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Global Healthcare Claims Management Market by Solutions (Claims Integration, Claims Management Reporting, Claims Review Management), Delivery Mode (Cloud-Based, On-Premise), End User - Forecast 2024-2030

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    Report

  • 195 Pages
  • March 2024
  • Region: Global
  • 360iResearch™
  • ID: 5666128
UP TO OFF until Dec 31st 2024
1h Free Analyst Time
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The Healthcare Claims Management Market size was estimated at USD 14.86 billion in 2023, USD 15.91 billion in 2024, and is expected to grow at a CAGR of 7.54% to reach USD 24.72 billion by 2030.

FPNV Positioning Matrix

The FPNV Positioning Matrix is pivotal in evaluating the Healthcare Claims Management Market. It offers a comprehensive assessment of vendors, examining key metrics related to Business Strategy and Product Satisfaction. This in-depth analysis empowers users to make well-informed decisions aligned with their requirements. Based on the evaluation, the vendors are then categorized into four distinct quadrants representing varying levels of success: Forefront (F), Pathfinder (P), Niche (N), or Vital (V).

Market Share Analysis

The Market Share Analysis is a comprehensive tool that provides an insightful and in-depth examination of the current state of vendors in the Healthcare Claims Management Market. By meticulously comparing and analyzing vendor contributions in terms of overall revenue, customer base, and other key metrics, we can offer companies a greater understanding of their performance and the challenges they face when competing for market share. Additionally, this analysis provides valuable insights into the competitive nature of the sector, including factors such as accumulation, fragmentation dominance, and amalgamation traits observed over the base year period studied. With this expanded level of detail, vendors can make more informed decisions and devise effective strategies to gain a competitive edge in the market.

Key Company Profiles

The report delves into recent significant developments in the Healthcare Claims Management Market, highlighting leading vendors and their innovative profiles. These include Accenture PLC, Allscripts Healthcare, LLC, athenahealth, Inc., Avaya Inc., CareCloud, Inc., Cerner Corporation by Oracle Corporation, Conifer Health Solutions, LLC, eClinicalWorks, LLC, Infor Equity Holdings LLC, Kareo, Inc. by Tebra Technologies, Inc., MCKESSON CORPORATION, Optum Inc., OSP Inc., Quest Diagnostics Incorporated, and The SSI Group, LLC.

Market Segmentation & Coverage

This research report categorizes the Healthcare Claims Management Market to forecast the revenues and analyze trends in each of the following sub-markets:

  • Solutions
    • Claims Integration
    • Claims Management Reporting
    • Claims Review Management
    • Claims Status Management
    • Remittance Management Solutions
  • Delivery Mode
    • Cloud-Based
    • On-Premise
  • End User
    • Healthcare Payers
    • Healthcare Providers
  • Region
    • Americas
      • Argentina
      • Brazil
      • Canada
      • Mexico
      • United States
        • California
        • Florida
        • Illinois
        • New York
        • Ohio
        • Pennsylvania
        • Texas
    • Asia-Pacific
      • Australia
      • China
      • India
      • Indonesia
      • Japan
      • Malaysia
      • Philippines
      • Singapore
      • South Korea
      • Taiwan
      • Thailand
      • Vietnam
    • Europe, Middle East & Africa
      • Denmark
      • Egypt
      • Finland
      • France
      • Germany
      • Israel
      • Italy
      • Netherlands
      • Nigeria
      • Norway
      • Poland
      • Qatar
      • Russia
      • Saudi Arabia
      • South Africa
      • Spain
      • Sweden
      • Switzerland
      • Turkey
      • United Arab Emirates
      • United Kingdom

The report offers valuable insights on the following aspects

  1. Market Penetration: It presents comprehensive information on the market provided by key players.
  2. Market Development: It delves deep into lucrative emerging markets and analyzes the penetration across mature market segments.
  3. Market Diversification: It provides detailed information on new product launches, untapped geographic regions, recent developments, and investments.
  4. Competitive Assessment & Intelligence: It conducts an exhaustive assessment of market shares, strategies, products, certifications, regulatory approvals, patent landscape, and manufacturing capabilities of the leading players.
  5. Product Development & Innovation: It offers intelligent insights on future technologies, R&D activities, and breakthrough product developments.

The report addresses key questions such as

  1. What is the market size and forecast of the Healthcare Claims Management Market?
  2. Which products, segments, applications, and areas should one consider investing in over the forecast period in the Healthcare Claims Management Market?
  3. What are the technology trends and regulatory frameworks in the Healthcare Claims Management Market?
  4. What is the market share of the leading vendors in the Healthcare Claims Management Market?
  5. Which modes and strategic moves are suitable for entering the Healthcare Claims Management Market?

Please note: For this report, the purchase of an Enterprise license allows up to ten worldwide users of an organization access to the report

Please note: This report can be updated on request. Please contact our Customer Experience team using the Ask a Question widget on our website.

With the purchase of this report at the Multi-user License or greater level, you will have access to one hour with an expert analyst who will help you link key findings in the report to the business issues you're addressing. This will need to be used within three months of purchase.

This report also includes a complimentary Excel file with data from the report for purchasers at the Site License or greater level.

Table of Contents

1. Preface
1.1. Objectives of the Study
1.2. Market Segmentation & Coverage
1.3. Years Considered for the Study
1.4. Currency & Pricing
1.5. Language
1.6. Limitations
1.7. Assumptions
1.8. Stakeholders
2. Research Methodology
2.1. Define: Research Objective
2.2. Determine: Research Design
2.3. Prepare: Research Instrument
2.4. Collect: Data Source
2.5. Analyze: Data Interpretation
2.6. Formulate: Data Verification
2.7. Publish: Research Report
2.8. Repeat: Report Update
3. Executive Summary
4. Market Overview
4.1. Introduction
4.2. Healthcare Claims Management Market, by Region
5. Market Insights
5.1. Market Dynamics
5.1.1. Drivers
5.1.1.1. Rising focus on providing quality healthcare services
5.1.1.2. Surge in demand for medical insurance
5.1.1.3. Increasing digitalization across the healthcare facilities
5.1.2. Restraints
5.1.2.1. High cost of deployment of healthcare claims management solutions
5.1.3. Opportunities
5.1.3.1. Introduction of advanced healthcare claims management solutions
5.1.3.2. Rising adoption of technology-based services across the region
5.1.4. Challenges
5.1.4.1. Privacy issues associated with healthcare claims management solutions
5.2. Market Segmentation Analysis
5.3. Market Trend Analysis
5.4. Cumulative Impact of High Inflation
5.5. Porter’s Five Forces Analysis
5.5.1. Threat of New Entrants
5.5.2. Threat of Substitutes
5.5.3. Bargaining Power of Customers
5.5.4. Bargaining Power of Suppliers
5.5.5. Industry Rivalry
5.6. Value Chain & Critical Path Analysis
5.7. Regulatory Framework
6. Healthcare Claims Management Market, by Solutions
6.1. Introduction
6.2. Claims Integration
6.3. Claims Management Reporting
6.4. Claims Review Management
6.5. Claims Status Management
6.6. Remittance Management Solutions
7. Healthcare Claims Management Market, by Delivery Mode
7.1. Introduction
7.2. Cloud-Based
7.3. On-Premise
8. Healthcare Claims Management Market, by End User
8.1. Introduction
8.2. Healthcare Payers
8.3. Healthcare Providers
9. Americas Healthcare Claims Management Market
9.1. Introduction
9.2. Argentina
9.3. Brazil
9.4. Canada
9.5. Mexico
9.6. United States
10. Asia-Pacific Healthcare Claims Management Market
10.1. Introduction
10.2. Australia
10.3. China
10.4. India
10.5. Indonesia
10.6. Japan
10.7. Malaysia
10.8. Philippines
10.9. Singapore
10.10. South Korea
10.11. Taiwan
10.12. Thailand
10.13. Vietnam
11. Europe, Middle East & Africa Healthcare Claims Management Market
11.1. Introduction
11.2. Denmark
11.3. Egypt
11.4. Finland
11.5. France
11.6. Germany
11.7. Israel
11.8. Italy
11.9. Netherlands
11.10. Nigeria
11.11. Norway
11.12. Poland
11.13. Qatar
11.14. Russia
11.15. Saudi Arabia
11.16. South Africa
11.17. Spain
11.18. Sweden
11.19. Switzerland
11.20. Turkey
11.21. United Arab Emirates
11.22. United Kingdom
12. Competitive Landscape
12.1. FPNV Positioning Matrix
12.2. Market Share Analysis, By Key Player
12.3. Competitive Scenario Analysis, By Key Player
13. Competitive Portfolio
13.1. Key Company Profiles
13.1.1. Accenture PLC
13.1.2. Allscripts Healthcare, LLC
13.1.3. athenahealth, Inc.
13.1.4. Avaya Inc.
13.1.5. CareCloud, Inc.
13.1.6. Cerner Corporation by Oracle Corporation
13.1.7. Conifer Health Solutions, LLC
13.1.8. eClinicalWorks, LLC
13.1.9. Infor Equity Holdings LLC
13.1.10. Kareo, Inc. by Tebra Technologies, Inc.
13.1.11. MCKESSON CORPORATION
13.1.12. Optum Inc.
13.1.13. OSP Inc.
13.1.14. Quest Diagnostics Incorporated
13.1.15. The SSI Group, LLC
13.2. Key Product Portfolio
14. Appendix
14.1. Discussion Guide
14.2. License & Pricing
List of Figures
FIGURE 1. HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH PROCESS
FIGURE 2. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2023 VS 2030
FIGURE 3. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2018-2030 (USD MILLION)
FIGURE 4. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY REGION, 2023 VS 2030 (%)
FIGURE 5. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY REGION, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 6. HEALTHCARE CLAIMS MANAGEMENT MARKET DYNAMICS
FIGURE 7. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY SOLUTIONS, 2023 VS 2030 (%)
FIGURE 8. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY SOLUTIONS, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 9. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY DELIVERY MODE, 2023 VS 2030 (%)
FIGURE 10. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY DELIVERY MODE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 11. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY END USER, 2023 VS 2030 (%)
FIGURE 12. HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY END USER, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 13. AMERICAS HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 14. AMERICAS HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 15. UNITED STATES HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY STATE, 2023 VS 2030 (%)
FIGURE 16. UNITED STATES HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY STATE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 17. ASIA-PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 18. ASIA-PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 19. EUROPE, MIDDLE EAST & AFRICA HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 20. EUROPE, MIDDLE EAST & AFRICA HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 21. HEALTHCARE CLAIMS MANAGEMENT MARKET, FPNV POSITIONING MATRIX, 2023
FIGURE 22. HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE, BY KEY PLAYER, 2023

Companies Mentioned

  • Accenture PLC
  • Allscripts Healthcare, LLC
  • athenahealth, Inc.
  • Avaya Inc.
  • CareCloud, Inc.
  • Cerner Corporation by Oracle Corporation
  • Conifer Health Solutions, LLC
  • eClinicalWorks, LLC
  • Infor Equity Holdings LLC
  • Kareo, Inc. by Tebra Technologies, Inc.
  • MCKESSON CORPORATION
  • Optum Inc.
  • OSP Inc.
  • Quest Diagnostics Incorporated
  • The SSI Group, LLC

Methodology

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Table Information