The global healthcare payer services market was valued at $19,409.52 million in 2019, and is projected to reach $41,906.64 million by 2027, registering a CAGR of 10.6% from 2020 to 2027. Healthcare payer refers Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), healthcare service contracts, state insurance agencies, and claim handlers. Healthcare payer solution providers help such public and private payers as well as healthcare insurers to manage the claims, member engagement, audits, medical documents, and customer relations. These businesses have dedicated units that help to improve overall health system performance through optimizing care quality; reducing costs & improving consumer experience & care provider performance; and leveraging distinctive capabilities in data & analytics, pharmacy care services, population health, healthcare delivery, & healthcare operations. Through all these services, healthcare payer solution providers help their clients to improve their operational efficiency and reduce their operational cost.
The growth of the global healthcare payer solution market is majorly driven by rise in cost of healthcare systems and urge to decrease wasteful spending. Moreover, surge in risk of healthcare frauds and increase in demand for streamlined business processes drive the growth of the healthcare payer solution market. Furthermore, rise in health insurance enrolment, an increase in adoption of healthcare IT solutions, and implementation of various healthcare reforms such as Patient Protection and Affordable Care Act fuel the growth of the healthcare payer solution market.
However, surge in incidence of data breaches and loss of confidentiality and cultural & language barriers are anticipated to restrict the growth of the market. On the contrary, high growth potential offered by emerging economies and increase in adoption of AI & analytics are expected to offer lucrative opportunities for the market expansion during the forecast period. The global healthcare payer solution market is segmented into service, application, end user, and region. On the basis of service, the market is fragmented into business process outsourcing (BPO) services, information technology outsourcing (ITO) services, and knowledge process outsourcing (KPO) services. By application, it is categorized into pharmacy audit & analysis systems, claims management services, fraud management services, computer-assisted coding (CAC) systems, member eligibility management services, provider network management services, payment management services, customer relationship management services, medical document management services, and general ledger & payroll management. Depending on end user, it is differentiated into private and public end user. Region wise, it is analyzed across North America (U.S., Canada, and Mexico), Europe (Germany, the UK, Italy, Spain, France, and rest of Europe), Asia-Pacific (Japan, China, India, and rest of Asia-Pacific), and LAMEA (Brazil, South Africa, Saudi Arabia, and rest of LAMEA).
Major players operating in the market include UnitedHealth Group Incorporated, McKesson Corporation, HMS Holdings Corp, International Business Machines Corporation, Change Healthcare, Inc., Accenture plc, Cognizant Technology Solutions Corporation, Hinduja Global Solutions Limited, Inovalon Holdings, Inc., and Wipro Limited.
Key Benefits for Stakeholders
Key Market Segments
By Services
By Application
By End User
By Region
List of key players profiled in the report
LIST OF OTHER PLAYERS IN THE VALUE CHAIN (These players are not profiled in the report. The same will be included on request.)
The growth of the global healthcare payer solution market is majorly driven by rise in cost of healthcare systems and urge to decrease wasteful spending. Moreover, surge in risk of healthcare frauds and increase in demand for streamlined business processes drive the growth of the healthcare payer solution market. Furthermore, rise in health insurance enrolment, an increase in adoption of healthcare IT solutions, and implementation of various healthcare reforms such as Patient Protection and Affordable Care Act fuel the growth of the healthcare payer solution market.
However, surge in incidence of data breaches and loss of confidentiality and cultural & language barriers are anticipated to restrict the growth of the market. On the contrary, high growth potential offered by emerging economies and increase in adoption of AI & analytics are expected to offer lucrative opportunities for the market expansion during the forecast period. The global healthcare payer solution market is segmented into service, application, end user, and region. On the basis of service, the market is fragmented into business process outsourcing (BPO) services, information technology outsourcing (ITO) services, and knowledge process outsourcing (KPO) services. By application, it is categorized into pharmacy audit & analysis systems, claims management services, fraud management services, computer-assisted coding (CAC) systems, member eligibility management services, provider network management services, payment management services, customer relationship management services, medical document management services, and general ledger & payroll management. Depending on end user, it is differentiated into private and public end user. Region wise, it is analyzed across North America (U.S., Canada, and Mexico), Europe (Germany, the UK, Italy, Spain, France, and rest of Europe), Asia-Pacific (Japan, China, India, and rest of Asia-Pacific), and LAMEA (Brazil, South Africa, Saudi Arabia, and rest of LAMEA).
Major players operating in the market include UnitedHealth Group Incorporated, McKesson Corporation, HMS Holdings Corp, International Business Machines Corporation, Change Healthcare, Inc., Accenture plc, Cognizant Technology Solutions Corporation, Hinduja Global Solutions Limited, Inovalon Holdings, Inc., and Wipro Limited.
Key Benefits for Stakeholders
- This report entails a detailed quantitative analysis of the current market trends from 2019 to 2027 to identify the prevailing opportunities along with strategic assessment of the global healthcare payer solution market.
- Market size and estimations are based on a comprehensive analysis of the end users, developments, and services in the industry.
- An in-depth analysis based on region assists to understand the regional market and facilitate the strategic business planning.
- The development strategies adopted by the key market players are enlisted to understand the competitive scenario of the market.
Key Market Segments
By Services
- Business Process Outsourcing Services
- Information Technology Outsourcing Services
- Knowledge Process Outsourcing Services
By Application
- Pharmacy Audit & Analysis Systems
- Claims Management Services
- Fraud Management Services
- Computer-assisted Coding (CAC) Systems
- Member Eligibility Management Services
- Provider Network Management Services
- Payment Management Services
- Customer Relationship Management Services
- Medical Document Management Services
- General Ledger & Payroll Management
By End User
- Private Provider
- Public Provider
By Region
- North America
- U.S.
- Canada
- Mexico
- Europe
- Germany
- UK
- Italy
- Spain
- France
- Rest of Europe
- Asia-Pacific
- Japan
- China
- India
- Rest of Asia-Pacific
- LAMEA
- Brazil
- Saudi Arabia
- South Africa
- Rest of Middle East
List of key players profiled in the report
- Accenture Plc.
- Change Healthcare, Inc.
- Cognizant Technology Solutions Corporation
- Hinduja Global Solutions Limited
- HMS Holdings Corp.
- Inovalon Holdings, Inc.
- International Business Machines Corporation Technology
- McKesson Corporation
- UnitedHealth Group Incorporated
- Wipro Limited
LIST OF OTHER PLAYERS IN THE VALUE CHAIN (These players are not profiled in the report. The same will be included on request.)
- HCL Technologies Limited
- Synnex Corporation (Concentrix Corporation)
- Genpact Ltd.
- Sutherland Global Services
- Hexaware Technologies Limited
Frequently Asked Questions about the Global Healthcare Payer Services Market
What is the estimated value of the Global Healthcare Payer Services Market?
What is the growth rate of the Global Healthcare Payer Services Market?
What is the forecasted size of the Global Healthcare Payer Services Market?
Table of Contents
Chapter 1: Introduction
Chapter 2: Executive Summary
Chapter 3: Market Overview
Chapter 4: Healthcare Payer Solution Market, by Service
Chapter 5: Healthcare Payer Solution Market, by Application
Chapter 6: Healthcare Payer Solution Market, by End-user
Chapter 7: Healthcare Payer Solution Market, by Region
Chapter 8: Company Profiles
Methodology
The analyst offers exhaustive research and analysis based on a wide variety of factual inputs, which largely include interviews with industry participants, reliable statistics, and regional intelligence. The in-house industry experts play an instrumental role in designing analytic tools and models, tailored to the requirements of a particular industry segment. The primary research efforts include reaching out participants through mail, tele-conversations, referrals, professional networks, and face-to-face interactions.
They are also in professional corporate relations with various companies that allow them greater flexibility for reaching out to industry participants and commentators for interviews and discussions.
They also refer to a broad array of industry sources for their secondary research, which typically include; however, not limited to:
- Company SEC filings, annual reports, company websites, broker & financial reports, and investor presentations for competitive scenario and shape of the industry
- Scientific and technical writings for product information and related preemptions
- Regional government and statistical databases for macro analysis
- Authentic news articles and other related releases for market evaluation
- Internal and external proprietary databases, key market indicators, and relevant press releases for market estimates and forecast
Furthermore, the accuracy of the data will be analyzed and validated by conducting additional primaries with various industry experts and KOLs. They also provide robust post-sales support to clients.
LOADING...
