Healthcare Payer Solution Global Market Report 2023

The healthcare payer solution refers to solutions that assist healthcare insurers, public and private payers, and members in managing claims, member engagement, audits, medical records, and customer relations. These solutions improve the overall performance of the healthcare system by improving care quality, lowering costs, increasing patient satisfaction and provider effectiveness, and leveraging unique competencies.

The main services of healthcare payer solutions are business process outsourcing services, information technology outsourcing services and knowledge process outsourcing services. Business process outsourcing services refer to software that helps in the transfer of one or more intensive business processes to a third party, who then owns, administers, and maintains the chosen processes by predetermined and quantifiable performance goals. The various application involved are pharmacy audit and 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 and payroll management which are used by a private provider and public provider end users.

The global healthcare payer solution market is expected to grow from $37.32 billion in 2022 to $41.15 billion in 2023 at a compound annual growth rate (CAGR) of 10.3%. The Russia-Ukraine war disrupted the chances of global economic recovery from the COVID-19 pandemic, at least in the short term. The war between these two countries has led to economic sanctions on multiple countries, surge in commodity prices, and supply chain disruptions, causing inflation across goods and services effecting many markets across the globe. The healthcare payer solution market is expected to reach $58.47 billion in 2027 at a CAGR of 9.2%.

The healthcare payer solutions market research report is one of a series of new reports that provides healthcare payer solutions market statistics, including healthcare payer solutions industry global market size, regional shares, competitors with healthcare payer solutions market share, detailed healthcare payer solutions market segments, market trends, and opportunities, and any further data you may need to thrive in the healthcare payer solutions industry. This healthcare payer solutions market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenarios of the industry.

Product innovations are a key trend gaining popularity in the healthcare payer solutions market. Major companies operating in the healthcare payer solutions market are focused on developing innovative solutions to strengthen their business position. For instance, in March 2022, IMAT Solutions, a US-baseddelivering innovative, real-time, healthcare data management and population health reporting solutions, launched new product that tackles the gathering, aggregation, dissemination, and reporting of healthcare data.The new technologies and services will enable payers, statewide organisations, and HIEs to benefit from IMAT's new clustering and SaaS-based solutions, in addition to the company's new NCQA Data Aggregator Validation (DAV) designation.

In September 2022, Zelis, a US-based healthcare and financial technology growth company acquired Payer Compass for an undisclosed amount. With this acquisition, Zelis and Payer Compass will work as a single organization to develop cutting-edge claims management solutions and have a bigger impact on the complexity and rising costs of healthcare. Payer Compass is a US-based healthcare industry provider of reimbursement and claims pricing, administration, and processing solutions.

North America was the largest region in the healthcare payer solution market in 2022. The regions covered in healthcare payer solution report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa.

The countries covered in the healthcare payer solution market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

Rising insurance enrolments are expected to propel the growth of the healthcare payer solutions market going forward. Insurance enrolment is the procedure through which a qualified applicant registers with the insurance provider and becomes a member of the plan. Healthcare payer solutions in the insurance market provide solid enterprise core administration and claims management platform solutions that enable and inspire expansion, innovation, and cost savings for payer organisations across a wide range of business lines. For instance, according to Centers for Medicare & Medicaid Services, a US-based Department of Health and Human Services that provides health coverage to people through Medicare, and Medicaid, in the USA, more than 13.6 million Americans signed up for health insurance coverage for 2022 through HealthCare.gov and State-based Marketplaces marking 92% of those who registered for plans until December 15, 2021. Therefore, the rising insurance enrolments are driving the demand for the healthcare payer solutions market.

The healthcare payer solution market includes revenues earned by entities by providing product assessments, health plan member engagement, payer analytics. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD, unless otherwise specified).

The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.

Major players in the healthcare payer solution market are Cognizant Technical Solutions, Concentrix Corporation, Accenture PLC, HCL Technologies Ltd, Xerox Corporation, Wipro Ltd, Hinduja Global Solutions Ltd, Exlservice Holdings Inc, Teleperformance Group, Sutherland Global Services., IBM Corporation, ZeOmega Inc., Verisk Analytics Inc., UnitedHealth Group, NXGN Management LLC, and Mckesson Corporation.



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