Physician Advisory Services Market Size, Share & Trends Analysis Report By Service (On-site Services, Remote Services), By End-use (Healthcare Providers, Payers), By Region, And Segment Forecasts, 2024 - 2030

Physician Advisory Services Market Trends

The global physician advisory services market size was estimated at USD 4.25 billion in 2023 and is estimated to grow at a CAGR of 6.8% from 2024 to 2030. The demand for physician advisory services is increasing as healthcare organizations aim to boost operational efficiency and enhance patient care.  By optimizing clinical documentation, streamlining workflows, enhancing revenue cycle management, ensuring regulatory compliance, and integrating technology effectively, physician advisory services (PAS) is boosting the operational efficiency of healthcare organizations. Moreover, as the focus on value-based care intensifies, providers are turning more frequently to advisory services to ensure that care decisions are appropriate and properly reimbursed.

Furthermore, integrating advanced technologies like artificial intelligence and machine learning into physician advisory services fuels innovation and enhances service delivery. For instance, XSOLIS utilizes its innovative CORTEX platform, which helps healthcare providers quickly identify patients needing urgent care and the appropriate type of care. This technology enhances decision-making and reduces denial rates, improving patient outcomes and operational efficiency.

Emerging technologies are significantly transforming physician advisory services, thereby driving the market. Big data and analytics are revolutionizing how physician advisory services operate. Advisors can identify trends, predict outcomes, and make evidence-based recommendations by analyzing vast patient data. This data-driven approach enhances decision-making processes, improves patient care, and helps healthcare organizations optimize resource allocation. Similarly, AI plays a transformative role in physician advisory services by automating routine tasks, enhancing diagnostic accuracy, and providing deeper insights into patient care.

Furthermore, key companies in the market are actively enhancing their offerings and adapting to the evolving healthcare landscape through various strategies and innovations. For instance, companies like R1 RCM and Sound Physicians provide extensive consulting services, including peer-to-peer reviews, utilization reviews, and training for healthcare providers. These firms focus on ensuring compliance with regulations and optimizing care delivery processes. They emphasize strong communication and partnership with clients to enhance service delivery and meet organizational needs, impelling market growth.

Market Concentration & Characteristics

The physician advisory service market is marked by a high degree of innovation driven by technological advancements, regulatory changes, and the evolving needs of healthcare organizations. For instance, in July 2024, Providence expanded its partnership with Xsolis, an AI-driven health technology company that enhances collaboration between healthcare providers and payers. This expansion builds on Providence's successful adoption of Xsolis AI solutions, highlighting the health system's leadership in integrating advanced AI technologies to streamline operations, reduce administrative burdens, and better support care teams while maintaining a strong focus on patient care.

“Providence is dedicated to pioneering the integration of cutting-edge AI technologies to lessen the administrative load and empower our caregivers to provide top-tier, patient-centric care. Expanding our collaboration with Xsolis not only streamlines crucial utilization review processes but also sets a new standard in healthcare by leveraging AI to focus our valuable clinical resources on our core mission-caring for our patients and serving the communities across the Pacific Northwest and beyond.”

- Adar Palis, group vice president of clinical and revenue cycle applications at Providence.

The level of M&A activities in the market is significant, as companies aim to expand their capabilities, integrate advanced technologies like AI, and strengthen their market positions. For instance, in January 2022, R1 RCM Inc. acquired Cloudmed. This acquisition expanded R1 RCM's offerings in CDI, revenue cycle management, and advisory services, allowing it to provide comprehensive solutions to optimize clinical and financial outcomes for healthcare organizations.

The impact of regulations is moderate to high in the industry. Regulations play a crucial role in shaping the market by maintaining healthcare delivery quality, safety, and integrity. Physician advisory services must ensure the confidentiality, integrity, and availability of protected health information (PHI). This includes implementing safeguards to protect against unauthorized access, use, or disclosure of PHI. Also, it must comply with CMS regulations, including accurate clinical documentation, coding, and billing practices to ensure proper reimbursement and avoid penalties.

The market is witnessing significant geographic expansion, driven by increasing demand for healthcare optimization, regulatory compliance, and the need to standardize care across different geographies.Emerging markets, particularly in Asia, Latin America, and Africa, present significant growth opportunities due to expanding healthcare infrastructure and the increasing need for advisory services to improve clinical outcomes and operational efficiency.

Case Study: MedsRole's Impact on Healthcare Practices

Overview:

MedsRole is a leading provider of physician advisory services that focuses on enhancing operational efficiency and patient care in healthcare practices.

Challenges Faced:

Healthcare organizations often encounter several hurdles, including:

• Complex Regulations: Navigating the intricacies of healthcare regulations can be daunting, leading to compliance risks and potential penalties.

• Operational Inefficiencies: Many practices struggle with inefficient workflows that waste time and resources, impacting patient care and satisfaction.

• High Readmission Rates: Hospitals face financial penalties for high readmission rates, necessitating better patient management and follow-up care.

MedsRole's Approach:

MedsRole employs a multifaceted strategy to address these challenges:

• Data-Driven Decision Making: MedsRole leverages advanced data analytics to help healthcare organizations make informed decisions that improve patient outcomes and operational efficiency.

• Workflow Optimization: The company focuses on streamlining processes by identifying redundancies and implementing best practices, ultimately saving time and reducing costs.

• Continuous Education: MedsRole offers ongoing training and education for healthcare staff, ensuring they remain informed about the latest regulations and best practices in patient care.

• Enhanced Communication: MedsRole improves communication and coordination by fostering collaboration among healthcare teams, leading to better patient management and satisfaction.

Outcome:

The implementation of MedsRole's physician advisory services led to several positive outcomes for healthcare organizations:

• Improved Compliance: Organizations reported enhanced understanding and adherence to complex regulations, reducing the risk of penalties.

• Increased Efficiency: Streamlined workflows resulted in significant time savings and reduced operational costs, allowing healthcare providers to focus more on patient care.

• Lower Readmission Rates: By enhancing patient follow-up and care coordination, hospitals experienced a decrease in readmission rates, leading to improved financial performance and patient outcomes.

• Positive Feedback from Staff: Healthcare professionals expressed satisfaction with the training and support provided, noting that it empowered them to deliver better care.

Conclusion:

MedsRole's case study illustrates the transformative impact of physician advisory services on healthcare organizations. By addressing operational inefficiencies, enhancing compliance, and improving patient management, these services play a crucial role in navigating the complexities of modern healthcare

Service Insights

The on-site segment held the largest market share of 60.69% in 2023. On-site physician advisory services involve placing physician advisors directly within healthcare facilities to provide immediate support and guidance.On-site advisors offer real-time support, allowing healthcare providers to make informed decisions quickly. Their presence helps address urgent clinical questions and improve patient care. Moreover, these on-site services help to enhance collaboration, provide tailored training and education, and help improve workflow efficiency. Companies such as Sound Physicians provide on-site services. Organizations using Sound Physicians reported high satisfaction with their on-site advisors, noting their strong communication skills and ability to build personal relationships within the organization. These advisors have been instrumental in improving internal processes, resulting in higher efficiency and better patient outcomes.

Remote physician advisory services leverage technology to provide support from off-site locations. This model is particularly beneficial for organizations that may not have the resources to maintain a full-time on-site advisory team.For instance, XSOLIS utilizes its CORTEX platform to provide remote advisory services, helping organizations quickly identify patients needing urgent care. Clients have reported that while on-site advisors are highly effective, the quality of remote advisors can vary. However, those utilizing the CORTEX technology have seen significant improvements in patient management and reduced denial rates. Moreover, remote services can be more affordable as they reduce the need for physical space and associated overhead costs. Also, these services provide access to a broader talent pool and can be scaled up or down based on the organization's needs, allowing for flexibility in resource allocation. These factors are expected to impel market growth over a forecast period.

End-use Insights

Based on the end use, the market is segmented into healthcare providers, healthcare payers, and others. Healthcare providers held the largest market share of 49.71% in 2023, which includes hospitals, physician practices, and healthcare systems. They are the primary users of physician advisory services. Healthcare providers increasingly utilize physician advisory services to enhance patient care, improve operational efficiency, and ensure regulatory compliance. They are adopting value-based care models, where reimbursement is tied to patient outcomes rather than the volume of services provided. PAS is critical in guiding providers through this transition, helping them optimize clinical practices, improve patient outcomes, and ensure they meet the necessary quality metrics for reimbursement. PAS plays a crucial role in helping providers stay compliant with regulations such as those related to Medicare and Medicaid, reducing the risk of audits and penalties. Moreover, it helps to improve documentation practices, ensuring that patient care is accurately reflected in records and that providers receive appropriate payment for services rendered. Furthermore, the growth of outpatient care, ambulatory surgery centers, and other non-hospital settings is expanding the scope of PAS. Healthcare providers in these settings increasingly rely on PAS to manage the unique challenges of delivering high-quality care outside of traditional hospital environments, thereby driving the segment growth.

Healthcare payers is expected to grow fastest over a forecast period. As healthcare payers shift from fee-for-service models to value-based care, where reimbursement is linked to patient outcomes, PAS assists payers in aligning physician practices with these value-based models, ensuring that care is cost-effective and high-quality. Also, these services help payers implement population health management strategies, which are critical in value-based care. By analyzing data and advising on care protocols, PAS enables payers to manage the health of populations more effectively, reducing costs and improving outcomes. Moreover, PAS utilizes advanced data analytics to provide payers with insights into care patterns, outcomes, and cost drivers. This data-driven approach enables payers to make informed decisions about coverage policies, provider networks, and patient care strategies. In addition, PAS helps payers to adhere to mandates and prevents fraud and abuse. This is expected to boost the adoption of PAS among the payers.

Regional Insights

North America dominated the physician advisory services market with a market share of 52.50% in 2023.  The market in North America is evolving rapidly in response to the shift toward value-based care, the need for regulatory compliance, and the integration of advanced technologies. The rise of bundled payments and Accountable Care Organizations (ACOs) in the U.S. and Canada has increased the demand for PAS to help healthcare providers navigate these complex payment models and ensure they meet quality and cost targets. Moreover, there is a growing trend towards specialization and customization in PAS offerings in North America. Healthcare organizations seek PAS providers that offer specialized services tailored to their specific needs, whether for a particular medical specialty, Service  of facility, or unique regulatory environment.

U.S. Physician Advisory Services Market Trends

The physician advisory services market in the U.S. is experiencing dynamic changes driven by evolving healthcare needs, regulatory demands, and advancements in technology. In addition, the shift towards outpatient and ambulatory care settings in the U.S. is driving demand for PAS that cater to these environments. PAS is helping integrate ambulatory care services into broader healthcare systems, ensuring that care is coordinated and financial performance is optimized across different care settings. Moreover, the U.S. regulatory environment is complex, with strict requirements from Medicare, Medicaid, and private insurers. PAS helps healthcare organizations navigate these regulations, ensure compliance, and avoid penalties.

Europe Physician Advisory Services Market Trends

The physician advisory services market in Europe is expected to grow significantly over the forecast period. European countries are increasingly adopting value-based care models, where reimbursement is tied to patient outcomes rather than service volume. Moreover, the shift towards integrated care systems in Europe drives demand for PAS. These models require seamless coordination between different care providers, and PAS helps ensure that care delivery is efficient and patient-centered. Furthermore, European healthcare organizations increasingly seek specialized and customized PAS to address their unique needs, whether related to specific medical fields or regional regulatory requirements, thereby impelling market growth.

Asia Pacific Physician Advisory Services Market Trends

The physician advisory services market in the Asia Pacific region is expected to grow at the fastest rate of 8.1% over the forecast period. Expanding healthcare infrastructure and a shift towards value-based care drive the PAS market. In addition, with increasing healthcare costs across the region, organizations are turning to PAS to optimize their operations and reduce unnecessary expenditures. Moreover, technological advancements, regulatory complexities, economic growth, and the need for operational efficiency are boosting the adoption of PAS services.

Key Physician Advisory Services Company Insights

Market players are utilizing innovative product development strategies, partnerships, and mergers and acquisitions to expand their presence

Recent Developments

• In September 2023, XSOLIS expanded its partnership with UMC Health System. This extension builds on their successful history of enhancing the provider's operational efficiency and minimizing administrative waste.

“Since implementing XSOLIS' CORTEX® platform in October 2020, as well as its award-winning Physician Advisory Services and Denials Management Services, UMC Health System has harnessed the power of AI and predictive analytics to reduce time conducting utilization review case reviews and better allocate staff members. Bidirectional integration of CORTEX with UMC Health System's electronic medical record has also allowed for broader adoption of XSOLIS' proprietary Care Level Score™ - a predictive, AI-driven numerical representation of medical necessity.”

-----------CIO Bill Eubanks, UMC Health System

• In June 2023, Sound Long-Term Care Management (SLTCM), a division of Sound Physicians, is excited to announce its collaboration with ALTEA Healthcare to improve and streamline patient care across the United States.

“Our proprietary technology and skilled nursing facility provider solution, combined with Sound’s ACO and inpatient expertise, will revolutionize the healthcare industry by improving patient outcomes and streamlining care, We are thrilled to be working with Sound to deliver exceptional patient care and look forward to the positive impact our partnership will have on providers and patients alike.”

  ----- Dr. Jodhvir Sarai, CEO for ALTEA.

Physician Advisory Services Market Report Scope

Global Physician Advisory Services Market Report Segmentation

This report forecasts revenue growth at the regional & country level and provides an analysis of the latest trends and opportunities in each of the sub-segments from 2018 - 2030. For this report, Grand View Research has segmented the global physician advisory services market based on service, end-use, and region:

• Service Outlook (Revenue, USD Billion, 2018 - 2030)

  • On-Site

  • Remote

• End-use Outlook (Revenue, USD Billion, 2018 - 2030)

  • Healthcare Payers

  • Healthcare Providers

  • Others

• Regional Outlook (Revenue, USD Billion, 2018 - 2030)

  • North America

    • U.S.

    • Canada

    • Mexico

  • Europe

    • Germany

    • UK

    • France

    • Spain

    • Italy

    • Norway

    • Denmark

    • Sweden

  • Asia Pacific

    • China

    • India

    • Japan

    • Australia

    • South Korea

    • Thailand

  • Latin America

    • Brazil

    • Argentina

  • MEA

    • South Africa

    • Saudi Arabia

    • UAE

    • Kuwait