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Clinical Risk Grouping Solution Market

ID: MRFR/HC/40100-HCR
200 Pages
Garvit Vyas
October 2025

Clinical Risk Grouping Solution Market Research Report By Deployment Type (On-Premises, Cloud-Based, Hybrid), By Component (Software, Services, Consulting), By End User (Hospitals, Ambulatory Surgical Centers, Diagnostic Laboratories, Government Organizations), By Application (Patient Risk Assessment, Population Health Management, Clinical Decision Support) andBy Regional (North America, Europe, South America, Asia Pacific, Middle East and Africa)- Forecast to 2035

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Clinical Risk Grouping Solution Market Summary

As per MRFR analysis, the Clinical Risk Grouping Solution Market Size was estimated at 5.64 USD Billion in 2024. The Clinical Risk Grouping Solution industry is projected to grow from 6.041 USD Billion in 2025 to 12.01 USD Billion by 2035, exhibiting a compound annual growth rate (CAGR) of 7.11 during the forecast period 2025 - 2035.

Key Market Trends & Highlights

The Clinical Risk Grouping Solution Market is poised for substantial growth driven by technological advancements and a shift towards value-based care.

  • Technological advancements are reshaping the Clinical Risk Grouping Solution Market, enhancing data analytics capabilities.
  • North America remains the largest market, while Asia-Pacific is emerging as the fastest-growing region in this sector.
  • The cloud-based segment leads the market, whereas the hybrid segment is experiencing the most rapid growth.
  • Increasing demand for data analytics and a rising focus on patient-centric care are key drivers propelling market expansion.

Market Size & Forecast

2024 Market Size 5.64 (USD Billion)
2035 Market Size 12.01 (USD Billion)
CAGR (2025 - 2035) 7.11%

Major Players

Optum (US), Cerner Corporation (US), Epic Systems Corporation (US), McKesson Corporation (US), Allscripts Healthcare Solutions (US), IBM Watson Health (US), Philips Healthcare (NL), Siemens Healthineers (DE), Cognizant Technology Solutions (US)

Clinical Risk Grouping Solution Market Trends

The Clinical Risk Grouping Solution Market is currently experiencing a notable evolution, driven by the increasing demand for efficient healthcare management systems. Stakeholders in the healthcare sector are recognizing the necessity of accurately categorizing patients based on their clinical risk profiles. This categorization not only aids in resource allocation but also enhances patient care by enabling tailored treatment plans. As healthcare providers strive to improve outcomes while managing costs, the adoption of clinical risk grouping solutions appears to be gaining momentum. Furthermore, the integration of advanced technologies, such as artificial intelligence and machine learning, is likely to play a pivotal role in refining these solutions, thereby enhancing their effectiveness and usability. In addition, regulatory frameworks are evolving to support the implementation of clinical risk grouping methodologies. Governments and health organizations are increasingly focusing on quality improvement initiatives, which may further propel the demand for these solutions. The emphasis on value-based care is also influencing the market landscape, as providers seek tools that facilitate better patient management and outcomes. Overall, the Clinical Risk Grouping Solution Market seems poised for growth, with various factors converging to create a favorable environment for innovation and adoption in the coming years.

Technological Advancements

The integration of cutting-edge technologies, such as artificial intelligence and machine learning, is transforming the Clinical Risk Grouping Solution Market. These advancements enable more accurate risk assessments and predictive analytics, which can significantly enhance patient management.

Regulatory Support

Evolving regulatory frameworks are increasingly favoring the adoption of clinical risk grouping methodologies. Governments and health organizations are promoting quality improvement initiatives, which may drive demand for effective risk grouping solutions.

Shift Towards Value-Based Care

The ongoing transition towards value-based care is influencing the Clinical Risk Grouping Solution Market. Healthcare providers are seeking tools that not only improve patient outcomes but also optimize resource utilization, aligning with the goals of value-driven healthcare.

Clinical Risk Grouping Solution Market Drivers

Emphasis on Cost Reduction

Cost reduction remains a critical driver in the Clinical Risk Grouping Solution Market. Healthcare organizations are under constant pressure to manage expenses while maintaining high-quality care. Clinical risk grouping solutions facilitate this by enabling providers to identify high-risk patients and allocate resources more effectively. By focusing on preventive care and early intervention, these solutions can help reduce hospital readmissions and associated costs. The potential for significant savings is prompting healthcare systems to invest in clinical risk grouping technologies, which are seen as essential tools for achieving financial sustainability in an increasingly competitive environment.

Increasing Demand for Data Analytics

The Clinical Risk Grouping Solution Market is experiencing a notable surge in demand for data analytics capabilities. Healthcare organizations are increasingly recognizing the value of data-driven decision-making to enhance patient outcomes and operational efficiency. The integration of advanced analytics tools allows for the identification of high-risk patients, enabling proactive interventions. According to recent estimates, the market for healthcare analytics is projected to reach USD 50 billion by 2026, reflecting a compound annual growth rate of approximately 25%. This trend underscores the necessity for clinical risk grouping solutions that can effectively harness data to inform clinical practices and resource allocation.

Rising Focus on Patient-Centric Care

In the Clinical Risk Grouping Solution Market, there is a pronounced shift towards patient-centric care models. Healthcare providers are increasingly prioritizing the needs and preferences of patients, which necessitates the implementation of clinical risk grouping solutions that can tailor interventions accordingly. This approach not only enhances patient satisfaction but also improves health outcomes. As healthcare systems evolve, the emphasis on personalized treatment plans is expected to drive the adoption of clinical risk grouping solutions. The market is anticipated to grow as organizations seek to align their services with patient expectations, thereby fostering a more engaged and informed patient population.

Integration of Artificial Intelligence

The integration of artificial intelligence (AI) technologies is transforming the Clinical Risk Grouping Solution Market. AI-driven solutions are capable of analyzing vast amounts of patient data to identify patterns and predict outcomes, thereby enhancing the accuracy of risk assessments. This technological advancement is likely to streamline clinical workflows and improve the efficiency of healthcare delivery. As AI continues to evolve, its application in clinical risk grouping is expected to expand, potentially leading to more precise and timely interventions. The market for AI in healthcare is projected to reach USD 36 billion by 2025, indicating a robust growth trajectory that will likely benefit clinical risk grouping solutions.

Regulatory Incentives for Quality Improvement

Regulatory incentives aimed at improving healthcare quality are playing a pivotal role in the Clinical Risk Grouping Solution Market. Governments and regulatory bodies are increasingly implementing policies that reward healthcare providers for delivering high-quality care. These incentives often require the use of clinical risk grouping solutions to accurately assess patient populations and demonstrate compliance with quality metrics. As a result, healthcare organizations are more likely to adopt these solutions to meet regulatory requirements and secure funding. The ongoing evolution of healthcare regulations is expected to further drive the demand for clinical risk grouping technologies, as providers seek to align their practices with established quality standards.

Market Segment Insights

By Deployment Type: Cloud-Based (Largest) vs. Hybrid (Fastest-Growing)

In the Clinical Risk Grouping Solution Market, the deployment type segment is primarily dominated by cloud-based solutions due to their accessibility, cost-effectiveness, and scalability. This deployment type is gradually becoming the preferred option for healthcare organizations looking to harness the power of data analytics without heavy upfront investments. In contrast, on-premises solutions maintain a significant presence among organizations prioritizing data security and control, yet their share is gradually declining as cloud adoption escalates. Cloud-based solutions are witnessing rapid adoption, attributed to increasing internet penetration and the healthcare industry's shift towards digital transformation. In addition, hybrid deployments are emerging as the fastest-growing segment, combining the advantages of both on-premises and cloud solutions. They offer flexibility and can cater to varied organizational needs, making them an attractive option for healthcare providers aiming to balance security and accessibility in their clinical risk grouping strategies.

Cloud-Based (Dominant) vs. Hybrid (Emerging)

Cloud-based deployment in the Clinical Risk Grouping Solution Market is characterized by its extensive integration capabilities, enabling real-time data access and collaboration. This type offers healthcare organizations significant advantages in terms of cost reduction and operational efficiency. As more providers transition to value-based care, the demand for such solutions continues to rise. On the other hand, hybrid deployment is emerging rapidly by appealing to organizations seeking to leverage the benefits of both cloud and on-premises setups. This segment's growth reflects a broader trend where healthcare organizations prioritize data compliance, privacy, and flexibility. Both types cater to the growing need for efficient clinical risk management, yet their approaches differ significantly, allowing them to coexist in a dynamic market.

By Component: Software (Largest) vs. Services (Fastest-Growing)

In the Clinical Risk Grouping Solution Market, the component segments display a varied distribution of market shares, where software has established itself as the largest segment. This dominance is driven by the increasing reliance on advanced digital solutions within healthcare organizations for risk assessment and management. Services, while currently smaller in share, are gaining traction as they enhance the overall effectiveness of software solutions. The integration of both segments is essential for facilitating comprehensive clinical risk management workflows.

Services: Consulting (Dominant) vs. Software (Emerging)

Consulting services are a dominant force in the Clinical Risk Grouping Solution Market, as they provide essential expertise in implementing and optimizing software solutions for client organizations. The consulting segment encompasses assessments, project management, and training, which help healthcare providers navigate the complexities of clinical risk grouping. On the other hand, software is emerging as a valuable component, as technological advancements and user-friendly interfaces lead to increased adoption among healthcare entities. These segments together create a solid foundation, ensuring that organizations can effectively leverage clinical risk grouping tools to enhance patient care and operational efficiency.

By End User: Hospitals (Largest) vs. Ambulatory Surgical Centers (Fastest-Growing)

In the Clinical Risk Grouping Solution Market, hospitals hold the largest market share as they represent a substantial portion of end-users requiring comprehensive risk management solutions. Their extensive patient base and complex case management needs necessitate advanced clinical risk grouping capabilities. Ambulatory Surgical Centers (ASCs), while currently smaller in market share compared to hospitals, are rapidly increasing in importance due to the growing trend towards outpatient care and minimally invasive procedures. These facilities are increasingly adopting clinical risk grouping solutions to enhance their operational efficiency and patient outcomes.

Hospitals (Dominant) vs. Ambulatory Surgical Centers (Emerging)

Hospitals dominate the Clinical Risk Grouping Solution Market due to their scale, patient volume, and complex procedural requirements. These institutions focus on implementing sophisticated risk management strategies to improve patient care and reduce operational costs. Conversely, Ambulatory Surgical Centers represent an emerging segment, characterized by their agility and focus on outpatient procedures. ASCs are exploring clinical risk grouping solutions to streamline processes, enhance patient management, and quickly adapt to evolving healthcare regulations, making them a vital part of the market's growth narrative.

By Application: Patient Risk Assessment (Largest) vs. Clinical Decision Support (Fastest-Growing)

In the Clinical Risk Grouping Solution Market, Patient Risk Assessment holds the largest share among application segments, reflecting its critical role in healthcare decision-making. This segment focuses on evaluating the potential risks associated with individual patients, and its dominance is driven by increasing awareness of patient safety and quality improvement initiatives. Meanwhile, Clinical Decision Support is emerging rapidly, integrating advanced analytics and real-time data to assist healthcare providers in making informed decisions, thus gaining traction in the market.

Patient Risk Assessment (Dominant) vs. Clinical Decision Support (Emerging)

The Patient Risk Assessment segment is characterized by its foundational importance in clinical settings, utilizing various metrics and algorithms to evaluate individual risks within patient populations. This dominant segment benefits from regulatory pushes towards enhanced patient safety protocols and quality care standards. On the other hand, Clinical Decision Support is increasingly seen as an emerging segment, leveraging artificial intelligence and big data to inform clinical pathways and improve decision-making processes at the point of care. As technology evolves, the Clinical Decision Support segment is expected to see accelerated growth, providing healthcare professionals with essential tools that improve outcomes and optimize resource utilization.

Get more detailed insights about Clinical Risk Grouping Solution Market

Regional Insights

The Global Clinical Risk Grouping Solution Market is showing promising growth across various regions, with 2024 valuing the overall market at approximately 5.64 USD Billion. North America leads significantly, holding a major share with 2.3 USD Billion in 2024, and is expected to grow to 5.0 USD Billion by 2035, highlighting its dominance and establishment in the market due to advanced healthcare infrastructure and technological adoption. Europe follows with a valuation of 1.4 USD Billion in 2024 and projected growth to 3.0 USD Billion, supported by increasing regulatory frameworks emphasizing patient safety.

The APAC region, valued at 1.2 USD Billion, is forecasted to reach 2.6 USD Billion, driven by expanding healthcare access and investment in digital health solutions. South America, while smaller at 0.4 USD Billion, expects to grow to 0.8 USD Billion, buoyed by rising healthcare spending. Meanwhile, the MEA region, starting at 0.34 USD Billion in 2024, is estimated to achieve 0.6 USD Billion, reflecting increasing focus on improving healthcare services. The Global Clinical Risk Grouping Solution Market statistics reveal that North America holds the majority, ensuring its critical role in advancing clinical risk management solutions globally.

Clinical Risk Grouping Solution Market Region

 Source: Primary Research, Secondary Research, Market Research Future Database and Analyst Review

Clinical Risk Grouping Solution Market Regional Image

Key Players and Competitive Insights

The Global Clinical Risk Grouping Solution Market is experiencing a notable transformation as healthcare providers increasingly seek to enhance patient outcomes through data-driven insights and risk management strategies. This market encompasses tools and systems designed to systematically classify patients based on risk levels, enabling healthcare organizations to implement targeted interventions. Competitive dynamics in this sector are shaped by technological advancements, regulatory changes, and the pressing need for cost containment in healthcare.

Vendors in this space are not only competing on the basis of technology and features but also on their ability to integrate these solutions within existing healthcare infrastructures to provide seamless experiences for both providers and patients.

The focus is also on ensuring compliance with evolving healthcare regulations while delivering real-time analytics that can significantly impact patient care pathways.IBM Watson Health stands out in the Global Clinical Risk Grouping Solution Market due to its advanced data analytics capabilities and robust artificial intelligence offerings. The company leverages its strong expertise in cognitive computing to provide healthcare organizations with powerful risk stratification tools that drive efficient clinical decision-making.

Its solutions are designed to improve patient outcomes through precise identification of high-risk cohorts, ultimately helping providers optimize resource allocation. The strength of IBM Watson Health lies in its ability to integrate vast amounts of medical data from diverse sources, applying machine learning algorithms to generate actionable insights. This capability not only enhances clinical workflows but also contributes to operational efficiencies by reducing unnecessary hospitalizations and streamlining care management strategies.

Cerner also plays a significant role in the Global Clinical Risk Grouping Solution Market, offering comprehensive solutions aimed at enhancing clinical outcomes and operational effectiveness. The organization is known for its healthcare information technology systems which facilitate effective patient data management and clinical risk assessment. Cerner's strength lies in its integrated approach to electronic health records (EHR) and clinical decision support systems, which empowers providers to identify at-risk populations and tailor interventions accordingly.

The ability of Cerner's solutions to seamlessly interact with existing healthcare technologies ensures that clinicians receive timely and relevant risk insights, fostering a proactive rather than reactive approach to patient care. With strong market presence and a commitment to innovation, Cerner continues to solidify its position as a key player in supporting the transformation of clinical risk management practices within healthcare organizations.

Key Companies in the Clinical Risk Grouping Solution Market market include

Industry Developments

  • Q2 2024: Optum launches new AI-powered clinical risk grouping platform for U.S. payers Optum announced the launch of an advanced AI-driven clinical risk grouping solution designed to help U.S. health insurers improve risk stratification and population health management. The platform integrates predictive analytics and social determinants of health data.
  • Q2 2024: 3M Health Information Systems partners with Cerner to integrate clinical risk grouping analytics 3M Health Information Systems entered a strategic partnership with Cerner to embed its clinical risk grouping analytics into Cerner’s electronic health record platform, aiming to enhance risk adjustment and care management for hospital clients.
  • Q3 2024: Conduent secures multi-year contract with NHS England for risk grouping analytics Conduent was awarded a multi-year contract by NHS England to deploy its clinical risk grouping solution across several regional health networks, supporting population health initiatives and value-based care programs.
  • Q3 2024: Cerner opens new analytics R&D center in Dublin focused on clinical risk grouping solutions Cerner inaugurated a new research and development facility in Dublin, Ireland, dedicated to advancing clinical risk grouping technologies and expanding its European market presence.
  • Q4 2024: Optum acquires predictive analytics startup focused on clinical risk grouping Optum completed the acquisition of a U.S.-based startup specializing in predictive analytics for clinical risk grouping, aiming to bolster its technology portfolio and accelerate innovation in risk stratification.
  • Q4 2024: 3M Health Information Systems receives regulatory approval for new risk grouping module in Canada 3M Health Information Systems announced regulatory approval from Health Canada for its latest clinical risk grouping module, enabling Canadian providers to adopt advanced risk adjustment tools.
  • Q1 2025: Conduent launches cloud-native clinical risk grouping dashboard for payers and providers Conduent introduced a new cloud-native dashboard for clinical risk grouping, offering real-time analytics and longitudinal risk tracking for healthcare payers and providers.
  • Q1 2025: Cerner signs partnership with Singapore Ministry of Health for risk grouping pilot program Cerner entered a partnership with Singapore’s Ministry of Health to pilot its clinical risk grouping solution in select hospitals, supporting the country’s digital health transformation efforts.
  • Q2 2025: Optum appoints new Chief Data Science Officer to lead clinical risk grouping innovation Optum named Dr. Priya Desai as Chief Data Science Officer, tasking her with driving innovation in clinical risk grouping and predictive analytics for global healthcare clients.
  • Q2 2025: 3M Health Information Systems wins contract with German hospital network for risk grouping solution 3M Health Information Systems secured a contract to deploy its clinical risk grouping solution across a major German hospital network, supporting risk adjustment and population health management.
  • Q3 2025: Conduent expands clinical risk grouping solution to Australia with new regulatory clearance Conduent received regulatory clearance to launch its clinical risk grouping solution in Australia, marking its entry into the Asia-Pacific market and supporting local value-based care initiatives.
  • Q3 2025: Cerner announces $100M investment in next-generation clinical risk grouping technology Cerner committed $100 million to develop next-generation clinical risk grouping technology, focusing on AI-driven risk stratification and global market expansion.

Future Outlook

Clinical Risk Grouping Solution Market Future Outlook

The Clinical Risk Grouping Solution Market is projected to grow at a 7.11% CAGR from 2024 to 2035, driven by technological advancements, regulatory changes, and increasing demand for efficient healthcare solutions.

New opportunities lie in:

  • Integration of AI-driven analytics for predictive risk assessment.
  • Development of customizable risk grouping software for diverse healthcare settings.
  • Expansion into emerging markets with tailored clinical solutions.

By 2035, the market is expected to achieve substantial growth, reflecting evolving healthcare needs and technological integration.

Market Segmentation

Clinical Risk Grouping Solution Market End User Outlook

  • Hospitals
  • Ambulatory Surgical Centers
  • Diagnostic Laboratories
  • Government Organizations

Clinical Risk Grouping Solution Market Component Outlook

  • Software
  • Services
  • Consulting

Clinical Risk Grouping Solution Market Application Outlook

  • Patient Risk Assessment
  • Population Health Management
  • Clinical Decision Support

Clinical Risk Grouping Solution Market Deployment Type Outlook

  • On-Premises
  • Cloud-Based
  • Hybrid

Report Scope

MARKET SIZE 2024 5.64(USD Billion)
MARKET SIZE 2025 6.041(USD Billion)
MARKET SIZE 2035 12.01(USD Billion)
COMPOUND ANNUAL GROWTH RATE (CAGR) 7.11% (2024 - 2035)
REPORT COVERAGE Revenue Forecast, Competitive Landscape, Growth Factors, and Trends
BASE YEAR 2024
Market Forecast Period 2025 - 2035
Historical Data 2019 - 2024
Market Forecast Units USD Billion
Key Companies Profiled Market analysis in progress
Segments Covered Market segmentation analysis in progress
Key Market Opportunities Integration of artificial intelligence enhances predictive analytics in the Clinical Risk Grouping Solution Market.
Key Market Dynamics Rising demand for data-driven healthcare solutions drives innovation in Clinical Risk Grouping technologies and competitive market dynamics.
Countries Covered North America, Europe, APAC, South America, MEA

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FAQs

What is the projected market valuation of the Clinical Risk Grouping Solution Market by 2035?

The Clinical Risk Grouping Solution Market is projected to reach a valuation of 12.01 USD Billion by 2035.

What was the market valuation of the Clinical Risk Grouping Solution Market in 2024?

In 2024, the market valuation of the Clinical Risk Grouping Solution Market was 5.64 USD Billion.

What is the expected CAGR for the Clinical Risk Grouping Solution Market during the forecast period 2025 - 2035?

The expected CAGR for the Clinical Risk Grouping Solution Market during the forecast period 2025 - 2035 is 7.11%.

Which deployment type segment is anticipated to grow the most by 2035?

The Cloud-Based deployment type segment is anticipated to grow from 2.26 USD Billion in 2024 to 5.04 USD Billion by 2035.

What are the key components of the Clinical Risk Grouping Solution Market?

The key components include Software, Services, and Consulting, with Software projected to grow from 2.26 USD Billion in 2024 to 4.8 USD Billion by 2035.

Which end user segment is expected to dominate the market by 2035?

The Hospitals segment is expected to dominate, growing from 2.82 USD Billion in 2024 to 5.85 USD Billion by 2035.

What applications are driving growth in the Clinical Risk Grouping Solution Market?

Key applications driving growth include Patient Risk Assessment, Population Health Management, and Clinical Decision Support.

Who are the leading players in the Clinical Risk Grouping Solution Market?

Leading players in the market include Optum, Cerner Corporation, Epic Systems Corporation, and McKesson Corporation.

What is the growth potential for the Ambulatory Surgical Centers segment by 2035?

The Ambulatory Surgical Centers segment is projected to grow from 1.13 USD Billion in 2024 to 2.36 USD Billion by 2035.

How does the Clinical Risk Grouping Solution Market compare to other healthcare technology markets?

The Clinical Risk Grouping Solution Market shows robust growth potential, with a projected increase in valuation and a strong CAGR, indicating a favorable comparison to other healthcare technology markets.

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