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Industry Landscape
The healthcare services industry, particularly in care coordination and social determinants of health, is experiencing significant transformation. There's a growing emphasis on value-based care, integrating social support, and leveraging technology (like AI) to improve outcomes for vulnerable populations. Government initiatives like CalAIM are driving innovation and funding models, pushing for more holistic and preventative approaches.
Total Assets Under Management (AUM)
US Healthcare Expenditure in United States
~$4.5 trillion (2022)
(3.8% CAGR)
- Hospital Care: Largest share (31%).
- Physician and Clinical Services: Second largest.
- Prescription Drugs: Significant component.
Total Addressable Market
4.5 trillion USD
Market Growth Stage
Pace of Market Growth
Emerging Technologies
Generative AI in Care Coordination
Generative AI can automate personalized care plan generation, predict patient needs, and optimize resource allocation for complex care management.
Blockchain for Interoperable Health Records
Blockchain can enhance the security, privacy, and seamless sharing of patient data across disparate healthcare and social service providers, improving care continuity.
Remote Patient Monitoring (RPM) with Predictive Analytics
RPM devices combined with AI-driven analytics can proactively identify health deteriorations in vulnerable populations, enabling timely interventions and preventing acute events.
Impactful Policy Frameworks
CalAIM (California Advancing and Innovating Medi-Cal) Initiative (2022 onwards)
CalAIM is a multi-year initiative by California's Department of Health Care Services to transform Medi-Cal by offering new Enhanced Care Management (ECM) and Community Supports benefits, focusing on whole-person care and addressing social determinants of health.
CalAIM directly funds Pair Team's core services, enabling their business model and incentivizing partnerships with community-based organizations.
CMS Interoperability and Patient Access Rule (2021)
This rule, enforced by the Centers for Medicare & Medicaid Services (CMS), requires certain payers (including Medicaid managed care plans) to implement APIs to enable patients to access their claims and clinical data, fostering greater data exchange.
This policy pushes for greater data sharing and interoperability, which can improve Pair Team's ability to access comprehensive patient information and coordinate care more effectively across health plans.
CMS Health Equity Framework (2022)
The Centers for Medicare & Medicaid Services (CMS) released a framework aimed at embedding health equity into all CMS programs, addressing disparities in healthcare access, quality, and outcomes for underserved populations.
This framework reinforces the federal commitment to health equity, aligning with Pair Team's mission and potentially leading to future funding opportunities or programmatic support for their work with vulnerable populations.
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