HOME Top Market Reports Healthcare EDI Market by Component (EDI Software, EDI Services), Transactions (Claim Status, Eligibility Verification), Mode of Delivery (Web-based EDI, Mobile EDI, EDI Van) & by End-users (Healthcare Payers, Providers) - Global Forecast to 2018

Healthcare EDI Market by Component (EDI Software, EDI Services), Transactions (Claim Status, Eligibility Verification), Mode of Delivery (Web-based EDI, Mobile EDI, EDI Van) & by End-users (Healthcare Payers, Providers) - Global Forecast to 2018

By: marketsandmarkets.com
Publishing Date: May 2014
Report Code: HIT 2464

 

  Speak to Analyst Enquiry Before Buying
 
purchase report
download pdf  request for customisation


The Global Healthcare EDI Market was valued at $916.5 million in 2013, expected to grow at a CAGR of 13.7% in the next five years owing to increase in the need of simplification and reduction of time for claims management transactions, and better management of administration costs. The increasing need for compliance with the regulatory standards and ever increasing need of healthcare cost reductions are further expected to help the growth of this market. However, the costs associated with the installation of software, lesser insurance coverage of citizens in the BRIC region, and lesser investments by the Healthcare sector on information technology are expected to hinder the growth of this market.

This report analyzes the global market for healthcare EDI based on components (EDI software, and EDI services), transactions (claim status, eligibility verification, payment remittance, referral certification authorization, enrolment/disenrollment transactions, and premium payments), end-users (healthcare payers, healthcare providers, and medical equipment/accessories suppliers), mode of delivery (web-based EDI, point-to-point EDI, mobile EDI, EDI VAN, and EDI via AS2), and geography (North America, Europe, Asia, and Rest of the World).

The North American market contributed the maximum share of the global healthcare EDI market in the year 2013, followed by the European and the Asian regions. While the North American market was majorly propelled by the United States, the European market showed signs of recovery from the economic crises. The Asia region on the other hand shows the maximum potential for growth due to the heavy population, increasing burden of diseases, and government initiatives to improve the overall healthcare delivery process.

The prominent players in the global healthcare EDI market include Emdeon Inc. (U.S.), Allscripts (U.S.), Mckesson (U.S.), Optum Health (U.S.), GE Healthcare (U.K.), Siemens Healthcare (Germany), SSI Group (U.S.), ZirMed (U.S.), Passport Health communications (U.S.), and Capario (U.S.).

Scope of the Report

Electronic data interchange (EDI) is majorly used for exchange for automated transfer of data as per specific format between healthcare providers and payers for better claims management and is also used for better supply chain management between the healthcare providers and equipment suppliers. EDI has applications for both healthcare payers and healthcare providers. Increased need for cost reductions and better time management for claims transactions will help drive this market, with the Asian markets showing the maximum growth rate.

Global Healthcare Edi Market

The global healthcare EDI market has been segmented based on the components, type of transactions, end-users, and mode of delivery.

By Components

  • EDI Software
  • EDI Services

By Type of transactions

  • Claim status
  • Eligibility verification
  • Payment remittance
  • Referral certification authorization
  • Enrolment/disenrollment transactions
  • Premium payments

By End-users

  • Healthcare payers
    • Government/Public payers (Medicare and Medicaid)
    • Private payers
      • For hospital transactions
      • For private practitioner transactions
  • Healthcare Providers (Hospitals)
  • Medical equipment and accessories suppliers/ pharmacies

By Mode of delivery

  • Web-based EDI
  • Point-to-point EDI
  • Mobile EDI
  • EDI VAN
  • EDI via AS2

By Geography

  • North America
  • Europe
  • Asia
  • Rest of the World

Customization Options:

With Market data, you can also customize MnM assessments that meet your Company’s specific needs. Customize to get comprehensive industry standard and deep dive analysis of the following parameters:

Product Analysis

  • Country-wise analysis of different product categories for the market segments covered in the report
  • Detailed coverage of product approvals and product pipeline
  • Unmet needs in the market
  • End user perception towards EDI solutions available in the market

Regulatory Analysis

  • Country wise analysis of regulatory framework for healthcare EDI solutions and its impact on market development and competitor strategies

Table Of Contents
 
1 Introduction (Page No. - 18)
    1.1 Objectives of The Study
    1.2 Report Description
    1.3 Markets Covered
    1.4 Stakeholders
    1.5 Research Methodology
          1.5.1 Market Size Estimation
          1.5.2 Market Crackdown and Data Triangulation
          1.5.3 Key Data From Secondary Resources
          1.5.4 Key Data Points From Primary Resources
          1.5.5 Assumptions

2 Executive Summary (Page No. - 18)

3 Market Dynamics (Page No. - 18)
    3.1 Introduction
    3.2 Market Segmentation
    3.3 Market Dynamics
          3.3.1 Key Market Drivers
                  3.3.1.1 The Healthcare Insurance Portability and Accountability Act, 1886, to Propel The Adoption of EDI in Healthcare
                  3.3.1.2 Patient Protection and Affordability Care Act
                  3.3.1.3 Initiatives By Different Governments For Encouragement of Healthcare IT
          3.3.2 Key Market Restraints
                  3.3.2.1 Data Security—A Major Concern For Patients and EDI Users
                  3.3.2.2 High Cost of EDI Software
                  3.3.2.3 EDI Management—A Major Challenge Inhibiting The Adoption of EDI
                  3.3.2.4 Restricted Investment in Healthcare IT
                  3.3.2.5 Limited Reimbursements to Hinder The Growth in The Bric Nations
          3.3.3 Key Market Opportunities
                  3.3.3.1 Increase in The Outsourcing of EDI Services
                  3.3.3.2 Conversion From Icd-8 to Icd-10
          3.3.4 Key Market Trends
                  3.3.4.1 Increasing Use of EDI in Healthcare Manufacturing/Distribution Industry
                  3.3.4.2 Gradual Acceptance of Mobile EDI
    3.4 Evolution of EDI and Its Future
    3.5 Benefits of EDI In Healthcare Industry
          3.5.1 Quicker Payment of Claims and Detection of Errors
          3.5.2 Reduced Administrative and Handling Costs
          3.5.3 Access to All Electronic Hipaa-Compliant Transactions
          3.5.4 Other Benefits to Medicare “A” Providers
    3.6 EDI Standards For Healthcare Industry
    3.7 Market Share Analysis

4 Healthcare EDI Market, By Product (Page No. - 18)
    4.1 Introduction
    4.2 By Component
          4.2.1 Software
          4.2.2 Services
    4.3 By Type of Transaction
          4.3.1 Claim Status
          4.3.2 Eligibility Verification
          4.3.3 Payment Remittance
          4.3.4 Referral Certification Authorization
          4.3.5 Enrollment/Disenrollment Transactions
          4.3.6 Premium Payments
    4.4 By Mode of Delivery
          4.4.1 Web-Based EDI/EDI Cloud
          4.4.2 EDI Via As2
          4.4.3 Point-to-Point EDI
          4.4.4 EDI Van
          4.4.5 Mobile EDI

5 Healthcare EDI Market, By End User (Page No. - 18)
    5.1 Introduction
    5.2 Healthcare Providers
          5.2.1 Healthcare Payers
          5.2.2 Government/Public Payers
          5.2.3 Private Payers
    5.3 Medical Equipment and Accessories Suppliers/Pharmacies

6 Geographic Analysis (Page No. - 18)
    6.1 Introduction
    6.2 North America
          6.2.1 U.S.
          6.2.2 Canada
    6.3 Europe
    6.4 Asia
    6.5 Rest of The World

7 Competitive Landscape (Page No. - 18)
    7.1 Introduction
          7.1.1 New Product Launches
          7.1.2 Mergers and Acquisitions
          7.1.3 Agreements, Alliances, Collaborations, Joint Ventures, and Partnerships
          7.1.4 Other Developments

8 Company Profiles (Page No. - 18)
    8.1 Allscripts Healthcare Solutions Inc.
          8.1.1 Business Overview
          8.1.2 Products
          8.1.3 Financials
          8.1.4 Growth Strategy
          8.1.5 Recent Developments
          8.1.6 SWOT Analysis
          8.1.7 MNM View
    8.2 Capario Inc.
          8.2.1 Business Overview
          8.2.2 Products
          8.2.3 Financials
          8.2.4 Growth Strategy
          8.2.5 Recent Developments
    8.3 Emdeon Inc.
          8.3.1 Business Overview
          8.3.2 Products
          8.3.3 Financials
          8.3.4 Growth Strategy
          8.3.5 Recent Developments
          8.3.6 SWOT Analysis
          8.3.7 MNM View
    8.4 GE Healthcare (A Division of General Electric Company)
          8.4.1 Business Overview:
          8.4.2 Products & Services
          8.4.3 Financials
          8.4.4 Growth Strategy
          8.4.5 Recent Developments
          8.4.6 SWOT Analysis
          8.4.7 MNM View
    8.5 Mckesson Corporation
          8.5.1 Business Overview
          8.5.2 Products
          8.5.3 Financials
          8.5.4 Growth Strategy
          8.5.5 Recent Developments
          8.5.6 SWOT Analysis
          8.5.7 MNM View
    8.6 Optum Inc.
          8.6.1 Business Overview
          8.6.2 Products
          8.6.3 Financials
          8.6.4 Growth Strategy
          8.6.5 Recent Developments
          8.6.6 SWOT Analysis
          8.6.7 MNM View
    8.7 Passport Health Communications Inc.
          8.7.1 Business Overview
          8.7.2 Products & Services
          8.7.3 Financials
          8.7.4 Growth Strategy
          8.7.5 Recent Developments
    8.8 Siemens Healthcare (Subsidiary of Siemens AG.)
          8.8.1 Business Overview
          8.8.2 Products and Services
          8.8.3 Key Financials
          8.8.4 Growth Strategy
          8.8.5
          8.8.6 SWOT Analysis
          8.8.7 MNM View
    8.9 Ssi Group Inc.
          8.9.1 Business Overview
          8.9.2 Products & Services
          8.9.3 Key Financials
          8.9.4 Growth Strategy
          8.9.5 Recent Developments
    8.10 Zirmed Inc.
          8.10.1 Business Overview
          8.10.2 Products
          8.10.3 Financials
          8.10.4 Growth Strategy
          8.10.5 Recent Developments

Appendix (Page No. - 207)


List of Tables (58 Tables)

Table 1 Global Healthcare EDI Market, By Component, 2011–2018 ($Million)
Table 2 Global Healthcare EDI Software Market, By Geography, 2011–2018 ($Million)
Table 3 Global Healthcare EDI Services Market, By Geography, 2011–2018 ($Million)
Table 4 Global Healthcare EDI Market, By Type of Transaction, 2011–2018 ($Million)
Table 5 Global Healthcare Claim Status Market, By Geography, 2011-2018 ($Million)
Table 6 Global Healthcare Eligibility Verification Market, By Geography, 2011–2018 ($Million)
Table 7 Global Healthcare Payment Remittance Market, By Geography, 2011–2018 ($Million)
Table 8 Global Healthcare Referral Certification Authorization Market, By Geography, 2011–2018, ($Million)
Table 8 Global Healthcare Enrollment/Disenrollment Transactions Market, By Geography, 2011–2018 ($Million)
Table 10 Global Healthcare Premium Payments Market, By Geography, 2011–2018 ($Million)
Table 11 Global Healthcare Electronic Data Interchange Market, By Mode of Delivery, 2011–2018 ($Million)
Table 12 Web-Based EDI/EDI Cloud Market, By Geography, 2011–2018 ($Million)
Table 13 EDI Via As2 Market, By Geography, 2011–2018 ($Million)
Table 14 Point-to-Point EDI Market, By Geography, 2011–2018 ($Million)
Table 15 EDI Van Market, By Geography, 2011–2018, ($Million)
Table 16 Mobile Healthcare EDI Market, By Geography, 2011–2018 ($Million)
Table 17 Global Healthcare Electronic Data Interchange Market, By End User, 2011–2018 ($Million)
Table 18 Global Healthcare EDI Market For Healthcare Providers (Hospitals), By Geography, 2011–2018 ($Million)
Table 18 Global Market For Healthcare Payers, By Geography, 2011–2018 ($Million)
Table 20 Global Market For Government/Public Payers, By Geography, 2011-2018 ($Million)
Table 21 Global Healthcare EDI Market For Private Payers, By Geography, 2011–2018 ($Million)
Table 22 Global Healthcare EDI Market For Medical Equipment and Accessories Suppliers/Pharmacies, By Geography, 2011–2018 ($Million)
Table 23 Healthcare Electronic Data Interchange Market, By Geography, 2011–2018 ($Million)
Table 24 North America: Healthcare EDI Market, By Country, 2011–2018 ($Million)
Table 25 North America: Market, By Component, 2011–2018 ($Million)
Table 26 North America: Market, By Type of Transaction, 2011–2018 ($Million)
Table 27 North America: Market, By Mode of Delivery, 2011–2018 ($Million)
Table 28 North America: Healthcare EDI Market, By End User, 2011–2018 ($Million)
Table 28 U.S.: Healthcare EDI Market, By Component 2011–2018 ($Million)
Table 30 U.S.: Market, By Type of Transaction, 2011–2018 ($Million)
Table 31 U.S.: Market, By Mode of Delivery, 2011–2018 ($Million)
Table 32 U.S.: Healthcare EDI Market, By End User, 2011–2018 ($Million)
Table 33 U.S.: Healthcare Payers Market, By Type of Payer, 2011–2018 ($Million)
Table 34 Canada: Healthcare EDI Market, By Component, 2011–2018 ($Million)
Table 35 Canada: Market, By Type of Transaction, 2011–2018 ($Million)
Table 36 Canada: Market, By Mode of Delivery, 2011–2018 ($Million)
Table 37 Canada: Healthcare EDI Market, By End User, 2011–2018 ($Million)
Table 38 Europe: Healthcare EDI Market, By Component, 2011–2018 ($Million)
Table 38 Europe: Market, By Type of Transaction, 2011–2018 ($Million)
Table 40 Europe: Market, By Mode of Delivery, 2011–2018 ($Million)
Table 41 Europe: Healthcare EDI Market, By End User, 2011–2018 ($Million)
Table 42 Asia: Healthcare EDI Market, By Component, 2011–2018 ($Million)
Table 43 Asia: Market, By Type of Transaction, 2011–2018 ($Million)
Table 44 Asia: Market, By Mode of Delivery, 2011–2018 ($Million)
Table 45 Asia: Healthcare EDI Market, By End User, 2011–2018 ($Million)
Table 46 ROW: Healthcare EDI Market, By Component, 2011–2018 ($Million)
Table 47 ROW: Market, By Type of Transaction, 2011–2018 ($Million)
Table 48 ROW: Market, By Mode of Delivery, 2011–2018 ($Million)
Table 48 ROW: Healthcare EDI Market, By End User, 2011–2018 ($Million)
Table 50 Growth Strategy Matrix, 2011-2014
Table 51 New Product Launches, 2011–2014
Table 52 Mergers and Acquisitions, 2011–2014
Table 53 Agreements, Alliances, Collaborations, Joint Ventures, and Partnerships, 2011–2014
Table 54 Other Developments, 2011-2014
Table 55 New Product Launches
Table 56 Mergers and Acquisitions
Table 57 Agreements, Alliances, Collaborations, Joint Ventures, and Partnerships
Table 58 Other Developments

List of Figures (32 Figures)

Figure 1 Research Methodology
Figure 2 Healthcare EDI Market Size Estimation Methodology
Figure 3 Data Triangulation Methodology
Figure 4 Global Healthcare EDI Market, By Type of Transaction, 2013 Vs. 2018 ($Million)
Figure 5 Global Market, By Mode of Delivery, 2013 Vs. 2018 ($Million)
Figure 6 Global Market Revenue Trend, 2011–2018 ($Million)
Figure 7 Healthcare EDI Market Segmentation
Figure 8 Evolution
Figure 8 Healthcare EDI Market, By Product
Figure 10 Market, By End Users
Figure 11 Key Growth Strategies, 2011-2014
Figure 12 Allscripts: Revenue Segmentation, 2013
Figure 13 Allscripts: total Revenue, 2011–2013
Figure 14 Allscripts: Total Revenue, By Segments, 2013
Figure 15 Emdeon: Revenue Segmentation, 2012
Figure 16 Emdeon: Total Revenue, 2010-2012 ($Million)
Figure 17 Emdeon: Total Revenue, By Segments, 2012
Figure 18 Payer Services: Total Revenue, By Sub-Segments, 2012
Figure 18 Payment Services: Total Revenue, By Sub-Segments, 2012
Figure 20 GE: Revenue Segmentation, 2013
Figure 21 GE: Total Revenue, 2011–2013 ($Million)
Figure 22 GE: Total Revenue, By Segments, 2013
Figure 23 GE: Total Revenue, By Geography, 2013 
Figure 24 Mckesson: Revenue Segmentation, 2013 
Figure 25 Mckesson: Total Revenue, 2011-2013 ($Million)
Figure 26 Mckesson: Total Revenue, By Segments, 2013
Figure 27 Mckesson: Total Revenue, By Geography
Figure 28 Optum: Total Revenue, 2011-2013 ($Million)  
Figure 28 Optum: Total Revenue, By Segments, 2013 
Figure 30 Siemens AG: Total Revenue, 2011–2013, ($Million)
Figure 31 Siemens AG: Total Revenue, By Segments, 2013
Figure 32 Siemens AG: Total Revenue, By Geography, 2013

Electronic data interchange (EDI) is the automated transfer of data as per specific format between healthcare providers and payers for better claims management, and also between healthcare organizations and medical equipment or accessories suppliers for better management of supply chain.

EDI has been increasingly embraced by the healthcare industry, and is experiencing a growth due to various advantages associated with its use like reduction of the administration costs, reduced errors and time for transfer of claims, and initiatives by various governments. The passing of the Obamacare Act in 2010, in the United States has mandated the use of enrolment/disenrollment transactions between the payers and providers in the U.S., with the North American market contributing the maximum share of the global healthcare EDI market. The European market also occupies a significant share of the global healthcare EDI market, with the Asian regions showing the maximum growth due to various factors like large population, growing burden of diseases, and government initiatives for the support of healthcare IT in these regions.

The global healthcare EDI market is segmented on the basis of components, type of transactions, end users, mode of deliveries, and geographies. The market based on components are further divided into EDI software and EDI services, whereas, the type of transactions are divided into claims status, eligibility verification, payment remittance, referral certification authorization, enrolment/disenrollment transactions, and premium payments. On the basis of end-users the market is sub-segmented into healthcare payers, healthcare providers, and medical equipment/accessories suppliers. Based on mode of deliveries, the market is divided into web-based EDI, point-to-point EDI, mobile EDI, EDI VAN, and EDI via AS2.

The North American market commanded the highest share of 70.3% in 2013, expected to grow at a rate of 12.9% from 2013 to 2018 followed by the Europe and Asia. As the Asian market is relatively new to healthcare EDI, the market share of this region is not expected to change significantly in the next five years. However, the increasing number of government initiatives towards implementation of IT in the healthcare industry will propel the demand for healthcare IT solutions, which in turn will drive the healthcare EDI market at a greater than average CAGR during 2013 and 2018.

The prominent players in the global healthcare EDI market include Emdeon Inc. (U.S.), Allscripts (U.S.), Mckesson (U.S.), Optum Health (U.S.), GE Healthcare (U.K.), Siemens Healthcare (Germany), SSI Group (U.S.), ZirMed (U.S.), Passport Health communications (U.S.), and Capario (U.S.).

Global Healthcare EDI Market Revenue Trend, 2011–2013 ($Million)

Healthcare EDI Market

Source: Annual Reports, SEC Filings, Integrated Healthcare Association (IHA), Health Level Seven International (HL7), Healthcare Information and Management System Society (HIMSS), American Health Information Management Association (AHIMA), other Healthcare IT Integration Associations, Expert Interviews, and MarketsandMarkets Analysis

Global Healthcare EED Market, by Type of Transaction, 2013 VS. 2018 ($Million)

Healthcare EDI Market

Source: Annual Reports, SEC Filings, Integrated Healthcare Association (IHA), Health Level Seven International (HL7), Healthcare Information and Management System Society (HIMSS), American Health Information Management Association (AHIMA), other Healthcare IT Integration Associations, Expert Interviews, and MarketsandMarkets Analysis

Custom Market Research Services

We will customize the research for you, in case the report listed above does not meet with your exact requirements. Our custom research will comprehensively cover the business information you require to help you arrive at strategic and profitable business decisions.

Please visit http://www.marketsandmarkets.com/knowledge-process-outsourcing-services.asp to specify your custom Research Requirement

Connect With Us

Follow us on LinkedIn  Follow us on Facebook   Follow us on Twitter 
Live Chat Support


US : 1-888-600-6441
UK : 44-800-368-9399

Search reports