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U.S. Healthcare Payer Analytics Market Size, Share & Trends Analysis Report by Analytics Type (Descriptive Analytics), Component (Software), Delivery Model, Application with Growth Forecasts, 2025-2030

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    Report

  • 150 Pages
  • May 2025
  • Region: United States
  • Grand View Research
  • ID: 5230423
The U.S. Healthcare Payer Analytics Market was valued at USD 5.90 billion in 2024, and is projected to reach USD 19.38 billion by 2030, rising at a CAGR of 21.50%. The digital advancements in the healthcare field, and the digitization of records, are one of the key factors driving the growth of this market. Adoption of such technologies is on an upward trend thus propelling the market. Digital data is being used to derive meaningful results, cost reduction, and minimize fraudulent insurance claims.

The U.S. government has been increasingly spending on healthcare and focusing on improving digital infrastructure, which is boosting technological advancements in the field. Due to technological advancements, decision-making for payers and healthcare providers has become easier with the help of analytical tools. The overall increase in healthcare expenditure has amounted to more than USD 4 trillion in the year 2020. It is not only helping the healthcare industry develop faster but has also made healthcare more affordable and precise.

The healthcare analytical tools are helping administrators and policymakers in determining what is the best course of action, how successful is it going to be, and how much cost can be saved by cutting unnecessary expenditures. For insurance companies, analytical tools have helped in recognizing patterns of insurance fraud and in turn saving billions of dollars per year. Doctors’ analytical tools have helped to determine the best treatment plans for a particular patient by studying and analyzing their history.

In the analytics type, the descriptive analysis held the largest market share of 358% in 2022. Descriptive analytics has been widely used during COVID by various research organizations as well as laboratories, to determine how contagious the virus is by studying the past and present tests being conducted for coronavirus. Descriptive analytics analyzes data to derive meaningful results and can significantly impact future decisions. The fastest-growing was the predictive analytics segment, this helps in charting the best treatment plan for a personalized treatment plan, it can help the doctor to find out what works best for a patient and can give better treatment outcomes.

In the components, the service segment dominated the market in 2022. Since the majority of establishments do not have an analytics department, it is generally outsourced to industry experts which saves the cost of training and teaching the staff about tools and methods. The fastest-growing component was the hardware, with rapid investment in healthcare IT, the need for better computers and hardware components has been responsible for the growth of the market.

Currently, the largest market share is held by the on-premises delivery model. Healthcare organizations have been opting for the installment of analytical tools and software. The on-premises installation results in less theft of data and provide easier access and maintenance of data and patient records. However, cloud-based storage has been gaining popularity due to ease of storage, and minimum requirement of setup, which has been a key driving factor for the growth of the market.

In the applications segment, the largest market share is currently held by financial applications. Private and government facilities have been increasingly adopting analytics for financial applications. Healthcare analytics is being used for claim settlement, risk analysis, and identifying frauds in insurance claims. The fastest-growing application is also financial applications, for use in identifying frauds related to insurance which cost the payers billions of dollars per year. These factors have contributed significantly to the growth of the healthcare payer analytics market.

The COVID-19 pandemic created a huge opportunity for the healthcare analytics market. The amount of patient data generated during the pandemic has greatly helped in studying how the disease spreads, how contagious it is, and what implications it can have on people. Economies around the world have suffered gravely due to supply chain disruptions saw a decline in the market, but the usage and rate of adoption of analytics have increased overall. Telehealth, a means to communicate with patients and doctors saw 38 times increase in adoption from pre-COVID times, as per McKinsey.

U.S. Healthcare Payer Analytics Market Report Highlights

  • The descriptive analytics segment had the largest market share in 2024. This analytics type is widely used in process optimization and administrative activities.
  • The on-premises segment dominated the market with a share of 47.0% in 2024. The healthcare industry is evolving in terms of technology.
  • Based on application, the financial application segment dominated the market with the largest revenue share in 2024.
  • Based on the components, the services segment had the largest market share of 42.4% in 2024.

This report addresses:

  • Market intelligence to enable effective decision-making
  • Market estimates and forecasts from 2018 to 2030
  • Growth opportunities and trend analyses
  • Segment and regional revenue forecasts for market assessment
  • Competition strategy and market share analysis
  • Product innovation listings for you to stay ahead of the curve

Why Should You Buy This Report?

  • Comprehensive Market Analysis: Gain detailed insights into the market across major regions and segments.
  • Competitive Landscape: Explore the market presence of key players.
  • Future Trends: Discover the pivotal trends and drivers shaping the future of the market.
  • Actionable Recommendations: Utilize insights to uncover new revenue streams and guide strategic business decisions.

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Table of Contents

Chapter 1. Methodology and Scope
1.1. Market Segmentation & Scope
1.2. Segment Definitions
1.2.1. Analytics Type
1.2.2. Component
1.2.3. Delivery Model
1.2.4. Application
1.3. Estimates and Forecast Timeline
1.4. Research Methodology
1.5. Information Procurement
1.5.1. Purchased Database
1.5.2. Internal Database
1.5.3. Secondary Sources
1.5.4. Primary Research
1.6. Information Analysis
1.6.1. Data Analysis Models
1.7. Market Formulation & Data Visualization
1.8. Model Details
1.8.1. Commodity Flow Analysis
1.9. List of Secondary Sources
1.10. Objectives
Chapter 2. Executive Summary
2.1. Market Snapshot
2.2. Segment Snapshot
2.3. Competitive Landscape Snapshot
Chapter 3. Market Variables, Trends, & Scope
3.1. Market Lineage Outlook
3.2. Market Dynamics
3.2.1. Market Driver Analysis
3.2.1.1. Growing usage of AI/ML-Driven in payer analytics solutions
3.2.1.2. Declining payer profit margins of insurance companies
3.2.1.3. Increasing need for risk management and predictive insights
3.2.2. Market Restraint Analysis
3.2.2.1. Data privacy and Security Concerns
3.2.2.2. Shortage of qualified professionals
3.2.2.3. Complex regulatory environment
3.2.3. Market Opportunity Analysis
3.2.3.1. Expansion into predictive and prescriptive analytics
3.2.4. Market Threat Analysis
3.3. Business Environment Analysis
3.3.1. Porter’s Five Forces Analysis
3.3.1.1. Supplier power
3.3.1.2. Buyer power
3.3.1.3. Substitution threat
3.3.1.4. Threat of new entrant
3.3.1.5. Competitive rivalry
3.3.2. PESTLE Analysis
3.3.3. Impact of COVID-19
Chapter 4. U.S. Healthcare Payer Analytics Market: Analytics Type Estimates & Trend Analysis
4.1. Segment Dashboard
4.1.1. U.S. Healthcare Payer Analytics Market: Type Movement Analysis, 2024 & 2030 (USD Million)
4.2. Descriptive Analytics
4.2.1. Descriptive Analytics Market Revenue Estimates and Forecasts, 2018-2030 (USD Million)
4.3. Predictive Analytics
4.3.1. Predictive Analytics Market Revenue Estimates and Forecasts, 2018-2030 (USD Million)
4.4. Prescriptive Analytics
4.4.1. Prescriptive Analytics Market Revenue Estimates and Forecasts, 2018-2030 (USD Million)
4.5. Diagnostic Analytics
4.5.1. Diagnostic Analytics Market Revenue Estimates and Forecasts, 2018-2030 (USD Million)
4.6. Discovery Analytics
4.6.1. Discovery Analytics Market Revenue Estimates and Forecasts, 2018-2030 (USD Million)
Chapter 5. U.S. Healthcare Payer Analytics Market: Component Estimates & Trend Analysis
5.1. Component Segment Dashboard
5.2. Component Market Share Movement Analysis, 2024 & 2030
5.3. Market Size & Forecasts and Trend Analysis, by Component, 2018 to 2030 (USD Million)
5.4. Software
5.4.1. Software market, 2018-2030 (USD Million)
5.5. Hardware
5.5.1. Hardware market 2018-2030 (USD Million)
5.6. Services
5.6.1. Services market, 2018-2030 (USD Million)
Chapter 6. U.S. Healthcare Payer Analytics Market: Delivery Model Estimates & Trend Analysis
6.1. Delivery Model Segment Dashboard
6.2. Delivery Model Market Share Movement Analysis, 2024 & 2030
6.3. Market Size & Forecasts and Trend Analysis, by Delivery Model, 2018 to 2030 (USD Million)
6.4. On-premises
6.5. Web & cloud-based market, 2018-2030 (USD Million)
6.6. Web & cloud-based
6.6.1. Web & cloud-based market, 2018-2030 (USD Million)
6.7. Cloud-Based
6.7.1. Cloud-Based market, 2018-2030 (USD Million)
Chapter 7. U.S. Healthcare Payer Analytics Market: Application Estimates & Trend Analysis
7.1. Application Segment Dashboard
7.2. Application Market Share Movement Analysis, 2024 & 2030
7.3. Market Size & Forecasts and Trend Analysis, by Application, 2018 to 2030 (USD Million)
7.4. Clinical
7.4.1. Clinical I market, 2018-2030 (USD Million)
7.5. Financial
7.5.1. Financial market, 2018-2030 (USD Million)
7.6. Operational and Administrative
7.6.1. Operational and Administrative market, 2018-2030 (USD Million)
Chapter 8. Competitive Landscape
8.1. Participant Overview
8.2. Company Market Position Analysis
8.3. Company Categorization
8.4. Strategy Mapping
8.5. Company Profiles/Listing
8.5.1. CloudMedx
8.5.1.1. Overview
8.5.1.2. Financial performance
8.5.1.3. Product benchmarking
8.5.1.4. Strategic initiatives
8.5.2. DataSmart Solutions
8.5.2.1. Overview
8.5.2.2. Financial performance
8.5.2.3. Product benchmarking
8.5.2.4. Strategic initiatives
8.5.3. Amitech Solutions
8.5.3.1. Overview
8.5.3.2. Financial performance
8.5.3.3. Product benchmarking
8.5.3.4. Strategic initiatives
8.5.4. Caserta Concepts
8.5.4.1. Overview
8.5.4.2. Financial performance
8.5.4.3. Product benchmarking
8.5.4.4. Strategic initiatives
8.5.5. Greenway Health, LLC
8.5.5.1. Overview
8.5.5.2. Financial performance
8.5.5.3. Product benchmarking
8.5.5.4. Strategic initiatives
8.5.6. IMAT Solutions
8.5.6.1. Overview
8.5.6.2. Financial performance
8.5.6.3. Product benchmarking
8.5.6.4. Strategic initiatives
8.5.7. Health Catalyst
8.5.7.1. Overview
8.5.7.2. Financial performance
8.5.7.3. Product benchmarking
8.5.7.4. Strategic initiatives
8.5.8. Indegene
8.5.8.1. Overview
8.5.8.2. Financial performance
8.5.8.3. Product benchmarking
8.5.8.4. Strategic initiatives
8.5.9. IBM
8.5.9.1. Overview
8.5.9.2. Financial performance
8.5.9.3. Product benchmarking
8.5.9.4. Strategic initiatives
8.5.10. Optum
8.5.10.1. Overview
8.5.10.2. Financial performance
8.5.10.3. Product benchmarking
8.5.10.4. Strategic initiatives
8.5.11. Oracle
8.5.11.1. Overview
8.5.11.2. Financial performance
8.5.11.3. Product benchmarking
8.5.11.4. Strategic initiatives
8.5.12. Citius Tech
8.5.12.1. Overview
8.5.12.2. Financial performance
8.5.12.3. Product benchmarking
8.5.12.4. Strategic initiatives
8.5.13. MedeAnalytics
8.5.13.1. Overview
8.5.13.2. Financial performance
8.5.13.3. Product benchmarking
8.5.13.4. Strategic initiatives
8.5.14. Verisk Analytics, Inc.
8.5.14.1. Overview
8.5.14.2. Financial performance
8.5.14.3. Product benchmarking
8.5.14.4. Strategic initiatives
8.5.15. McKesson Medical-Surgical Inc.
8.5.15.1. Overview
8.5.15.2. Financial performance
8.5.15.3. Product benchmarking
8.5.15.4. Strategic initiatives
8.5.16. Veradigm LLC
8.5.16.1. Overview
8.5.16.2. Financial performance
8.5.16.3. Product benchmarking
8.5.16.4. Strategic initiatives
8.5.17. IQVIA
8.5.17.1. Overview
8.5.17.2. Financial performance
8.5.17.3. Product benchmarking
8.5.17.4. Strategic initiatives
List of Tables
Table 1. List of secondary sources
Table 2. List of abbreviations
Table 3. U.S. Healthcare payer analytics market, Type, 2018-2030 (USD Million)
Table 4. U.S. Healthcare payer analytics market, by Analytics Types, 2018-2030 (USD Million)
Table 5. U.S. Healthcare payer analytics market, by Component, 2018-2030 (USD Million)
Table 6. U.S. Healthcare payer analytics market, by Delivery Model, 2018-2030 (USD Million)
Table 7. U.S. Healthcare payer analytics market, by Application, 2018-2030 (USD Million)
List of Figures
Figure 1 Market research process
Figure 2 Information procurement
Figure 3 Primary research pattern
Figure 4 Market research approaches
Figure 5 Value chain-based sizing & forecasting
Figure 6 Market formulation & validation
Figure 7 Market segmentation
Figure 8 Market snapshot
Figure 9 Segment snapshot
Figure 10 Competitive landscape snapshot
Figure 11 Market trends & outlook
Figure 12 Market driver relevance analysis (current & future impact)
Figure 13 Market restraint relevance analysis (current & future impact)
Figure 14 PESTLE analysis
Figure 15 Porter’s five forces analysis
Figure 16 U.S.U.S. healthcare payer analytics market analytics type outlook: Key Takeaways
Figure 17 U.S.U.S. healthcare payer analytics market: Analytics type movement analysis, 2018 & 2030
Figure 18 Descriptive analytics market estimates and forecasts 2018-2030 (USD Million)
Figure 19 Predictive analytics market estimates and forecasts 2018-2030 (USD Million)
Figure 20 Prescriptive analytics market estimates and forecasts 2018-2030 (USD Million)
Figure 21 Diagnostic Analytics market estimates and forecasts 2018-2030 (USD Million)
Figure 22 Discovery Analytics market estimates and forecasts 2018-2030 (USD Million)
Figure 23 U.S.U.S. Healthcare payer analytics Market component outlook: Key takeaways
Figure 24 U.S.U.S. Healthcare payer analytics market: Component movement analysis, 2018 & 2030
Figure 25 Software market estimates and forecasts 2018-2030 (USD Million)
Figure 26 Hardware market estimates and forecasts 2018-2030 (USD Million)
Figure 27 Services market estimates and forecasts 2018-2030 (USD Million)
Figure 28 U.S.U.S. healthcare payer analytics market delivery model outlook: Key takeaways
Figure 29 U.S.U.S. healthcare payer analytics market: Delivery model movement analysis, 2018 & 2030 (USD Million)
Figure 30 On-Premises market estimates and forecasts 2018-2030 (USD Million)
Figure 31 Web-based market estimates and forecasts 2018-2030 (USD Million)
Figure 32 Cloud-based market estimates and forecasts 2018-2030 (USD Million)
Figure 33 U.S.U.S. healthcare payer analytics market application outlook: Key takeaways
Figure 34 U.S.U.S. healthcare payer analytics market: Application movement analysis, 2018 & 2030 (USD Million)
Figure 35 Clinical market estimates and forecasts 2018-2030 (USD Million)
Figure 36 Financial market estimates and forecasts 2018-2030 (USD Million)
Figure 37 Operational and Administrative market estimates and forecasts 2018-2030 (USD
Figure 38 Market Participant Categorization
Figure 39 Strategy mapping
Figure 40 Company market position analysis

Companies Mentioned

The major companies featured in this U.S. Healthcare Payer Analytics market report include:
  • CloudMedx
  • DataSmart Solutions
  • Amitech Solutions
  • Caserta Concepts
  • Greenway Health, LLC
  • IMAT Solutions
  • Health Catalyst
  • Indegene
  • IBM
  • Optum
  • Oracle
  • Citius Tech
  • MedeAnalytics
  • Verisk Analytics, Inc.
  • McKesson Medical-Surgical Inc.
  • Veradigm LLC
  • IQVIA

Table Information