London, March 07, 2024 (GLOBE NEWSWIRE) -- Global healthcare reimbursement market is experiencing a notable surge, projected to exceed a staggering U$36 billion value by the end of 2030. This significant growth, estimated at a CAGR of 18.2% during the years of projection 2023 – 2030, highlights the increasing demand for efficient and sustainable healthcare financing models as suggested by a newly released report by Fairfield Market Research.
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REPORT SCOPE
| Report Attributes | Details | |
| Base Year | 2022 | |
| Forecast Year | 2023 – 2030 | |
| Market Size in 2022 | US$11.2 Bn | |
| Estimated Market Size in 2030 | US$36.1 Bn | |
| CAGR | 18.2% | |
| Growth Drivers |
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| Segmentation |
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| Regional Coverage |
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Several factors are fueling this market expansion. Rising healthcare costs, especially in the US, are pushing governments and private insurers to seek innovative solutions for managing these expenses. This is leading to a growing focus on value-based care, which rewards healthcare providers based on patient outcomes rather than the volume of services delivered.
The expansion of telehealth services, and the implementation of alternative payment models are playing a key role in shaping the future of healthcare reimbursement. Telehealth, which allows patients to receive consultations remotely, is gaining significant traction due to its convenience and cost-effectiveness. This is prompting governments and insurers to develop reimbursement policies specific to telehealth services.
Additionally, alternative payment models like bundled payments and pay-for-performance programs are being actively explored as they incentivise providers to deliver high-quality, efficient care. As these models become more prevalent, the demand for robust reimbursement infrastructure will continue to grow.
“While the global healthcare reimbursement market presents exciting opportunities, challenges remain. Regulatory complexities, data security concerns, and the need for standardisation across different healthcare systems require careful consideration,” highlights the company’s analyst. “As the industry evolves, innovative solutions, and collaborative efforts will be crucial in ensuring sustainable and equitable access to high-quality healthcare for all,” says the analyst.
The report underscores some of the top trends driving this industry, including the rise of value-based care, policy structures developing in favour of telehealth reimbursement, rising adoption of alternative payment models (APMs), increasing focus on preauthorisation and utilisation management, and an incessantly growing sector of chronic disease management.
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Key Research Insights
- Fully paid claims maintain dominance, underpaid claims show the fastest growth, and the battle between public and private payers intensifies.
- North America leads the charge in the healthcare reimbursement market.
- Asia Pacific is slated for the highest CAGR between the years of forecast.
Insights into Segmentation Analysis
Fully Paid Claims Dominate with Efficiency, and Relationship Building
- Fully paid claims, representing successfully processed reimbursements, hold the largest market share.
- These claims signify efficient reimbursement processes, ensuring healthcare organisations maintain consistent revenue streams while reducing administrative efforts related to denied or underpaid claims.
- Positive relationships between providers and payers are fostered through effective management of fully paid claims, solidifying their dominance in the market.
Underpaid Claims Surge
- Underpaid claims are poised for the fastest CAGR globally, through 2030. The surge is attributed to the complexity of billing and coding, evolving reimbursement policies, and errors in claims processing.
- Healthcare providers are proactively identifying and appealing underpaid claims, maximizing revenue.
- Technological advancements and data analytics enhance claim accuracy, driving the growth of underpaid claims as providers optimise reimbursement processes and revenue recovery efforts.
Public Payers Lead, Fairfield Expects Swift Growth of Private Payers
- Public payers, exemplified by government-funded programs like Medicare, and Medicaid, have seized the largest market share. Their extensive coverage and influence over reimbursement policies position them as dominant players.
- In contrast, private payers are projected to experience the highest CAGR, offering diverse insurance plans and introducing innovative reimbursement models such as value-based care and bundled payments.
- The demand for personalised coverage options and rising healthcare costs contribute to the rapid growth of private payers, expanding their market presence.
Hospitals Maintain Dominance While Diagnostic Laboratories Emerge as Growth Leaders
- Hospital service providers, with their comprehensive range of services, secure the largest market share. Established contracts and negotiation power with payers enable them to secure favourable reimbursement rates.
- However, diagnostic laboratories are set to experience the highest growth.
- The increasing demand for diagnostic testing, advancements in medical testing technologies, and a trend toward early disease detection contribute to their surge.
- The evolving reimbursement landscape, supporting preventive testing, further propels the growth of diagnostic laboratories.
Key Report Highlights
- The healthcare reimbursement landscape is evolving rapidly due to factors such as the escalating complexity of healthcare billing, rising healthcare costs, transformative reimbursement models, and the imperative need for streamlined claims processing.
- The increasing prevalence of chronic diseases fuels demand for reimbursement services, while technological advancements, including blockchain, and EHR, play a pivotal role in streamlining processes and ensuring market growth.
- As the healthcare reimbursement market surges forward, stakeholders are increasingly focused on innovative solutions to address evolving healthcare needs, manage costs efficiently, and embrace value-based care models.
Insights into Regional Analysis
North America's Leadership Prevails
- Driven by its advanced healthcare infrastructure, robust regulatory framework, high healthcare expenditure, and extensive insurance coverage, the North American market retains its top spot in the global space.
- In North America, government programs like Medicare and Medicaid, coupled with a robust healthcare infrastructure and technological advancements, contribute to its dominance in the healthcare reimbursement market.
- The region's large and diverse population, along with ongoing innovation, solidifies North America's leadership.
Asia Pacific's Rapid Ascent
- Asia Pacific witnesses a rapidly improving insurance coverage scenario, driving demand for reimbursement solutions.
- The region's growing population, increasing healthcare investments, and adoption of advanced technologies align with modernisation efforts, making Asia Pacific a dynamic and rapidly expanding market in the healthcare reimbursement landscape.
Key Companies in Healthcare Reimbursement Market
- UnitedHealth Group
- Anthem, Inc.
- Magellan Health
- Humana Inc.
- Cigna
- Centene Corporation
- Blue Cross Blue Shield Association
- Kaiser Permanente
- Molina Healthcare
- Tenet Healthcare
- CVS Health
- Gateway Health
- HCA Healthcare
- The Joint Commission
- Universal American
Global Healthcare Reimbursement Industry Analysis, Size, Share, Growth, Trends, and Forecast 2023-2030 - (By Claim Coverage, By Payer Coverage, By Service Provider Coverage, By Geographic Coverage and By Company): https://www.fairfieldmarketresearch.com/report/healthcare-reimbursement-market
About Us
Fairfield Market Research is a UK-based market research provider. Fairfield offers a wide spectrum of services, ranging from customized reports to consulting solutions. With a strong European footprint, Fairfield operates globally and helps businesses navigate through business cycles, with quick responses and multi-pronged approaches. The company values an eye for insightful take on global matters, ably backed by a team of exceptionally experienced researchers. With a strong repository of syndicated market research reports that are continuously published & updated to ensure the ever-changing needs of customers are met with absolute promptness.
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