Global Healthcare Payer Services Market Report 2023: Rising Number of Healthcare Insurance Enrollments Bolsters Sector


Dublin, March 17, 2023 (GLOBE NEWSWIRE) -- The "Global Healthcare Payer Services Market by Service Type (BPO (Claims, Front-end, Provider, Product Development, Care Management, Billing, HR), ITO (Provider Network, Accounts, Analytics, Fraud), & KPO), End-user (Public, Private), and Region - Forecast to 2027" report has been added to ResearchAndMarkets.com's offering.

The global healthcare payer services market is projected to reach USD 118.2 billion by 2027 from USD 69.9 billion in 2022, at a CAGR of 11.1% during the forecast period. The increased usage of outsourcing, federal mandates, rising instances of healthcare fraud, rising enrolment in health insurance, and rising chronic disease cases are the key drivers of industry growth. However, it is anticipated that some factors, such as the possibility of data breaches, the loss of administrative control, linguistic and cultural hurdles, and the high costs of outsourcing, may limit this market's expansion to some extent.

BPO service type segment holds the largest share of the healthcare payer services market in 2021

On the basis of service type, the healthcare payer services market is bifurcated into ITO services, BPO services and KPO services. In 2021, the BPO services segment accounted for the largest market share. ITO services segment is projected to grow at the highest CAGR during the forecast period due to factors such as rising integration of healthcare and information technology, increasing use of EHRs and EMRs, increasing investment in technology to improve operational efficiency, leveraging data analytics for better decision making, and need for secure and complaint IT systems.

Private payers segment accounted for the largest share of the healthcare payer services market in 2021

On the basis of end-user, the healthcare payer services market is bifurcated into private payers & public payers. The private payers segment accounted for the largest market share in 2021 and is expected to register the highest CAGR during the forecast period. The high growth of this segment is attributed to the growing focus on patient centric healthcare delivery and the increasing government initiatives to encourage private sector participation in the healthcare industry and rising competitiveness among private payers.

Asia-Pacific to be the fastest-growing regional market in 2021

On the basis of region, the healthcare payer services market is bifurcated into North America, Europe, Asia-Pacific, and the Rest of the World (RoW). In 2021, North America dominated the healthcare payer services market, followed by Asia-Pacific. The large share of this market is attributed to the rise in insurance enrolments due to PPACA, federal healthcare mandates to drive the demand for outsourcing of services, rising need to curb healthcare expenditure. However, Asia-Pacific is expected to grow at the highest CAGR during the forecast period owing to the increasing adoption of advanced technologies and the growing focus of major players on expanding their presence in emerging Asia-Pacific countries.

Market Dynamics

Drivers

  • Rising Number of Healthcare Insurance Enrollments
  • Outsourcing of Services to Reduce Healthcare Costs
  • Stringent Federal Mandates to Increase Payer Workloads
  • Increasing Cases of Healthcare Fraud
  • Rising Incidence of Chronic Diseases

Restraints

  • Data Breaches and Loss of Confidentiality
  • High Costs Associated with Outsourcing Healthcare Payer Services
  • Loss of Managerial Control

Opportunities

  • Adoption of Advanced Data Analytics
  • Gradual Shift to ICD-11 Standards
  • Service Portfolio Expansion for Vendors
  • Rising Need for Cost-Effective Solutions

Challenges

  • Migration from Legacy Systems
  • Concerns Regarding Data Security
  • Cultural Differences and Language Barriers

Key Attributes:

Report AttributeDetails
No. of Pages237
Forecast Period2022 - 2027
Estimated Market Value (USD) in 2022$69.9 Billion
Forecasted Market Value (USD) by 2027$118.2 Billion
Compound Annual Growth Rate11.1%
Regions CoveredGlobal

Key Topics Covered:

1 Introduction

2 Research Methodology

3 Executive Summary

4 Premium Insights

5 Market Overview

6 Healthcare Payer Services Market, by Service Type
6.1 Introduction
6.2 Business Process Outsourcing (BPO) Services
6.2.1 Claims Management Services
6.2.2 Integrated Front-End Services and Back-Office Operations
6.2.3 Member Management Services
6.2.4 Provider Management Services
6.2.5 Product Development and Business Acquisition Services (Pdba)
6.2.6 Care Management Services
6.2.7 Billing and Accounts Management Services
6.2.8 HR Services
6.3 Information Technology Outsourcing (ITO) Services
6.3.1 Claims Management Services
6.3.2 Provider Network Management Services
6.3.3 Billing and Accounts Management Services
6.3.4 Fraud Analytics Services
6.3.5 Other ITO Services
6.4 Knowledge Process Outsourcing Services

7 Healthcare Payer Services Market, by End-user
7.1 Introduction
7.2 Private Payers
7.3 Public Payers

8 Healthcare Payer Services Market, by Region

9 Competitive Landscape

10 Company Profiles

11 Appendix

Companies Mentioned

  • Accenture
  • Allscripts Healthcare, LLC
  • Cognizant
  • Conduent, Inc.
  • Conifer Health Solutions, LLC
  • Dell Inc.
  • Firstsource Solutions
  • Genpact Limited
  • HCL Technologies Limited
  • IBM
  • Infosys BPM
  • Inovalon
  • IQVIA Inc.
  • Mphasis
  • NTT Data Corporation
  • Omega Healthcare
  • Oracle Corporation
  • Parexel International Corporation
  • R1RCM, Inc.
  • SAS Institute, Inc.
  • Tata Consultancy Services
  • UnitedHealth Group
  • Wipro Limited
  • WNS (Holdings) Ltd.
  • XEROX Corporation

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Global Healthcare Payer Services Market

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