Report Id: SNS/HC/2194 | July 2022 | Region: Global | 131 Pages
Healthcare Claims Management Market Size was valued at USD 12.77 billion in 2021, and is expected to reach USD 19.08 billion by 2028, and grow at a CAGR of 5.9% over the forecast period 2022-2028.
Medical claims linked to patient diagnosis, treatment, and prescription are organized, billed, filled out, updated, and processed as part of the healthcare claims management process. In other words, it is software that controls medical claims and payment processes that is increasingly enabling healthcare providers to maximize their profits through appropriate claim management. It is typically a healthcare professional, billing companies, bilateral process between patients, and insurance carriers. Due to the healthcare insurance industry's quick growth, the market for claims management is expanding quickly.
Patient Volumes Are Growing
Health Insurance Market is Growing
Enhancements to Process in Healthcare Organizations
Denials Management's Increasing Relevance
Declining Payment Rates
Exorbitant Deployment Costs
Solutions Based in the Cloud
Expanding Use of Electronic Health Records
Combining Claim Management Products
Loss of Privacy and Data Breach
Lack of Healthcare IT Experts with the Necessary Skill
IMPACT OF COVID-19
Since the pandemic began affecting people's lives all across the world, this management software has provided excellent assistance. People are having a difficult time adjusting to the new normal tendencies since the pandemic has spread globally. Furthermore, there have been significant disruptions to markets and enterprises. Major difficulties for the operation of a variety of markets that have developed since the pandemic's spread include the lack of labor, raw supplies, and investment. These have an effect on the manufacturing and production departments' level of competitiveness. In order to satisfy the demands of the worldwide target audience, it is getting harder for the departments to maintain a seamless supply chain structure. The coronavirus-infected individuals are under medical care or home isolation and require periodic monitoring. Utilizing these tools or management systems, they must share their health issues and the best and most accurate information they are aware of for the purpose of receiving better and more effective care.
However, in the current projected period, this management software will become more competitive and technologically advanced. Similar initiatives are receiving backing from the government. Additionally, several of them are funding global initiatives of a similar nature that will cause the industry to expand across numerous global areas.
Additionally, the leading market players are open to growth by product modification, invention, creation, mergers and acquisitions, and establishment, followed by market launches for the target audience that is dispersed throughout a number of regions worldwide.
The market for healthcare claims management was dominated by the software sector. Growing software technology improvements and an increase in software usage for accurate and efficient claim processing are the drivers driving the component segment.
Both integrated and standalone solutions are available in the global market for healthcare claims management. The market segment for integrated solutions is predicted to have the greatest CAGR over the forecast period. The rapid expansion of this market can be ascribed to the rising demand for integrated solutions, which are crucial to raising process effectiveness and lowering costs.
By Delivery Mode
On-premise and cloud-based systems make up the two segments of the healthcare claims management market. The sector based on the cloud is anticipated to experience the largest CAGR growth during the projection period. This segment's rapid growth can be explained by the substantially reduced capital expenditures and operating costs, as well as higher scalability, flexibility, and affordability.
By End User
Healthcare payers and providers make up the two segments of the global market.
Some of the major key players are as follows: Oracle Corporation, Allscripts Healthcare Solutions, Inc., eClinicalWorks LLC, Athenahealth Inc., GE Healthcare, COGNIZANT TECHNOLOGY SOLUTIONS CORPORATION, Optum, Inc, Quest Diagnostics, The SSI Groups Inc., McKesson Corporation, and other players.
By Delivery Mode
By End User
Europe, Asia, and the Rest of the World, respectively. The market for these is anticipated to be dominated by the North American region. The significant market share of North America is explained by the region's high and expanding HCIT investments as well as the existence of legislative requirements that encourage the adoption of healthcare claims management solutions. Additionally, the US has a number of significant international competitors, which has made it a hub for innovation in the healthcare claims management solutions industry.
The region with the highest CAGR is anticipated to be Asia. High growth is expected to occur in Asia during the forecast period due to a number of factors, including investments in modernizing the healthcare infrastructure in China, growing adoption of healthcare IT solutions, initiatives to improve the quality of healthcare delivery in Japan, and the rapid expansion of the healthcare sector in India.
Rest of Europe
Rest of Asia-Pacific
The Middle East & Africa
Rest of Middle East & Africa
Rest of Latin America
|Market Size in 2021||US$ 12.77 Billion|
|Market Size by 2028||US$ 19.08 Billion|
|CAGR||CAGR of 5.9% From 2022 to 2028|
|Report Scope & Coverage||Market Size, Segments Analysis, Competitive Landscape, Regional Analysis, DROC & SWOT Analysis, Forecast Outlook|
|Key Segments||• By Component (Software, Services)
• By Type (Integrated Solutions, Standalone Solutions)
• By Delivery Mode (On-premise, Cloud-based)
• By End User (Healthcare Payers, Healthcare Providers)
|Regional Analysis/Coverage||North America (USA, Canada, Mexico), Europe
(Germany, UK, France, Italy, Spain, Netherlands,
Rest of Europe), Asia-Pacific (Japan, South Korea,
China, India, Australia, Rest of Asia-Pacific), The
Middle East & Africa (Israel, UAE, South Africa,
Rest of Middle East & Africa), Latin America (Brazil, Argentina, Rest of Latin America)
|Company Profiles||Oracle Corporation, Allscripts Healthcare Solutions, Inc., eClinicalWorks LLC, Athenahealth Inc., GE Healthcare, COGNIZANT TECHNOLOGY SOLUTIONS CORPORATION, Optum, Inc, Quest Diagnostics, The SSI Groups Inc., McKesson Corporation, and other players.|
|Key Drivers||• Patient Volumes Are Growing
• Health Insurance Market is Growing
• Enhancements to Process in Healthcare Organizations
|Restraints||• Exorbitant Deployment Costs|
Frequently Asked Questions (FAQ) :
The market segment for integrated solutions is predicted to have the greatest CAGR over the forecast period.
The market for these is anticipated to be dominated by the North American region.
Healthcare Claims Management Market is divided into three segments By Component, By Type, By Delivery Mode, and By End User
Exorbitant Deployment Costs are the restraints of Healthcare Claims Management Market
Healthcare Claims Management market is expected grow at a CAGR of 5.9% over the forecast period 2022-2028.
Table of Content
1.1 Market Definition
1.3 Research Assumptions
2. Research Methodology
3. Market Dynamics
4. Impact Analysis
4.1 COVID 19 Impact Analysis
4.2 Impact of Ukraine ware
5. Value Chain Analysis
6. Porter’s 5 forces model
7. PEST Analysis
8. Healthcare Claims Management Market Segmentation, By Component
9. Healthcare Claims Management Market Segmentation, By Type
9.1 Integrated Solutions
9.2 Standalone Solutions
10. Healthcare Claims Management Market Segmentation, By Delivery Mode
11. Healthcare Claims Management Market Segmentation, By End User
11.1 Healthcare Payers
11.2 Healthcare Providers
12. Regional Analysis
12.2 North America
12.3.6 The Netherlands
12.3.7 Rest of Europe
12.4.2 South Korea
12.4.6 Rest of Asia-Pacific
12.5 The Middle East & Africa
12.5.3 South Africa
12.6 Latin America
12.6.3 Rest of Latin America
13.1 Allscripts Healthcare Solutions, Inc.,
13.1.2 Products/ Services Offered
13.1.3 SWOT Analysis
13.1.4 The SNS view
13.2 eClinicalWorks LLC
13.3 Athenahealth Inc.
13.4 GE Healthcare
13.5 Cognizant Technology Solutions corporation
13.6 Optum, Inc
13.7 Quest Diagnostics
13.8 The SSI Groups Inc.
13.9 McKesson Corporation
13.10 Oracle Corporation
14.1 Competitive Benchmark
14.2 Market Share analysis
14.3 Recent Developments
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