Dublin, April 02, 2024 (GLOBE NEWSWIRE) -- The "US Healthcare BPO - Market Share Analysis, Industry Trends & Statistics, Growth Forecasts 2019-2029" report has been added to ResearchAndMarkets.com's offering.
The United States healthcare BPO market is expected to register a CAGR of 8.11% during the forecast period.
The COVID-19 pandemic spurred complex changes in the BPO industry, prompting firms to swiftly adapt. Despite challenges, BPOs transitioned to remote work, adjusted to shifting consumer behavior, and met rising demand for services like customer support and e-commerce assistance, leveraging automation and AI. Despite these disruptions, the industry has shown resilience, poised for continued growth with a strategic approach.
In the United States, the healthcare system's rapid adoption of advanced technologies creates opportunities for growth across sectors like pharmacies, medical equipment, and care facilities. Outsourcing healthcare IT services is increasingly popular, driven by market leaders' strategic actions such as acquisitions and expansions. Government initiatives, like virtual care funding, further bolster market growth.
Factors such as expanding insurance coverage, cost-cutting pressures, healthcare system consolidation, and regulatory changes like ICD-10 implementation contribute to the healthcare BPO market's growth in the United States. While government initiatives and strategic actions fuel growth, challenges related to data security may hinder progress.
Claims Management is Expected to Grow with High CAGR in the Forecast Period
- Claims processing outsourcing (CPO) is a relatively new business concept for insurance firms. This has emerged as the preferred option for organizations aiming to minimize operating expenses while improving service quality. The relationship between policyholders, healthcare providers, and insurance companies is essential for understanding the details of the medical billing and coding process. Medical claims management is the process that deals with the billing, filling, updating, and processing of medical claims related to the patient's diagnosis, treatments, and medications. Many hospitals and medical facilities outsource these tasks to medical claims management firms, as maintaining patient records, interacting with health insurance agencies, and issuing invoices for medical services are time-consuming processes.
- The increased burden of chronic diseases, the aging population, and increasing healthcare claims activity are driving segment expansion. For instance, according to Cancer Facts and Figures 2023, published in January 2023 by the American Cancer Society, an estimated 1.9 million new cancer cases will be diagnosed in the United States in 2023, among which prostate cancer is estimated to be 288,300, followed by 238,340 cases of lung cancer, and 300,590 cases of female breast cancer. Therefore, with a rising burden of chronic diseases such as cancer, healthcare providers claim the request to insurance companies to offset the treatment cost incurred in cancer, which drives the demand for claim management services, thereby boosting the segment growth.
- Furthermore, strategic activities by market players, such as partnerships, are expected to boost the market over the forecast period. For instance, in January 2021, Tractable announced a collaboration with Hartford to use artificial intelligence to speed up claims processing.
- Thus, all the aforementioned factors, such as the growing burden of chronic diseases and strategic activities by the market players, are expected to boost the segment's growth.
Revenue Cycle Management Segment is Expected to Hold a Significant Share Over the Forecast Period
- Revenue cycle management (RCM) is a tool used by healthcare institutions to monitor all financial interactions with patients, from their first appointment until the settlement of any outstanding debt. All clinical and administrative tasks that are involved in managing and collecting patient service revenues collectively are referred to as the RCM. Therefore, it is anticipated that the growing need for RCM services in healthcare will promote segment expansion.
- The RCM provides various advantages to the supplier, ranging from billing and collections to administrative responsibilities. It is a cutting-edge system that manages administrative tasks via sophisticated billing, payment processing, and electronic health record systems. According to a June 2022 article published by the Medical Group Management Association (MGMA), medical practices that outsource their RCM experience increased performance in areas such as collections, staff efficiency, and more. Thus, owing to the benefits associated with the RCM and increasing adoption, RCM is expected to boost the segment growth over the forecast period.
- The market players are focusing on new partnerships and agreements to bolster their market positions, which is ultimately responsible for segment growth. For instance, in July 2022, Waystar, a revenue cycle management (RCM) vendor, planned to buy Patientco in the latest transaction involving an RCM vendor and a patient payment company. The RCM vendor hopes that the combination will improve the patient's financial experience by providing user-friendly options for paying medical costs. Additionally, in December 2022, Luminis Health, situated in Annapolis, Maryland, selected VisiQuate, an AI-powered analytics firm, to handle its revenue cycle management operations. Similarly, in November 2022, Cornerstone Specialty Hospitals in West Monroe, Louisiana, decided to partner with CareCloud to take on its revenue cycle management services.
- Thus, all the aforementioned factors, such as the huge benefits of RCM outsourcing and strategic collaboration between healthcare companies and market vendors, are expected to boost the segment's growth.
US Healthcare BPO Industry Overview
The United States healthcare BPO market is fragmented and consists of several big and even small-scale players. The competitive landscape includes an analysis of a few international as well as local companies that hold significant market shares and are well known. Some of the major players in the market studied are Accenture PLC, Genpact Limited, IBM Corporation, Parexel International, and Cognizant, among others.
Key Topics Covered
1 INTRODUCTION
1.1 Study Assumptions and Market Definition
1.2 Scope of the Study
2 RESEARCH METHODOLOGY
3 EXECUTIVE SUMMARY
4 MARKET DYNAMICS
4.1 Market Overview
4.2 Market Drivers
4.2.1 Rapid Increase in Clinical Process Outsourcing (CPO)
4.2.2 Increasing R&D in the Healthcare Industry
4.3 Market Restraints
4.3.1 Data Integrity and Confidentiality
4.4 Porter's Five Forces Analysis
5 MARKET SEGMENTATION (Market Size by Value - USD)
5.1 By Payer Service
5.1.1 Human Resource Management
5.1.2 Claims Management
5.1.3 Customer Relationship Management (CRM)
5.1.4 Operational/Administrative Management
5.1.5 Care Management
5.1.6 Provider Management
5.1.7 Other Payer Services
5.2 By Provider Service
5.2.1 Patient Enrollment and Strategic Planning
5.2.2 Patient Care Service
5.2.3 Revenue Cycle Management
5.3 By Pharmaceutical Service
5.3.1 Research and Development
5.3.2 Manufacturing
5.3.3 Non-clinical Services
5.3.3.1 Supply Chain Management and Logistics
5.3.3.2 Sales and Marketing Services
5.3.3.3 Other Non-clinical Services
6 COMPETITIVE LANDSCAPE
6.1 Company Profiles
6.1.1 Accenture PLC
6.1.2 Capgemini
6.1.3 Cognizant
6.1.4 GeBBs Healthcare Solutions
6.1.5 Genpact Limited
6.1.6 IBM Corporation
6.1.7 IQVIA
6.1.8 Parexel International
6.1.9 Sutherland Healthcare Solutions
6.1.10 UnitedHealth Group Incorporated
7 MARKET OPPORTUNITIES AND FUTURE TRENDS
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