Pune, July 29, 2024 (GLOBE NEWSWIRE) -- US Healthcare Payer Services Market Size Analysis:
“According to SNS Insider Research, The US Healthcare Payer Services Market size was valued at US$ 34.29 Billion in 2023 and is anticipated to surpass US$ 65.31 Billion by 2032, with a compound annual growth rate (CAGR) of 7.74% over the forecast period 2024-2032.”
The healthcare payer services market is benefiting in multiple ways due to the increasing disease burden across the U.S. Disease burden is the impact of a health problem in an area measured by financial cost, morbidity, or mortality. A poll of 4,000 American adults by The Harris Poll and CNBC found that about half (44%) of elder millennials had received a diagnosis for one or more chronic health problems. This has been one of the key contributors to an overall increase in healthcare service demands across the U.S., boosting growth potential within the region's provider services market.
In the U.S., the growing penetration of different healthcare policies is expected to have a considerable effect on the development and evolution in demand for healthcare payer services. Though they may be intended to enhance healthcare access and reduce costs, these policies can have a market impact in several maritime areas. The most significant effect of healthcare policies is cost. For payers: Payer demand continues to grow with the prevalence of policies such as the Affordable Care Act and Medicaid, which have put more people onto health insurance rolls. The policies that aim at controlling costs in the United States - including value-based reimbursement models - can decrease providers' and payers' rates of reimbursements, which makes complete sense to a layperson as further increases are incurred.
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Major Players Analysis Listed in this Report are:
- Cognizant Technology Solutions
- Accenture PLC
- Infosys
- Xerox Corporation
- Iqvia
- Flatworld Solutions
- Orion Healthcorp
- Medisys Data Solutions, Inc.
- Wipro Ltd.
- Promantra
- Other Players
US Healthcare Payer Services Market Report Scope:
| Report Attributes | Details |
| Market Size in 2023 | USD 34.29 Billion |
| Market Size by 2032 | USD 65.31 Billion |
| CAGR | CAGR of 7.74% From 2024 to 2032 |
| Base Year | 2023 |
| Forecast Period | 2024-2032 |
| Historical Data | 2020-2022 |
| Key Growth Drivers | •Raising Healthcare costs in the U.S. are Driving Healthcare Payer Services Market Growth. •The Increasing Prevalence of Chronic Diseases in the U.S. Increases the Volume of Healthcare Claims Boosting the Healthcare Payer Services Market Growth. |
Segmentation Dynamics
The U.S. healthcare payer services market was led by the claims management services segment in 2023, which accounted for a share up to the tune of ~29% of market revenue. The rapid expansion of insured individuals leads to an increase in claims requiring processing by healthcare payers, which increases the demand for services related to efficient claims management. Furthermore, the fact that U.S. healthcare expenditure is increasing overall contributes to one of the approaches that fuel up this segment -claims management. With rising healthcare costs, there is a constant necessity for advanced claims processing systems to handle the high number of error-free claims efficiently. Not only is this important to healthcare payers but also for providers who need streamlined claims processing to maintain a steady cash flow while keeping administrative overhead low.
Increasing patient load in healthcare institutes is also a factor responsible for it. This impact has been two-fold: greater patient visits and admissions create a need for more robust claims processing systems designed to manage the increase in the volume of claims. This involves confirming insurance and processing claims efficiently and within regulatory compliance. Increased healthcare coverage, in part due to private and public sector efforts (as the next section will discuss), also served to grow the pool of insured people with a high demand for effective claims management services.
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U.S. Healthcare Payer Services Market Key Segmentation:
By Services
- 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-Use
- Private Payers
- Public Payers
EHRs help in minimizing claims by compiling all patient information accurately which also helps decrease error as well and provides quick access to clinical documents for claim adjudication. With the increased adoption of technology in this sector, it has been easier for healthcare providers and payers to manage claims well which also improves their overall service delivery.
However, the provider management services category is expected to grow at the fastest CAGR of 8% during the projected timeframe. They cover all segments such as provider credentialing, contracting, network management, and a lot more. Technological advancements in healthcare provider management services and an increasing focus on enhancing the quality of care are compelling payers to meet stringent payer requirements driving their growth. Provider management is made efficient so that the healthcare networks consist of quality credentialed providers, bringing about good patient care and improved outcomes. Additionally, improvements in data management and analytics tools further facilitate better network management and contracting processes thus augmenting the growth of the market segment.
Recent Developments
- Accenture partnered with League to deliver a more personalized digital health experience starting in February 2022. This effort would leverage Accenture's data analytics and League's health operating system to extend the availability & effectiveness of care for individuals, payers, providers, as well shoppers.
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Table of Contents – Major Key Points
1. Introduction
2. Industry Flowchart
3. Research Methodology
4. Market Dynamics
5. Porter’s 5 Forces Model
6. Pest Analysis
7. US Healthcare Payer Services Market Segmentation, By Services
8. US Healthcare Payer Services Market Segmentation, By Application
9. US Healthcare Payer Services Market Segmentation, By End-Use
10. Company Profiles
11. Competitive Landscape
12. Use Case and Best Practices
13. Conclusion
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