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Medical Case Management Services in the US Industry Data and Analysis
Demographic and economic factors are the driving forces supporting growth for medical case management service providers. An aging population's expanding medical needs are costly and complex, requiring case managers to coordinate and manage care across multiple providers and settings. An evolving healthcare landscape is also enhancing the role of medical case management in the broader health sector. Shifts toward value-based care incentivize healthcare providers to adopt case managers to improve outcomes and lower readmissions to secure maximum reimbursements. At the same time, workforce challenges and operating pressures impacting the health sector have encouraged more providers to outsource medical case management services. These factors have accelerated the industry's growth, with revenue expanding at a CAGR of 7.3% over the past five years, totaling an estimated $21.0 billion in 2025, when revenue will rise an expected 3.8%.
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What's included in this industry analysis
IBISWorld's research coverage on the Medical Case Management Services industry in the United States includes market sizing, forecasting, data and analysis from 2015-2030. The most recent publication was released August 2025.
About this industry
What's this industry report about?
The Medical Case Management Services industry in the United States operates under the NAICS industry code OD5774. Medical case management providers are individuals or organizations that coordinate and oversee the care of patients with complex, chronic or acute medical conditions. Medical case managers aim to optimize patient care, improve quality of life and lower healthcare costs. Related terms covered in the Medical Case Management Services industry in the United States include third-party administrators and workers' compensation claims .
What's included in this industry?
Products and services covered in Medical Case Management Services industry in the United States include Direct care management, Utilization management and Accessing financial resources.
What companies are included in this industry?
The Medical Case Management Services industry in the United States is highly fragmented with no companies holding a market share greater than 5%.
Performance
What's included in the Performance chapter?
The Performance chapter covers detailed analysis, datasets, detailed current performance, sources of volatility and an outlook with forecasts for the Medical Case Management Services industry in the United States.
Questions answered in this chapter include what's driving current industry performance, what influences industry volatility, how do successful businesses overcome volatility, what's driving the industry outlook. This analysis is supported with data and statistics on industry revenues, costs, profits, businesses and employees.
Products & Markets
What's included in the Products and Markets chapter?
The Products and Markets chapter covers detailed products and service segmentation and analysis of major markets for the for the Medical Case Management Services industry in the United States.
Questions answered in this chapter include how are the industry's products and services performing, what are innovations in industry products and services, what products or services do successful businesses offer and what's influencing demand from the industry's markets. This includes data and statistics on industry revenues by product and service segmentation and major markets.
Geographic Breakdown
What's included in the Geographic Breakdown chapter?
The Geographic Breakdown chapter covers detailed analysis and datasets on regional performance of the Medical Case Management Services industry in the United States.
Questions answered in this chapter include where are industry businesses located and how do businesses use location to their advantage. This includes data and statistics on industry revenues by location.
Competitive Forces
What's included in the Competitive Forces chapter?
The Competitive Forces chapter covers the concentration, barriers to entry and supplier and buyer profiles in the Medical Case Management Services industry in the United States. This includes data and statistics on industry market share concentration, barriers to entry, substitute products and buyer & supplier power.
Questions answered in this chapter include what impacts the industry's market share concentration, how do successful businesses handle concentration, what challenges do potential industry entrants face, how can potential entrants overcome barriers to entry, what are substitutes for industry services, how do successful businesses compete with substitutes and what power do buyers and suppliers have over the industry and how do successful businesses manage buyer & supplier power.
Companies
What's included in the Companies chapter?
The Companies chapter covers Key Takeaways, Market Share and Companies in the Medical Case Management Services industry in the United States. This includes data and analysis on companies operating in the industry that hold a market share greater than 5%.
Questions answered in this chapter include what companies have a meaningful market share and how each company is performing.
External Environment
What's included in the External Environment chapter?
The External Environment chapter covers Key Takeaways, External Drivers, Regulation & Policy and Assistance in the Medical Case Management Services industry in the United States. This includes data and statistics on factors impacting industry revenue such as economic indicators, regulation, policy and assistance programs.
Questions answered in this chapter include what demographic and macroeconomic factors impact the industry, what regulations impact the industry, what assistance is available to this industry.
Financial Benchmarks
What's included in the Financial Benchmarks chapter?
The Financial Benchmarks chapter covers Key Takeaways, Cost Structure, Financial Ratios, Valuation Multiples and Key Ratios in the Medical Case Management Services industry in the United States. This includes financial data and statistics on industry performance including key cost inputs, profitability, key financial ratios and enterprise value multiples.
Questions answered in this chapter include what trends impact industry costs and how financial ratios have changed overtime.
Industry Data
What's included in the Industry Data chapter?
The Industry Data chapter includes 10 years of historical data with 5 years of forecast data covering statistics like revenue, industry value add, establishments, enterprises, employment and wages in the Medical Case Management Services industry in the United States.
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Frequently Asked Questions
What is the market size of the Medical Case Management Services industry in the United States in 2026?
The market size of the Medical Case Management Services industry in the United States is $21.0bn in 2026.
How many businesses are there in the Medical Case Management Services industry in the United States in 2025?
There are 77,798 businesses in the Medical Case Management Services industry in the United States, which has grown at a CAGR of 22.7 % between 2020 and 2025.
How may import tariffs affect the Medical Case Management Services industry in the United States?
The Medical Case Management Services industry in the United States is unlikely to be materially impacted by import tariffs with imports accounting for a low share of industry revenue.
How may export tariffs affect the Medical Case Management Services industry in the United States?
The Medical Case Management Services industry in the United States is unlikely to be materially impacted by export tariffs with exports accounting for a low share of industry revenue.
Has the Medical Case Management Services industry in the United States grown or declined over the past 5 years?
The market size of the Medical Case Management Services industry in the United States has been growing at a CAGR of 7.3 % between 2020 and 2025.
What is the forecast growth of the Medical Case Management Services industry in the United States over the next 5 years?
Over the next five years, the Medical Case Management Services industry in the United States is expected to grow.
What does the Medical Case Management Services industry in the United States include?
Direct case management and Utilization management are part of the Medical Case Management Services industry in the United States.
How competitive is the Medical Case Management Services industry in the United States?
The level of competition is high and increasing in the Medical Case Management Services industry in the United States.
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