunity for organizations to enhance revenue capture by formalizing these essential data elements.

Key Market Players

• UnitedHealth Group
• Kaiser Permanente
• Aetna Inc.
• Optum
• Cleveland Clinic
• Mayo Clinic
• Cigna
• Humana
• BCBS
• DaVita

Report Scope

In this report, the Global Value Based Healthcare Market has been segmented into the following categories, in addition to the industry trends which have also been detailed below:

Value Based Healthcare Market, By Model

• Accountable Care Organization
• Patient-Centered Medical Home
• Pay for Performance
• Bundled Payments

Value Based Healthcare Market, By Deployment

• Cloud
• On-premises

Value Based Healthcare Market, By End User

• Hospitals
• Clinics
• Insurance Companies
• Government
• Others

Value Based Healthcare Market, By Region

• North America
  • United States
  • Canada
  • Mexico
• Europe
  • France
  • United Kingdom
  • Italy
  • Germany
  • Spain
• Asia Pacific
  • China
  • India
  • Japan
  • Australia
  • South Korea
• South America
  • Brazil
  • Argentina
  • Colombia
• Middle East & Africa
  • South Africa
  • Saudi Arabia
  • UAE

Competitive Landscape

Company Profiles: Detailed analysis of the major companies present in the Global Value Based Healthcare Market.

Available Customizations:

Global Value Based Healthcare Market report with the given market data, TechSci Research offers customizations according to a company's specific needs. The following customization options are available for the report:

Company Information

• Detailed analysis and profiling of additional market players (up to five).

Table of Contents

1. Product Overview

• 1.1. Market Definition
• 1.2. Scope of the Market
  • 1.2.1. Markets Covered
  • 1.2.2. Years Considered for Study
  • 1.2.3. Key Market Segmentations

2. Research Methodology

• 2.1. Objective of the Study
• 2.2. Baseline Methodology
• 2.3. Key Industry Partners
• 2.4. Major Association and Secondary Sources
• 2.5. Forecasting Methodology
• 2.6. Data Triangulation & Validation
• 2.7. Assumptions and Limitations

3. Executive Summary

• 3.1. Overview of the Market
• 3.2. Overview of Key Market Segmentations
• 3.3. Overview of Key Market Players
• 3.4. Overview of Key Regions/Countries
• 3.5. Overview of Market Drivers, Challenges, Trends

4. Voice of Customer

5. Global Value Based Healthcare Market Outlook

• 5.1. Market Size & Forecast
  • 5.1.1. By Value
• 5.2. Market Share & Forecast
  • 5.2.1. By Model (Accountable Care Organization, Patient-Centered Medical Home, Pay for Performance, Bundled Payments)
  • 5.2.2. By Deployment (Cloud, On-premises)
  • 5.2.3. By End User (Hospitals, Clinics, Insurance Companies, Government, Others)
  • 5.2.4. By Region
  • 5.2.5. By Company (2025)
• 5.3. Market Map

6. North America Value Based Healthcare Market Outlook

• 6.1. Market Size & Forecast
  • 6.1.1. By Value
• 6.2. Market Share & Forecast
  • 6.2.1. By Model
  • 6.2.2. By Deployment
  • 6.2.3. By End User
  • 6.2.4. By Country
• 6.3. North America: Country Analysis
  • 6.3.1. United States Value Based Healthcare Market Outlook
    • 6.3.1.1. Market Size & Forecast
      • 6.3.1.1.1. By Value
    • 6.3.1.2. Market Share & Forecast
      • 6.3.1.2.1. By Model
      • 6.3.1.2.2. By Deployment
      • 6.3.1.2.3. By End User
  • 6.3.2. Canada Value Based Healthcare Market Outlook
    • 6.3.2.1. Market Size & Forecast
      • 6.3.2.1.1. By Value
    • 6.3.2.2. Market Share & Forecast
      • 6.3.2.2.1. By Model
      • 6.3.2.2.2. By Deployment
      • 6.3.2.2.3. By End User
  • 6.3.3. Mexico Value Based Healthcare Market Outlook
    • 6.3.3.1. Market Size & Forecast
      • 6.3.3.1.1. By Value
    • 6.3.3.2. Market Share & Forecast
      • 6.3.3.2.1. By Model
      • 6.3.3.2.2. By Deployment
      • 6.3.3.2.3. By End User

7. Europe Value Based Healthcare Market Outlook

• 7.1. Market Size & Forecast
  • 7.1.1. By Value
• 7.2. Market Share & Forecast
  • 7.2.1. By Model
  • 7.2.2. By Deployment
  • 7.2.3. By End User
  • 7.2.4. By Country
• 7.3. Europe: Country Analysis
  • 7.3.1. Germany Value Based Healthcare Market Outlook
    • 7.3.1.1. Market Size & Forecast
      • 7.3.1.1.1. By Value
    • 7.3.1.2. Market Share & Forecast
      • 7.3.1.2.1. By Model
      • 7.3.1.2.2. By Deployment
      • 7.3.1.2.3. By End User
  • 7.3.2. France Value Based Healthcare Market Outlook
    • 7.3.2.1. Market Size & Forecast
      • 7.3.2.1.1. By Value
    • 7.3.2.2. Market Share & Forecast
      • 7.3.2.2.1. By Model
      • 7.3.2.2.2. By Deployment
      • 7.3.2.2.3. By End User
  • 7.3.3. United Kingdom Value Based Healthcare Market Outlook
    • 7.3.3.1. Market Size & Forecast
      • 7.3.3.1.1. By Value
    • 7.3.3.2. Market Share & Forecast
      • 7.3.3.2.1. By Model
      • 7.3.3.2.2. By Deployment
      • 7.3.3.2.3. By End User
  • 7.3.4. Italy Value Based Healthcare Market Outlook
    • 7.3.4.1. Market Size & Forecast
      • 7.3.4.1.1. By Value
    • 7.3.4.2. Market Share & Forecast
      • 7.3.4.2.1. By Model
      • 7.3.4.2.2. By Deployment
      • 7.3.4.2.3. By End User
  • 7.3.5. Spain Value Based Healthcare Market Outlook
    • 7.3.5.1. Market Size & Forecast
      • 7.3.5.1.1. By Value
    • 7.3.5.2. Market Share & Forecast
      • 7.3.5.2.1. By Model
      • 7.3.5.2.2. By Deployment
      • 7.3.5.2.3. By End User

8. Asia Pacific Value Based Healthcare Market Outlook

• 8.1. Market Size & Forecast
  • 8.1.1. By Value
• 8.2. Market Share & Forecast
  • 8.2.1. By Model
  • 8.2.2. By Deployment
  • 8.2.3. By End User
  • 8.2.4. By Country
• 8.3. Asia Pacific: Country Analysis
  • 8.3.1. China Value Based Healthcare Market Outlook
    • 8.3.1.1. Market Size & Forecast
      • 8.3.1.1.1. By Value
    • 8.3.1.2. Market Share & Forecast
      • 8.3.1.2.1. By Model
      • 8.3.1.2.2. By Deployment
      • 8.3.1.2.3. By End User
  • 8.3.2. India Value Based Healthcare Market Outlook
    • 8.3.2.1. Market Size & Forecast
      • 8.3.2.1.1. By Value
    • 8.3.2.2. Market Share & Forecast
      • 8.3.2.2.1. By Model
      • 8.3.2.2.2. By Deployment
      • 8.3.2.2.3. By End User
  • 8.3.3. Japan Value Based Healthcare Market Outlook
    • 8.3.3.1. Market Size & Forecast
      • 8.3.3.1.1. By Value
    • 8.3.3.2. Market Share & Forecast
      • 8.3.3.2.1. By Model
      • 8.3.3.2.2. By Deployment
      • 8.3.3.2.3. By End User
  • 8.3.4. South Korea Value Based Healthcare Market Outlook
    • 8.3.4.1. Market Size & Forecast
      • 8.3.4.1.1. By Value
    • 8.3.4.2. Market Share & Forecast
      • 8.3.4.2.1. By Model
      • 8.3.4.2.2. By Deployment
      • 8.3.4.2.3. By End User
  • 8.3.5. Australia Value Based Healthcare Market Outlook
    • 8.3.5.1. Market Size & Forecast
      • 8.3.5.1.1. By Value
    • 8.3.5.2. Market Share & Forecast
      • 8.3.5.2.1. By Model
      • 8.3.5.2.2. By Deployment
      • 8.3.5.2.3. By End User

9. Middle East & Africa Value Based Healthcare Market Outlook

• 9.1. Market Size & Forecast
  • 9.1.1. By Value
• 9.2. Market Share & Forecast
  • 9.2.1. By Model
  • 9.2.2. By Deployment
  • 9.2.3. By End User
  • 9.2.4. By Country
• 9.3. Middle East & Africa: Country Analysis
  • 9.3.1. Saudi Arabia Value Based Healthcare Market Outlook
    • 9.3.1.1. Market Size & Forecast
      • 9.3.1.1.1. By Value
    • 9.3.1.2. Market Share & Forecast
      • 9.3.1.2.1. By Model
      • 9.3.1.2.2. By Deployment
      • 9.3.1.2.3. By End User
  • 9.3.2. UAE Value Based Healthcare Market Outlook
    • 9.3.2.1. Market Size & Forecast
      • 9.3.2.1.1. By Value
    • 9.3.2.2. Market Share & Forecast
      • 9.3.2.2.1. By Model
      • 9.3.2.2.2. By Deployment
      • 9.3.2.2.3. By End User
  • 9.3.3. South Africa Value Based Healthcare Market Outlook
    • 9.3.3.1. Market Size & Forecast
      • 9.3.3.1.1. By Value
    • 9.3.3.2. Market Share & Forecast
      • 9.3.3.2.1. By Model
      • 9.3.3.2.2. By Deployment
      • 9.3.3.2.3. By End User

10. South America Value Based Healthcare Market Outlook

• 10.1. Market Size & Forecast
  • 10.1.1. By Value
• 10.2. Market Share & Forecast
  • 10.2.1. By Model
  • 10.2.2. By Deployment
  • 10.2.3. By End User
  • 10.2.4. By Country
• 10.3. South America: Country Analysis
  • 10.3.1. Brazil Value Based Healthcare Market Outlook
    • 10.3.1.1. Market Size & Forecast
      • 10.3.1.1.1. By Value
    • 10.3.1.2. Market Share & Forecast
      • 10.3.1.2.1. By Model
      • 10.3.1.2.2. By Deployment
      • 10.3.1.2.3. By End User
  • 10.3.2. Colombia Value Based Healthcare Market Outlook
    • 10.3.2.1. Market Size & Forecast
      • 10.3.2.1.1. By Value
    • 10.3.2.2. Market Share & Forecast
      • 10.3.2.2.1. By Model
      • 10.3.2.2.2. By Deployment
      • 10.3.2.2.3. By End User
  • 10.3.3. Argentina Value Based Healthcare Market Outlook
    • 10.3.3.1. Market Size & Forecast
      • 10.3.3.1.1. By Value
    • 10.3.3.2. Market Share & Forecast
      • 10.3.3.2.1. By Model
      • 10.3.3.2.2. By Deployment
      • 10.3.3.2.3. By End User

11. Market Dynamics

• 11.1. Drivers
• 11.2. Challenges

12. Market Trends & Developments

• 12.1. Merger & Acquisition (If Any)
• 12.2. Product Launches (If Any)
• 12.3. Recent Developments

13. Global Value Based Healthcare Market: SWOT Analysis

14. Porter's Five Forces Analysis

• 14.1. Competition in the Industry
• 14.2. Potential of New Entrants
• 14.3. Power of Suppliers
• 14.4. Power of Customers
• 14.5. Threat of Substitute Products

15. Competitive Landscape

• 15.1. UnitedHealth Group
  • 15.1.1. Business Overview
  • 15.1.2. Products & Services
  • 15.1.3. Recent Developments
  • 15.1.4. Key Personnel
  • 15.1.5. SWOT Analysis
• 15.2. Kaiser Permanente
• 15.3. Aetna Inc.
• 15.4. Optum
• 15.5. Cleveland Clinic
• 15.6. Mayo Clinic
• 15.7. Cigna
• 15.8. Humana
• 15.9. BCBS
• 15.10. DaVita

16. Strategic Recommendations

17. About Us & Disclaimer