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Patient Access Solutions - Market Share Analysis, Industry Trends & Statistics, Growth Forecasts 2021 - 2029

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  • 112 Pages
  • February 2024
  • Region: Global
  • Mordor Intelligence
  • ID: 4622774
The Patient Access Solutions Market size is estimated at USD 2.07 billion in 2024, and is expected to reach USD 3.02 billion by 2029, growing at a CAGR of 7.82% during the forecast period (2024-2029).

The COVID-19 pandemic impacted the global healthcare system and the patient access solutions market. Patient access solutions witnessed a dramatic increase in their adoption rate during the pandemic to mitigate and prevent the spread of COVID-19. Government and public healthcare officials adopted electronic case reporting (ECR) platforms to track the infection spread status. For instance, an article published by the NCBI in March 2022 mentioned that the surge in COVID-19 cases led to increased adoption of cloud-based solutions by pharmacies, hospitals, and other healthcare facilities, resulting in remote access to data, real-time data tracking, and simpler complex physical ecosystem. Thus, the patient access solutions market witnessed significant growth during the pandemic. Besides, digital patient access underwent a major transformation during the pandemic, and consumer preferences have evolved. As a result, the studied market is expected to witness significant growth over the forecast period.

The need to maintain regulatory compliance, the rising importance of denial management, and an increasing number of patients with health insurance are driving the market studied.

Denial management is an essential part of revenue cycle management. Hospitals can investigate every unpaid claim, spot trends, and appeal the rejection of a claim. Through this solution, healthcare providers can also improve their processes to avoid payment issues for future claims. Thus, the rising importance of denial management is driving the need for a patient access solution. For instance, as per the April 2022 published article in the Journal of AHIMA, denial rates for hospitals are on the rise, increasing by more than 20% over the past five years, with average claims denial rates reaching 10% or more. Thus, the rising number of denial claims is creating a need for its proper management, and healthcare providers are shifting toward healthcare IT solutions, such as patient access solutions, to properly analyze denial claims, thereby driving the growth of the patient access solutions market.

Patient portals help encourage better physician-patient relationships and give patients more control over their treatment. They can check lab results, request prescription refills, update insurance information, manage any unpaid balances, and more. Thus, increasing demand for health insurance and accessibility of patient access solutions in maintaining such data is driving the growth of the market. For instance, in November 2021, My Healthcare partnered with global technology providers Amazon and Microsoft to integrate digital clinical solutions across expensive healthcare data to create a patient longitudinal map. This system maintains a database of patients' insurance information and assists doctors working in the field of cardiology, pediatrics, and other fields to ensure better medical outcomes.

However, data privacy and confidentiality may slow down the growth of the market over the forecast period.

Patient Access Solutions Market Trends

Claims Denial and Appeal Management Solutions Segment is Expected to Witness Significant Growth During the Forecast Period

The claims denial and appeal management solutions segment is expected to witness significant growth over the forecast period, as this software uses current and historical data to maintain every patient detail. With digital data collection, there is more healthcare data to be analyzed every second. With the increasing application of electronic record keeping and other electronic means of data collection and storage, there is a significant amount of data being collected in real time. Many companies are developing software that can be used to do the same, thereby boosting the segment's growth.

Patient access solutions consist of claims denial and appeal management solutions, payment estimation solutions, and other software that helps patients with patient registration and determination of insurance eligibility. The rising awareness of healthcare denial management has given rise to the development of claims denial and appeal management solutions. For instance, a study published by a Journal for Healthcare Quality in April 2022 stated that increased workloads and a shortage of staff, new documentation, and backlogs of both procedures and claims denials have contributed to a rise in claim denials. Hayes, a healthcare technology company, found that an astounding 40% of the claims related to COVID-19 care were denied in the first 10 months of 2021. Hence, this problem may boost the adoption of claims denial and appeal management solutions, thereby contributing to the market's growth.

Further, technological developments and the introduction and launch of new electronic health record (EHR) systems are propelling the demand for these solutions. For instance, in August 2022, Anomaly launched its new offering, Anomaly Smart Response, which uses AI to enable providers and payers to reduce avoidable claim denials and rework and increase payment transparency, which are the top priorities for healthcare stakeholders. The product gives providers a real-time response, predicting actionable denials and payment amounts so they can correct and avoid denials before they occur. Smart Response operates directly within providers' native workflows by integrating with payers, practice management software, and claims clearing houses. Such developments are expected to drive the segment's growth in the future.

North America is Expected to Witness Significant Growth During the Forecast Period

North America is expected to witness significant growth over the forecast period due to technological developments, acquisitions, mergers, and partnerships by key market players. For instance, in May 2021, Optum collaborated with Bassett Healthcare Network (United States) to provide software and data analytics technology-enabled services and research and advisory and revenue cycle management to advance quality care and the patient experience.

Similarly, in July 2021, Philips and Cognizant collaborated to develop an end-to-end digital health solution that will enable life science companies to improve patient care and accelerate clinical trials. The strategic alliance brings together Philips HealthSuite, a cloud-based platform, and Cognizant's digital engineering expertise to deliver and maintain leading-edge digital health solutions at scale, providing advanced connectivity and using big data to create actionable insights. Thus, such collaborations are providing better services to patients, thereby encouraging the engagement of patients on this portal and driving the growth of the market in the region.

Digital tools have led to the minimized cost of services, further resulting in more patient engagement. Many such digital tools were developed during the pandemic for COVID-19 testing. For instance, in January 2022, CureMD Healthcare, the manufacturer of SMART Cloud Health IT solutions, launched its rapid testing platform for COVID-19. CureMD has assisted governments, public and private healthcare facilities, businesses, educational institutions, and nonprofit organizations to mobilize and manage rapid testing at scale through the new rapid testing platform. The solution is designed to introduce efficient, intuitive, and automated workflows to manage COVID-19 testing at an unprecedented scale, thereby driving the market in the region.

Thus, technological developments, new product launches, and mergers and acquisitions in the region are expected to drive the growth of the market.

Patient Access Solutions Industry Overview

The patient access solutions market is fragmented and competitive due to the presence of many companies globally and regionally. The competitive landscape includes an analysis of a few international and local companies that hold market shares and are well known, such as McKesson Corporation, Epic Systems Corporation, Allscripts Healthcare Solutions Inc., Cognizant Technology Solutions Corporation, and Oracle Corporation.

Additional Benefits:

  • The market estimate (ME) sheet in Excel format
  • 3 months of analyst support

This product will be delivered within 2 business days.

Table of Contents

1.1 Study Assumptions and Market Definition
1.2 Scope of the Study
4.1 Market Overview
4.2 Market Drivers
4.2.1 Need to Maintain Regulatory Compliance
4.2.2 Rising Importance of Denial Management
4.2.3 Increasing Number of Patients with Health Insurance
4.3 Market Restraints
4.3.1 Data Privacy and Confidentiality
4.4 Porter's Five Forces Analysis
4.4.1 Threat of New Entrants
4.4.2 Bargaining Power of Buyers/Consumers
4.4.3 Bargaining Power of Suppliers
4.4.4 Threat of Substitute Products
4.4.5 Intensity of Competitive Rivalry
5 MARKET SEGMENTATION (Market Size by Value - USD million)
5.1 By Product and Services
5.1.1 Software Claims Denial and Appeal Management Solutions Payment Estimation Solutions Other Software
5.1.2 Services
5.2 By Deployment
5.2.1 Web and Cloud-based Solutions
5.2.2 On-premise Solutions
5.3 By End User
5.3.1 Healthcare Providers
5.3.2 HCIT Outsourcing Companies
5.3.3 Other End Users
5.4 By Geography
5.4.1 North America United States Canada Mexico
5.4.2 Europe Germany United Kingdom France Italy Spain Rest of Europe
5.4.3 Asia-Pacific China Japan India Australia South Korea Rest of Asia-Pacific
5.4.4 Middle East and Africa GCC South Africa Rest of Middle East and Africa
5.4.5 South America Brazil Argentina Rest of South America
6.1 Company Profiles
6.1.1 Database Solutions Inc.
6.1.2 Oracle Corporation
6.1.3 Cirius Group Inc.
6.1.4 Cognizant Technology Solutions Corporation
6.1.5 Conifer Health Solutions LLC
6.1.6 Epic Systems Corporation
6.1.7 Experian PLC
6.1.8 McKesson Corporation
6.1.9 Optum Inc.
6.1.10 ZirMed Inc.
6.1.11 Roche Holdings Inc. (Genentech Inc.)
6.1.12 Allscripts Healthcare Solutions Inc.

Companies Mentioned (Partial List)

A selection of companies mentioned in this report includes, but is not limited to:

  • Database Solutions Inc.
  • Oracle Corporation
  • Cirius Group Inc.
  • Cognizant Technology Solutions Corporation
  • Conifer Health Solutions LLC
  • Epic Systems Corporation
  • Experian PLC
  • McKesson Corporation
  • Optum Inc.
  • ZirMed Inc.
  • Roche Holdings Inc. (Genentech Inc.)
  • Allscripts Healthcare Solutions Inc.