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The Healthcare Payer Services Market Size was valued at USD 67.37 billion in 2023 and is expected to reach USD 129.16 billion by 2032 and grow at a CAGR of 7.5% over the forecast period 2024-2032.
Healthcare insurance payers contract out healthcare payer services. Payers are intrigued by the shifting dynamics of the healthcare industry and are redesigning their business models and procedures to compete in the market while offering better patient care by streamlining the process, cutting costs, and enhancing customer relations. Healthcare insurance payers and providers are using a variety of outsourcing solutions to improve customer experience and optimize internal operations. A profitable company strategy that reduces the workload of administrative, accounting, purchasing, shipping, and other responsibilities while creating efficient corporate procedures is outsourcing.
DRIVERS
Outsourcing: A Practical Choice for Healthcare Payers
Federal Requirements in the United States Increasing Payer Workload
The prevalence of healthcare fraud
The Adaptiveness of Health Benefit Plan Designs
Lack of Skilled Personnel Within the Company
RESTRAINTS
Data breaches and confidentiality breaches are becoming more common.
Costs of Outsourcing That We Didn't Expect
Abandonment of Managerial Control
OPPORTUNITIES
sophisticated data analytics
Implementing Icd-10 Standards
Increased Service Portfolio
CHALLENGES
The replacement of legacy systems
Language disparities and cultural differences
Healthcare services have had a major impact due to Covid-19. According to an article by the National Academy of Medicine entitled "COVID-19 Payment Impact Assessment: Lessons Learned and Compulsory Needs" from May 2021, payers have taken steps to increase access to COVID-19 health care and non-COVID-19 spring-based issues. controls and recommendations (e.g., withdrawal of administrative requirements, telehealth recovery). Many payers also independently send financial and financial assistance to assist providers in sustainability, and use their technical and social media resources to assist with outbreak activities such as arranging non-medical services and assisting with vaccination campaigns.
By Service Type
The market is divided into the BPO services, ITO services, and KPO services categories. According to estimates, the BPO services segment holds the greatest market share for healthcare payer services globally. The main reason for this high proportion is that BPO services help in important administrative areas. In turn, this helps payers cut costs and shorten time to market, which is primarily what payer groups are aiming for.
By Application
The claims management services, provider management services, integrated front office services & back-office operations, member management services, analytics & fraud management services, billing & accounts management services, and HR services are the different market segments for healthcare payer services.
By End User
The worldwide healthcare payer services market is anticipated to be dominated by claims management services. End users anticipate that private payers will dominate the market.
By Service Type
BPO Services
ITO Services
KPO Services
By Application
Integrated front office service and back-office operations
Member management services
Provider management services
Billing and accounts management services
Analytics and fraud management services
HR Services
By End User
Private Payers
Public Payers
Due to the presence of large providers of healthcare payer solutions in the region as well as the substantial demand for these products, North America captured a sizable portion of the market. However, Asia-Pacific is anticipated to expand at the highest rate over the course of the projection period due to increased use of healthcare IT solutions and the region's sizable uninsured population, which presents considerable market expansion prospects. In addition, attractive commercial expansion opportunities are provided by growing markets for providers of healthcare payment solutions.
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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 are Accenture, Cognizant, Genpact, HGS Ltd, Concentric Corporation, EXL, HCL Technologies, WIPRO Ltd., Xerox Corporation and other players.
| Report Attributes | Details |
|---|---|
| Market Size in 2023 | US$ 67.37 Billion |
| Market Size by 2032 | US$ 129.16 Billion |
| CAGR | CAGR of 7.5% From 2024 to 2032 |
| Base Year | 2023 |
| Forecast Period | 2024-2032 |
| Historical Data | 2020-2022 |
| Report Scope & Coverage | Market Size, Segments Analysis, Competitive Landscape, Regional Analysis, DROC & SWOT Analysis, Forecast Outlook |
| Key Segments | • By Service Type (BPO Services, ITO Services, KPO Services) • By Application (Claims management services, Integrated front office service and back-office operations, Member management services, Provider management services, Billing and accounts management services, Analytics and fraud management services, HR Services) • By End User (Private Payers, Public Payers) |
| 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 | Accenture, Cognizant, Genpact, HGS Ltd, Concentric Corporation, EXL, HCL Technologies, WIPRO Ltd., Xerox Corporation. |
| Key Drivers | • Outsourcing: A Practical Choice for Healthcare Payers • Federal Requirements in the United States Increasing Payer Workload • The prevalence of healthcare fraud |
| Restraints | • Data breaches and confidentiality breaches are becoming more common. • Costs of Outsourcing That We Didn't Expect • Abandonment of Managerial Control |
Ans: The Healthcare Payer Services Market size was valued at US$ 67.37 Bn in 2023.
North America captured a sizable portion of the market. However, Asia-Pacific is anticipated to expand at the highest rate over the course of the projection period.
Healthcare Payer Services Market is divided into three segments and they are By Service Type, By Application, and By End User
Language disparities and cultural differences are the restraints of the market.
Ans: The Healthcare Payer Services market is expected to grow at a CAGR of 7.5% over the forecast period 2024-2032.
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 Payer Services Market Segmentation, By Service Type
8.1 BPO Services
8.2 ITO Services
8.3 KPO Services
9. Healthcare Payer Services Market Segmentation, By Application
9.1 Claims management services
9.2 Integrated front-office service and back-office operations
9.3 Member management services
9.4 Provider management services
9.5 Billing and accounts management services
9.6 Analytics and fraud management services
9.7 HR Services
10. Healthcare Payer Services Market Segmentation, by End User
10.1 Private Payers
10.2 Public Payers
11. Regional Analysis
11.1 Introduction
11.2 North America
11.2.1 USA
11.2.2 Canada
11.2.3 Mexico
11.3 Europe
11.3.1 Germany
11.3.2 UK
11.3.3 France
11.3.4 Italy
11.3.5 Spain
11.3.6 The Netherlands
11.3.7 Rest of Europe
11.4 Asia-Pacific
11.4.1 Japan
11.4.2 South Korea
11.4.3 China
11.4.4 India
11.4.5 Australia
11.4.6 Rest of Asia-Pacific
11.5 The Middle East & Africa
11.5.1 Israel
11.5.2 UAE
11.5.3 South Africa
11.5.4 Rest
11.6 Latin America
11.6.1 Brazil
11.6.2 Argentina
11.6.3 Rest of Latin America
12. Company Profiles
12.1 Accenture
12.1.1 Financial
12.1.2 Products/ Services Offered
12.1.3 SWOT Analysis
12.1.4 The SNS view
12.2 Cognizant
12.3 Genpact
12.4 HGS Ltd
12.5 Concentric Corporation
12.6 EXL
12.7 HCL Technologies
12.8 WIPRO Ltd.
12.9 Xerox Corporation
13. Competitive Landscape
13.1 Competitive Benchmark
13.2 Market Share Analysis
13.3 Recent Developments
14. Conclusion
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