The Healthcare EDI Market Size was valued at USD 4.82 billion in 2023, and is expected to reach USD 10.12 billion by 2031, and grow at a CAGR of 9.7% over the forecast period 2024-2031.
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.
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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.
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
OPPORTUNITIES
Outsourcing EDI services has become more common.
ICD-11 guidelines are now in use.
CHALLENGES
Within the healthcare market, there is integration between several HCIT solutions.
restrictions and prerequisites
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.
By End-User
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.
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
Medical Device & Pharmaceutical Industries
Pharmacies
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.
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REGIONAL COVERAGE:
North America
USA
Canada
Mexico
Europe
Germany
UK
France
Italy
Spain
The 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
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, Effective Data and Other Players.
Report Attributes | Details |
---|---|
Market Size in 2023 | US$ 4.82 Billion |
Market Size by 2031 | US$ 10.12 Billion |
CAGR | CAGR of 9.7% From 2024 to 2031 |
Base Year | 2023 |
Forecast Period | 2024-2031 |
Historical Data | 2020-2022 |
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 |
Ans: The expected value of the Healthcare EDI Market in 2031 is USD 10.12 billion.
Ans: The CAGR of the Healthcare EDI Market is 9.7% over the forecast period 2024-2031.
Transaction-process-friendly regulations
The need to reduce healthcare spending is becoming more pressing.
HCIT is backed by the government.
Within the healthcare market, there is integration between several HCIT solutions.
restrictions and prerequisites
Ans: The prominent players in the market are 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, and others in the final report.
Table of Contents
1. Introduction
1.1 Market Definition
1.2 Scope
1.3 Research Assumptions
2. Research Methodology
3. Market Dynamics
3.1 Drivers
3.2 Restraints
3.3 Opportunities
3.4 Challenges
4. Impact Analysis
4.1 COVID-19 Impact Analysis
4.2 Impact of Ukraine- Russia war
4.3 Impact of ongoing Recession
4.3.1 Introduction
4.3.2 Impact on major economies
4.3.2.1 US
4.3.2.2 Canada
4.3.2.3 Germany
4.3.2.4 France
4.3.2.5 United Kingdom
4.3.2.6 China
4.3.2.7 Japan
4.3.2.8 South Korea
4.3.2.9 Rest of the World
5. Value Chain Analysis
6. Porter’s 5 forces model
7. PEST Analysis
8. Healthcare EDI Market Segmentation, By Component Type
8.1 Services
8.2 Solutions
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
11.4 Pharmacies
12. Regional Analysis
12.1 Introduction
12.2 North America
12.2.1 USA
12.2.2 Canada
12.2.3 Mexico
12.3 Europe
12.3.1 Germany
12.3.2 UK
12.3.3 France
12.3.4 Italy
12.3.5 Spain
12.3.6 The Netherlands
12.3.7 Rest of Europe
12.4 Asia-Pacific
12.4.1 Japan
12.4.2 South Korea
12.4.3 China
12.4.4 India
12.4.5 Australia
12.4.6 Rest of Asia-Pacific
12.5 The Middle East & Africa
12.5.1 Israel
12.5.2 UAE
12.5.3 South Africa
12.5.4 Rest
12.6 Latin America
12.6.1 Brazil
12.6.2 Argentina
12.6.3 Rest of Latin America
13. Company Profiles
13.1 OSP
13.1.1 Financial
13.1.2 Products/ Services Offered
13.1.3 SWOT Analysis
13.1.4 The SNS view
13.2 Optum, Inc.
13.3 Cleo
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
15. Conclusion
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