Dublin, Jan. 18, 2024 (GLOBE NEWSWIRE) -- The "Healthcare Payer Solution Global Market Report 2024" report has been added to ResearchAndMarkets.com's offering.
The global healthcare payer solution market has grown rapidly in recent years. It will grow from $40.94 billion in 2023 to $45.06 billion in 2024 at a compound annual growth rate (CAGR) of 10.1%. North America was the largest region in the healthcare payer solution market in 2023. The growth observed in the historic period can be attributed to several factors, including the introduction of managed care, regulatory changes (such as HIPAA, ACA, etc.), an increased emphasis on data analytics, a focus on member engagement and experience, and a transition towards interoperability in healthcare payer solutions.
The healthcare payer solution market is expected to see strong growth in the next few years. It will grow to $65.66 billion in 2028 at a compound annual growth rate (CAGR) of 9.9%. The anticipated growth in the forecast period can be attributed to factors such as the shift towards patient-centric care, the rise in telemedicine and remote care services, an increased emphasis on data security, and the adoption of value-based payment models in healthcare payer solutions. Key trends expected in the forecast period encompass financial transparency and cost management, risk stratification and population health management, data interoperability and exchange, the growing prominence of value-based care models, and the integration of artificial intelligence (AI) and predictive analytics in payer solutions.
The anticipated increase in insurance enrolments is poised to drive the growth of the healthcare payer solutions market. For example, as reported by the Centers for Medicare & Medicaid Services in the USA, more than 13.6 million Americans enrolled in health insurance coverage for 2022 through HealthCare.gov and State-based Marketplaces, constituting 92% of those who registered for plans by December 15, 2021. Consequently, the increasing insurance enrolments are fueling the demand for the healthcare payer solutions market.
The upward trend in the aging population is expected to drive the growth of healthcare payer solutions in the future. For example, the World Health Organization projected in October 2022 that by 2030, one out of every six individuals globally would be 60 years old or older. The proportion of the population aged 60 and over is expected to increase from 1 billion in 2020 to 1.4 billion during this period. Additionally, by 2050, the global population of individuals aged 60 and older is projected to double, reaching 2.1 billion. Therefore, the rising aging population is a driving force for the healthcare payer solutions market.
Product innovations emerge as a significant trend gaining traction in the healthcare payer solutions market. Major companies in this sector are dedicated to developing innovative solutions to fortify their business positions. For instance, in March 2022, IMAT Solutions, a US-based provider of innovative, real-time healthcare data management, and population health reporting solutions, introduced a new product addressing the gathering, aggregation, dissemination, and reporting of healthcare data. The new technologies and services from IMAT Solutions enable payers, statewide organizations, and Health Information Exchanges (HIEs) to leverage clustering and Software as a Service (SaaS)-based solutions, in addition to the company's new National Committee for Quality Assurance (NCQA) Data Aggregator Validation (DAV) designation.
Major companies operating in the healthcare payer solutions market are focusing on developing advanced solutions such as Payer Exchange to handle the escalating volumes of medical records and clinical data. Payer Exchange is a technological solution designed to facilitate clinical data exchange between healthcare providers and payers. For example, in June 2023, MRO Corp, a US-based clinical data exchange company, launched a Payer Exchange solution. This technology digitizes and automates the patient information request and fulfillment process, reducing manual burdens for hospital staff and improving workflows. Payer Exchange addresses the growing demand from payers for high-quality and timely clinical data, providing a secure, electronic connection for efficient communication between providers and payers. The solution emphasizes patient privacy, data quality, and risk adjustment premium accuracy.
In September 2022, Zelis, a US-based healthcare and financial technology growth company, acquired Payer Compass for an undisclosed amount. Through this acquisition, Zelis and Payer Compass aim to collaborate as a single organization to advance claims management solutions and make a substantial impact on the complexity and rising costs of healthcare. Payer Compass is a US-based provider in the healthcare industry offering reimbursement and claims pricing, administration, and processing solutions.
Report Scope
Markets Covered:
- By Services: Business Process Outsourcing Services; Information Technology Outsourcing Services; Knowledge Process Outsourcing Services.
- By Application: Pharmacy Audit and Analysis Systems; Claims Management Services; Fraud Management Services; Computer-assisted Coding (CAC) Systems; Member Eligibility Management Services; Provider Network Management Services; Payment Management Services; Customer Relationship Management Services; Medical Document Management Services; General Ledger and Payroll Management.
- By End User: Private Provider; Public Provider.
Key Companies Mentioned: Cognizant Technical Solutions; Concentrix Corporation; Accenture plc; HCL Technologies Ltd.; Xerox Corporation.
Countries: Australia; Brazil; China; France; Germany; India; Indonesia; Japan; Russia; South Korea; UK; USA; Canada; Italy; Spain.
Regions: Asia-Pacific; Western Europe; Eastern Europe; North America; South America; Middle East; Africa.
Time Series: Five years historic and ten years forecast.
Data: Ratios of market size and growth to related markets, GDP proportions, expenditure per capita.
Data Segmentation: Country and regional historic and forecast data, market share of competitors, market segments.
A selection of companies mentioned in this report includes:
- Cognizant Technical Solutions
- Concentrix Corporation
- Accenture plc
- HCL Technologies Ltd.
- Xerox Corporation
- UnitedHealth Group Inc.
- McKesson Corporation
- HMS Holdings Corp.
- International Business Machines Corporation
- Change Healthcare Inc.
- Wipro Limited
- Infosys Limited
- Tata Consultancy Services Limited
- NTT Data Corporation
- Genpact Limited
- Mphasis Limited
- Firstsource Solutions Limited
- WNS Limited
- IQVIA Inc.
- Omega Healthcare
- R RCM Inc.
- Conduent Inc.
- EXL Service Holdings Inc.
- Cotiviti Holdings Inc.
- Cerner Corporation
- Allscripts Healthcare Solutions Inc.
- Epic Systems Corporation
- Athenahealth Inc.
- NextGen Healthcare Inc.
- eClinicalWorks LLC
For more information about this report visit https://www.researchandmarkets.com/r/dax4wz
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