Report Id: SNS/HC/1789 | June 2022 | Region: Global | 125 Pages
Report Scope & Overview:
The Healthcare EDI Market Size was valued at USD 3.5 billion in 2021, and is expected to reach USD 12.87 billion by 2028, and grow at a CAGR of 8.9% over the forecast period 2022-2028.
The programmed development of information between a specialist co-op and a payer is known as electronic data interchange (EDI). It gives advantages to suppliers, for example, quicker data handling, less managerial weight, and the evasion of guarantee handling delays. Payers and health-care providers can use EDI to send and receive data more quickly and at a lower cost. EDI helps with the exchange of patient health information, insurance processing, and prescription information exchanges. As a result, EDI is critical for data administration in a range of medical sectors, including regulatory affairs, clinical testing, and data management for insurance companies.
When data is transmitted electronically, there are fewer chances of human error. It aids in the reduction of manual systems via medical electronic data interchange, hence minimising manual errors. As a result, the healthcare industry is rapidly accepting EDI services in order to cut paperwork and speed up financial issues. It eliminates manual errors by reducing manual systems with medical electronic data interchange. Demand for Healthcare EDI services technology is likely to rise in the next years, driven by the growing requirement for supply chain management and claims administration. The healthcare EDI has a wide range of applications, including insurance, dental and medical patient database administration, regulatory, reimbursement data management, and clinical trials, to name a few.
The need to reduce healthcare spending is becoming more pressing.
HCIT is backed by the government.
Patients and EDI users alike are concerned about data security.
High cost of EDI software implementation
Outsourcing EDI services has become more common.
ICD-11 guidelines are now in use.
Within the healthcare market, there is integration between several HCIT solutions.
restrictions and prerequisites
IMPACT OF COVID-19
There is a continuing slowdown in the healthcare business as a result of the global epidemic of COVID-19 and the imposed lockout. COVID-19 wreaked havoc on major world economies, especially the healthcare sector, in addition to communities. The approach of major players is still being adjusted to the quickly changing scenario. The medical services business is supposed to be affected essentially by COVID-19 over the long haul. Until the emergency dies down, nations and significant players would need to make huge medical services changes.
Technological advancements, cost containment, and expanded access will all be part of healthcare reform in the near future. In the current pandemic, computerized wellbeing and telemedicine have become the dominant focal point. The need of far-off finding, care, and counsel was focused on again at COVID-19. Regulatory and behavioural constraints have hindered market growth in recent years. Patients with intermediate social distancing were also required to consult online as part of the social distancing treatments. COVID-19 is predicted to have a substantial influence on the Healthcare EDI Market due to these considerations.
Value chain Analysis
Web-based and cloud-based services are the most common ways for healthcare organisations to exchange electronic data. Conducting Electronic Data Interchange operations via an internet browser is part of the Web-based sector. The seller or trading partners will fill out paper-based paperwork on an internet browser. This data is transferred automatically via secure internet protocols in the form of an EDI message. In most cases, FTPS and HTTPS are used. For businesses with trading partners from a variety of (different) countries, web-based solutions are extremely helpful.
Because of the greater flexibility that mobile-based solutions provide, they are widely used. The key benefit of using the software solution is the supply chain control that the mobile-based system provides. For example, incidents such as making an invoice with a simple barcode scan and delivering it to the customer are propelling the increase of the Healthcare electronic data interchange industry.
On the other hand, cloud-based solutions provide reliable data mobility and flexibility, as well as faster ride, and are thought to be more profitable for companies that process B2B data. Accuracy of record keeping, as well as timely processing of insurance claims, payment information, and other IT-related information. Prior to HIPAA, the healthcare industry had to deal with more than 400 medical forms, which took time and effort to manage by hand. These are the main drivers of the Healthcare Electronic Data Interchange market expansion.
By Component Type
Due to reasons such as rising claims volume, increasing complexity and size of EDI systems, and the need for expensive training programmes, the services segment is likely to rise at a higher rate in this market. Similarly, a growing tendency of outsourcing activities including revenue cycle management, claims handling and administration, and partner management services is likely to drive the services industry forward.
By Transaction Type
The healthcare supply chain and claims management segments of the healthcare EDI market are separated. During the forecast period, the claims management sector is estimated to account for the highest proportion of the healthcare EDI market. The increased usage of EDI services by healthcare providers and payers, as well as the necessity to meet regulatory requirements, can be attributable to this segment's substantial share.
By Delivery Mode
The mobile EDI segment is predicted to develop at the fastest rate among the delivery mode segments over the projection period. The technical advancements in the healthcare business, as well as the increased acceptance of mobile solutions by healthcare providers, are contributing to this segment's rapid rise.
The health care EDI is divided into four categories: providers, payers, medical equipment and pharmaceutical firms, and pharmacies. Due to the growing number of independent insurance players in the market, the healthcare sector is predicting that it will grow at a much faster CAGR at the time of forecasting.
Some of the major key players of Healthcare EDI Market are as follows: OSP, Optum, Inc., Cleo, McKesson Corporation, Cerner Corporation, NXGN Management, LLC, Data Trans Solutions, 1 EDI Source (Epicor Software Corporation), SSI Group LLC, and Effective Data.
By Component Type
By Transaction Type
Healthcare Supply Chain
By Delivery Mode
Web & Cloud-based EDI
Medical Device & Pharmaceutical Industries
Because of the higher adoption of Healthcare Information Technology (HCIT) in North America, the region dominated the market. Due to rising demand for electronic data exchange services/solutions among pharmaceutical companies and medical device makers to combat growing competitiveness, pricing pressure, and decreased profit margins, Europe is likely to hold a significant market share throughout the projection period.
The Asia Pacific region's market is predicted to be driven by regulatory reforms, economic expansion, and the increasing IT industry. Furthermore, increased patient volume, the requirement to manage a huge volume of patient data, and the deployment of HCIT programmes in India, Japan, and Australia are projected to aid the vertical's growth.
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$ 3.5 Billion|
|Market Size by 2028||US$ 12.87 Billion|
|CAGR||CAGR of 8.9% From 2022 to 2028|
|Report Scope & Coverage||Market Size, Segments Analysis, Competitive Landscape, Regional Analysis, DROC & SWOT Analysis, Forecast Outlook|
|Key Segments||• By Component Type (Services, Solutions)
• By Transaction Type (Claims Management, Healthcare Supply Chain)
• By Delivery Mode (Web & Cloud-based EDI, EDI VAN, Point-to-Point EDI, Mobile EDI)
• By End-User (Healthcare Providers, Healthcare Payers, Medical Device & Pharmaceutical Industries, Pharmacies)
|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||OSP, Optum, Inc., Cleo, McKesson Corporation, Cerner Corporation, NXGN Management, LLC, Data Trans Solutions, 1 EDI Source (Epicor Software Corporation), SSI Group LLC, and Effective Data.|
|DRIVERS||• Transaction-process-friendly regulations
• The need to reduce healthcare spending is becoming more pressing.
• HCIT is backed by the government.
|RESTRAINTS||• Patients and EDI users alike are concerned about data security.
• High cost of EDI software implementation
Frequently Asked Questions (FAQ) :
Table of Contents
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 EDI Market Segmentation, By Component Type
9. Healthcare EDI Market Segmentation, By Transaction Type
9.1 Claims Management
9.2 Healthcare Supply Chain
10. Healthcare EDI Market Segmentation, By Delivery Mode
10.1 Web & Cloud-based EDI
10.2 EDI VAN
10.3 Point-to-Point EDI
10.4 Mobile EDI
11. Healthcare EDI Market Segmentation, By End-User
11.1 Healthcare Providers
11.2 Healthcare Payers
11.3 Medical Device & Pharmaceutical Industries
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. Company Profiles
13.1.2 Products/ Services Offered
13.1.3 SWOT Analysis
13.1.4 The SNS view
13.2 Optum, Inc.
13.4 McKesson Corporation
13.5 Cerner Corporation
13.6 NXGN Management, LLC
13.7 Data Trans Solutions
13.8 1 EDI Source (Epicor Software Corporation)
13.9 SSI Group LLC
13.10 Effective Data.
14. Competitive Landscape
14.1 Competitive Benchmark
14.2 Market Share analysis
14.3 Recent Developments
An accurate research report requires proper strategizing as well as implementation. There are multiple factors involved in the completion of good and accurate research report and selecting the best methodology to compete the research is the toughest part. Since the research reports we provide play a crucial role in any company’s decision-making process, therefore we at SNS Insider always believe that we should choose the best method which gives us results closer to reality. This allows us to reach at a stage wherein we can provide our clients best and accurate investment to output ratio.
Each report that we prepare takes a timeframe of 350-400 business hours for production. Starting from the selection of titles through a couple of in-depth brain storming session to the final QC process before uploading our titles on our website we dedicate around 350 working hours. The titles are selected based on their current market cap and the foreseen CAGR and growth.
The 5 steps process:
Step 1: Secondary Research:
Secondary Research or Desk Research is as the name suggests is a research process wherein, we collect data through the readily available information. In this process we use various paid and unpaid databases which our team has access to and gather data through the same. This includes examining of listed companies’ annual reports, Journals, SEC filling etc. Apart from this our team has access to various associations across the globe across different industries. Lastly, we have exchange relationships with various university as well as individual libraries.
Step 2: Primary Research
When we talk about primary research, it is a type of study in which the researchers collect relevant data samples directly, rather than relying on previously collected data. This type of research is focused on gaining content specific facts that can be sued to solve specific problems. Since the collected data is fresh and first hand therefore it makes the study more accurate and genuine.
We at SNS Insider have divided Primary Research into 2 parts.
Part 1 wherein we interview the KOLs of major players as well as the upcoming ones across various geographic regions. This allows us to have their view over the market scenario and acts as an important tool to come closer to the accurate market numbers. As many as 45 paid and unpaid primary interviews are taken from both the demand and supply side of the industry to make sure we land at an accurate judgement and analysis of the market.
This step involves the triangulation of data wherein our team analyses the interview transcripts, online survey responses and observation of on filed participants. The below mentioned chart should give a better understanding of the part 1 of the primary interview.
Part 2: In this part of primary research the data collected via secondary research and the part 1 of the primary research is validated with the interviews from individual consultants and subject matter experts.
Consultants are those set of people who have at least 12 years of experience and expertise within the industry whereas Subject Matter Experts are those with at least 15 years of experience behind their back within the same space. The data with the help of two main processes i.e., FGDs (Focused Group Discussions) and IDs (Individual Discussions). This gives us a 3rd party nonbiased primary view of the market scenario making it a more dependable one while collation of the data pointers.
Step 3: Data Bank Validation
Once all the information is collected via primary and secondary sources, we run that information for data validation. At our intelligence centre our research heads track a lot of information related to the market which includes the quarterly reports, the daily stock prices, and other relevant information. Our data bank server gets updated every fortnight and that is how the information which we collected using our primary and secondary information is revalidated in real time.
Step 4: QA/QC Process
After all the data collection and validation our team does a final level of quality check and quality assurance to get rid of any unwanted or undesired mistakes. This might include but not limited to getting rid of the any typos, duplication of numbers or missing of any important information. The people involved in this process include technical content writers, research heads and graphics people. Once this process is completed the title gets uploader on our platform for our clients to read it.
Step 5: Final QC/QA Process:
This is the last process and comes when the client has ordered the study. In this process a final QA/QC is done before the study is emailed to the client. Since we believe in giving our clients a good experience of our research studies, therefore, to make sure that we do not lack at our end in any way humanly possible we do a final round of quality check and then dispatch the study to the client.