Accountable Care Solutions: Why Value-Based Care Has Become a Software Business
Updated: 4 days ago
Executive summary. Accountable care began as a payment experiment. In 2026 it is an operating model, and the software that runs it is a market of its own. Strategic Revenue Insights estimates the global accountable care solutions market at USD 28.50 billion in 2025, rising to USD 100.22 billion by 2035 at a 13.40 percent compound annual growth rate. The forces behind that growth are concrete: the Centers for Medicare and Medicaid Services has set a goal that every person in traditional Medicare should be in an accountable care relationship by 2030, Medicare's largest accountable care programme recorded its best financial year in 2024, and the analytics, care coordination and revenue cycle tools that make shared savings possible have moved from pilot budgets to core infrastructure. The organisations capturing the growth are the ones that treat accountable care as a data and workflow business rather than a contracting exercise. This article sets out five lessons from the providers, payers and vendors moving first, with takeaways for strategy, data, operations, technology and revenue.
The structure of that growth matters more than the headline. Strategic Revenue Insights' Accountable Care Solutions Market research finds that software is the largest component segment, that healthcare analytics is the fastest-growing solution type ahead of population health management, care coordination, revenue cycle management, health information exchange and claims management, that healthcare providers are the largest end-user group alongside payers and accountable care organisations, that cloud deployment is gaining traction, and that North America is the largest region while Asia Pacific is the fastest growing. The research identifies the shift to value-based care supported by government incentives, digital transformation, the integration of artificial intelligence into analytics and demand for integrated solutions as the drivers, and regulatory compliance, data privacy and intensifying competition as the restraints.
The policy evidence is unusually clear for a healthcare market. The Centers for Medicare and Medicaid Services reported that as of January 2026 an estimated 14.3 million Medicare beneficiaries receive care coordinated by accountable care organisations across its programmes, up 4.4 percent from 13.7 million in 2025, and that 53.4 percent of people in traditional Medicare were in an accountable care relationship in January 2025 against the 100 percent goal for 2030. The Medicare Shared Savings Program's 2024 results showed 75 percent of 476 participating organisations earning performance payments totalling USD 4.1 billion while Medicare saved USD 2.5 billion against benchmarks, the programme's largest savings to date, and the programme grew to 511 organisations in 2026. Independent research is more measured: a JAMA analysis found that organisations in the programme reduced annual per-patient Medicare spending by a mean of USD 142 in their first three years and USD 294 over six years, with the effect growing over time and larger in physician-led groups. The model works, slowly, and the software determines how fast.
Why the Accountable Care Solutions Market Is Entering a New Phase
Three structural forces are converging.
The policy horizon has become a deadline. The 2030 goal, the growth of the Shared Savings Program and the announcement that a Long-term Enhanced Accountable Care Design model will launch in 2027 at the conclusion of the current ACO REACH model together signal that risk-based contracting is the permanent direction of Medicare, and commercial payers and Medicaid programmes are following. SRI's research names government policy and incentives as the first driver; for providers the question has moved from whether to take risk to how to manage it.
Analytics has become the core capability. Shared savings depend on identifying which patients will become expensive, closing care gaps before they do, and documenting quality to earn the payment. That is an analytics problem, and SRI's research identifies healthcare analytics as the fastest-growing solution type and the integration of artificial intelligence as a driver. The same technologies that are moving agentic AI from pilots into the operating model of care are being applied to risk stratification, prior authorisation and care coordination inside accountable care platforms.
Providers and payers are converging on the same platform. Health systems, physician groups, insurers and the organisations that sit between them are buying population health, care coordination and revenue cycle tools from a shrinking set of vendors, and the companies named in SRI's research, Epic, Oracle Health, Veradigm, athenahealth, McKesson, Optum, IBM, Cognizant, Aetna and eClinicalWorks, are each building toward an integrated stack. SRI's research names demand for integrated solutions as a driver and competition as a restraint; both describe a market consolidating around platforms.
These forces explain SRI's forecast of a market that more than triples between 2025 and 2035, with growth concentrated in analytics software, in cloud deployment and in the provider organisations taking on risk.
Five Lessons From the Organisations Moving First
The providers, payers and software vendors converting accountable care from a contract into a managed operating model share a recognisable pattern. We have distilled it into five lessons, each followed by a takeaway for a specific leadership function.
Lesson 1: Risk Is a Data Problem Before It Is a Contract Problem
The organisations earning the largest shared savings have one thing in common: they know their attributed population better than the payer does. That knowledge is built from claims, clinical records, pharmacy data, social determinants and admission feeds, integrated and refreshed continuously so that care managers see who is deteriorating this week rather than who was expensive last year. SRI's research identifies healthcare analytics as the fastest-growing solution type for this reason: the analytics layer is where the savings are found.
The JAMA finding that savings grow over time, and are larger in physician-led organisations, points to the same conclusion. Savings compound as the data improves and as the organisation learns which interventions move cost, and physician-led groups have fewer competing incentives to fill hospital beds. The organisations moving first have invested in data integration and risk stratification before signing for more risk, so that each contract is priced against a population they can actually manage.
The lesson extends to payers. Insurers moving into accountable care are buying or building the same analytics, because a risk contract they cannot model is a liability.
"Every accountable care contract is a bet that you understand your patients better than the benchmark does. The organisations winning that bet have built the data to prove it before they signed."
Takeaway on strategy and data. Build the integrated data asset first: claims, clinical, pharmacy, admissions and social determinants, refreshed continuously and attributed at the patient level. Price every risk contract against the organisation's demonstrated ability to manage that population, and expand risk as the analytics mature. Treat the data platform as the core asset of accountable care rather than as a reporting tool.
Lesson 2: Care Coordination Is Where the Savings Are Realised
Analytics finds the patient; coordination changes the outcome. The organisations moving first have built care management workflows that act on the analytics: outreach within days of discharge, closing gaps in chronic disease care, managing medications, connecting patients to behavioural health and social services, and keeping the primary care relationship at the centre. SRI's research names care coordination and population health management as distinct solution types; in practice they are one workflow, and the software that connects the risk score to the care manager's task list is what turns insight into savings.
This is also where artificial intelligence is being applied most practically. Prior authorisation, documentation, outreach prioritisation and scheduling are being handled by agentic systems inside care coordination platforms, which lowers the cost per managed patient and allows organisations to extend care management to more of the population. The economics matter: care management is labour, and the organisations that can manage more patients per care manager earn more shared savings.
The same discipline applies to specialty care, where Medicare's strategy for value-based specialty payment is pushing accountable organisations to coordinate across the hospital, the specialist and the post-acute setting.
Takeaway on operations. Connect analytics directly to care management workflow so that every risk signal becomes a task with an owner and a deadline. Automate the administrative layer of coordination with artificial intelligence to extend care management across the population, and measure the programme on avoided admissions, closed gaps and per-patient cost rather than on contacts made. Extend coordination across specialty and post-acute care as payment models follow.
Lesson 3: Revenue Cycle and Risk Adjustment Decide Whether Savings Reach the Balance Sheet
An organisation can lower cost and still lose money in accountable care if its documentation, coding and quality reporting do not reflect the care it delivered. Benchmarks are risk adjusted, quality scores gate the payment, and claims and payment management determine whether the money arrives. SRI's research names revenue cycle management and claims and payment management as solution types for this reason; the companies moving first have integrated them with clinical and analytics systems so that documentation at the point of care supports both patient management and financial accuracy.
Regulatory compliance, which SRI's research names as a restraint, cuts both ways here. Scrutiny of risk adjustment coding has increased, and the organisations that document accurately and audit themselves are protected; those that over-code face clawbacks and reputational damage. The 2027 transition from the current risk-based model to its successor, which is designed to reach smaller, independent and rural practices, will bring new benchmarking and quality rules, and the vendors that implement them first will win those practices.
Revenue cycle is also where accountable care meets the health system's existing financial operations, which makes it the integration point that platform vendors compete on.
"In fee for service you get paid for what you do. In accountable care you get paid for what you prove. The organisations that confuse the two leave their savings on the table."
Takeaway on finance and compliance. Integrate revenue cycle, risk adjustment and quality reporting with clinical workflow so that accurate documentation is a by-product of care rather than a separate task. Audit coding internally against regulatory standards, prepare now for the 2027 model transition, and treat compliance as the protection of earned savings rather than as overhead.
Lesson 4: The Platform Is Consolidating, and Interoperability Is the Price of Entry
SRI's research names demand for integrated solutions as a driver and competition as a restraint, and the market is behaving accordingly. The large electronic health record vendors are extending into population health and revenue cycle, the payer-owned analytics businesses are extending into provider workflow, and the specialist analytics and coordination vendors are being acquired or partnering to stay relevant. Buyers increasingly want one platform, or at least a set of tools that share data without integration projects.
That makes interoperability the condition of survival for every vendor and the main procurement criterion for every buyer. Health information exchange, which SRI's research lists as a solution type, is no longer a separate product but a capability every platform must deliver, supported by federal interoperability rules and the standard application programming interfaces they require. The vendors moving first have opened their platforms, built certified interfaces and made data exchange a selling point rather than a concession.
Cloud deployment, which SRI's research notes is gaining traction, is part of the same shift. Cloud platforms update faster, scale across affiliated practices and integrate more easily than on-premise systems, which is why they are winning in the physician-led and multi-site organisations where accountable care is growing fastest.
Takeaway on technology and partnerships. Build or buy toward an integrated platform, but make interoperability non-negotiable: certified interfaces, standard data models and open exchange with payers and partners. Prefer cloud deployment for speed and scale across affiliated practices, and choose vendors on the strength of their integration roadmap rather than on any single module.
Lesson 5: The Growth Frontier Is Smaller Practices, Medicaid and International Systems
Medicare's early accountable care growth came from large health systems. The next phase, as the Centers for Medicare and Medicaid Services has made explicit in designing its 2027 model, targets smaller, independent and rural practices, which need software and services that make risk manageable without a large administrative staff. The organisations moving first are packaging analytics, coordination and revenue cycle as a managed service for those practices, often through enabling organisations that aggregate practices into accountable groups. SRI's research names accountable care organisations as a distinct end-user segment; the enablers serving small practices are that segment's fastest-growing members.
The same model is spreading beyond Medicare. State Medicaid programmes and commercial insurers are adopting accountable contracts, and health systems in Europe, Asia Pacific and the Middle East are building population health capabilities under their own payment reforms. SRI's research identifies Asia Pacific as the fastest-growing region, driven by digital health investment and demand for integrated care in large, ageing populations.
The capabilities that decide who captures this demand are specific:
Integrated patient-level data assets that make risk measurable before it is contracted.
Care coordination workflows that convert analytics into action and scale with artificial intelligence.
Revenue cycle, risk adjustment and quality reporting integrated with clinical documentation.
Open, interoperable, cloud-deployed platforms that consolidate the stack without locking out partners.
Managed-service models that extend accountable care to small practices, Medicaid and international health systems.
Companies evaluating these competitive dynamics in greater detail can use SRI's Accountable Care Solutions Market analysis to assess component, solution, deployment, end-user and regional segments and the positioning of the leading health technology and payer-owned vendors.
Takeaway on market expansion. Package accountable care as a managed service for small, independent and rural practices ahead of the 2027 model, extend the same platform to Medicaid and commercial contracts, and build international capability in the Asia Pacific and European systems adopting population-based payment. The frontier of accountable care is where the administrative capacity is smallest and the software does the most work.
Where the Opportunity Is Concentrating
Value is moving toward analytics, toward cloud platforms and toward the organisations taking on risk.
By component, software is the largest segment, services grow with implementation and managed care management, and consulting and implementation expand as smaller organisations enter risk.
By solution type, healthcare analytics is growing fastest, population health management and care coordination are the operational core, revenue cycle and claims management protect the earnings, and health information exchange is becoming a platform capability.
By deployment, cloud is gaining share on speed, scale and integration, hybrid serves large health systems with legacy estates, and on-premise is declining.
By end user, healthcare providers are the largest segment, accountable care organisations and the enablers behind them are growing fastest, and payers are expanding as risk contracts spread.
By geography, North America is the largest market on Medicare's 2030 goal and the maturity of its programmes, Asia Pacific is the fastest growing on digital health investment and ageing populations, and Europe is adopting integrated care under its own payment reforms.
At the Horizon: What to Watch Over the Next Three Years
The 2027 model transition. The design of the successor to the current risk-based model, and how many small and rural practices it attracts, will determine the shape of the next growth wave and which vendors serve it.
Analytics performance under scrutiny. As risk adjustment and quality reporting face closer regulatory review, the vendors whose analytics are accurate and auditable will gain share from those whose models cannot be explained.
Commercial and Medicaid adoption. The pace at which employers, insurers and state programmes move to accountable contracts will decide whether the market remains Medicare-led or becomes the default payment model for the health system.
"The next phase of competition in accountable care will not be won by the organisation with the most contracts. It will be won by the one whose data, workflow and documentation turn risk into reliable savings, patient by patient, year after year."
The Strategic Revenue Opportunity
For software vendors, the task is to build integrated, interoperable, cloud-deployed platforms with analytics at the core and to package them as managed services for smaller organisations. For providers, the priority is to build the data asset and care coordination capability before expanding risk. For payers, the opportunity is to bring analytics and coordination to provider partners and to extend accountable contracts across lines of business. For investors, the signal is the growth of analytics software and enabling organisations against a policy horizon that is fixed through 2030.
Market intelligence turns these questions into decisions. Segment-level sizing shows where spend is concentrating across solutions, deployments and end users, competitive benchmarking shows where platform vendors and specialists are strong, and regional analysis shows which markets will adopt population-based payment next. This is the path from market signals to strategic insight to revenue impact.
Takeaway on revenue. Treat the accountable care solutions market as four revenue pools with different buyers and sales cycles: analytics software sold to providers and payers on savings performance, care coordination platforms sold on managed patients and outcomes, revenue cycle and compliance tools sold on protected earnings, and managed services sold to small practices and new markets on access to risk. Each needs its own evidence of return. Enter where the policy deadline is fixed and the administrative capacity is smallest.
The Next Leg: Preparing for the Journey Ahead
The defining shift in accountable care is that the contract has become the easy part. The hard part, and the part where value is being created, is the data, the workflow and the documentation that turn a risk arrangement into reliable savings. The organisations moving first are not the ones with the most beneficiaries; they are the ones who built the analytics, connected it to care management, protected the earnings through revenue cycle and compliance, chose interoperable platforms and extended the model to the practices and markets that need it most.
The next three years will decide which vendors and organisations own the operating system of value-based care through 2030 and beyond. Decision-makers should build the data asset first, make coordination the engine of savings, protect earnings through documentation, insist on interoperability and expand to the frontier. Companies evaluating growth opportunities in this market can use Strategic Revenue Insights' Accountable Care Solutions Market report to assess market size, competitive dynamics, regional opportunities and strategic growth priorities.
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Frequently Asked Questions
How big is the accountable care solutions market?
Strategic Revenue Insights estimates the global accountable care solutions market at USD 28.50 billion in 2025, rising to USD 100.22 billion by 2035 at a 13.40 percent compound annual growth rate.
Why is value-based care becoming a software business?
The Centers for Medicare and Medicaid Services aims for every person in traditional Medicare to be in an accountable care relationship by 2030, and analytics, care coordination and revenue cycle tools have become core infrastructure for shared savings.
Which accountable care solutions segments lead?
Software is the largest component segment and healthcare analytics is the fastest growing solution type. Healthcare providers are the largest end users, cloud deployment is gaining traction and North America is the largest region.
What are the restraints on accountable care solutions?
Regulatory compliance, data privacy and intensifying competition are the main restraints identified in SRI's research.
About the authors: This article was prepared by the Strategic Revenue Insights research team, which combines market intelligence, competitive analysis and strategic advisory for growth-stage, mid-market and enterprise organisations across the healthcare sector. Sector analyst: Kamrul Hasan, Research Manager. Our market estimates combine primary research (interviews, surveys and expert panels) with secondary data (industry reports, databases and public disclosures); read more about how Strategic Revenue Insights works. To discuss this market with our analysts, contact our team.
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