HOME Top Market Reports Healthcare EDI Market by Component (Solution, Service), Delivery Mode (Web & Cloud, Mobile) Transaction Type (Claims Management, Remittance, Payments, Healthcare Supply Chain), End User (Healthcare Provider, Payer, Pharmacies) - Global Forecast to 2022

Healthcare EDI Market by Component (Solution, Service), Delivery Mode (Web & Cloud, Mobile) Transaction Type (Claims Management, Remittance, Payments, Healthcare Supply Chain), End User (Healthcare Provider, Payer, Pharmacies) - Global Forecast to 2022

By: marketsandmarkets.com
Publishing Date: June 2017
Report Code: HIT 2464

 

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The healthcare EDI market deals with the exchange of computer-processable healthcare data in a standardized format and secure manner among healthcare institutions. The global healthcare EDI market is expected to be at USD 2.56 Billion in 2017, growing at a CAGR of 8.1% during the forecast period. The growing need to regularize electronic transactions and curtail healthcare costs, along with rising government support for healthcare IT are driving the growth of the healthcare EDI market.

Objectives of the Study

  • To define, describe, and forecast the global healthcare electronic data interchange (EDI) market on the basis of component, delivery mode, transaction type, end user, and region
  • To provide detailed information regarding the major factors influencing growth of the global healthcare EDI market (drivers, restraints, opportunities, and industry-specific challenges)
  • To analyze micro-markets with respect to individual growth trends, future prospects, and contributions to the overall market
  • To analyze the opportunities in the market for stakeholders and provide details of the competitive landscape for market leaders
  • To forecast the size of the healthcare EDI market with respect to four main regions, namely, North America (further divided in the U.S. and Canada), Europe, Asia-Pacific, and the Rest of the World
  • To profile key players in the global healthcare EDI market and comprehensively analyze their core competencies and market shares
  • To track and analyze competitive developments such as acquisitions, product launches, collaborations, partnerships, and expansions in the market

Research Methodology

Top-down and bottom-up approaches were used to validate the size of the global healthcare EDI market and estimate the size of other dependent submarkets. Various secondary sources such as directories, industry journals, databases such as Hoover’s, Bloomberg Business, Factiva, and Avention, and annual reports of the companies have been used to identify and collect information useful for the study of this market. Primary sources such as experts from both supply and demand sides have been interviewed to obtain and validate information as well as to assess dynamics of this market. The breakdown of profiles of primaries is shown in the figure below:

Healthcare EDI Market

To know about the assumptions considered for the study, download the pdf brochure

The prominent players in the global healthcare EDI market are McKesson Corporation (U.S.), GE Healthcare (U.S.), Allscripts Healthcare Solutions Inc. (U.S.), Cognizant Technology Corporation (U.S.), SSI Group, LLC (U.S.), Cerner Corporation (U.S.), Comarch SA (Poland), Axway Software SA (France), Optum Inc. (U.S.), Dell Technologies Inc. (U.S.), Quality Systems Inc. (U.S.), and Synnex Corporation (U.S.).

Target Audience:

  • Healthcare service providers
  • Healthcare service payers/insurance payers
  • Pharmaceutical and medical device companies
  • Healthcare EDI database and software providers
  • Healthcare EDI service providers
  • Venture capitalists
  • Government bodies
  • Business research and consulting firms

Scope of the Report:

The research report categorizes the healthcare EDI market into the following segments and subsegments:

Healthcare EDI Market, by Component

  • Services
  • Solutions

Healthcare EDI Market, by Delivery Mode

  • Web & Cloud-based EDI
  • EDI VAN
  • Point-to-Point EDI
  • Mobile EDI

Healthcare EDI Market, by Transaction Type

  • Claims Management
    • Claims Submission
    • Claim Status
    • Eligibility Verification
    • Payment Remittance
    • Referral Certification & Authorization
    • Claim Payments
    • Others
  • Healthcare Supply Chain

Healthcare EDI Market, by End User

  • Healthcare Providers
  • Healthcare Payers
  • Medical Device & Pharmaceutical Industries
  • Pharmacies

Healthcare EDI Market, by Region

  • North America
    • U.S.
    • Canada
  • Europe
  • Asia-Pacific
  • RoW

Available Customization

With the given market data, MarketsandMarkets offers customizations as per the company’s specific needs. The following customization options are available for the report:

Geographic Analysis

  • Further breakdown of the European healthcare EDI market into Germany, France, the U.K., Spain, Italy, and RoE
  • Further breakdown of the RoW healthcare EDI market into Latin America and the Middle East & Africa

Company Information

  • Detailed analysis and profiling of additional market players (Up to 5)

Table of Contents

1 Introduction (Page No. - 15)
    1.1 Objectives of the Study
    1.2 Market Definition
    1.3 Market Scope
           1.3.1 Markets Covered
           1.3.2 Years Considered for the Study
    1.4 Limitations
    1.5 Currency
    1.6 Stakeholders

2 Research Methodology (Page No. - 18)
    2.1 Research Approach
           2.1.1 Secondary Sources
                    2.1.1.1 Key Data From Secondary Sources
           2.1.2 Primary Sources
                    2.1.2.1 Breakdown of Primaries
                    2.1.2.2 Key Data From Primary Sources
                    2.1.2.3 Key Industry Insights
    2.2 Market Size Estimation
    2.3 Market Breakdown and Data Triangulation
    2.4 Assumptions for the Study

3 Executive Summary (Page No. - 27)

4 Premium Insights (Page No. - 32)
    4.1 Healthcare EDI: Market Overview
    4.2 Healthcare EDI: Market, By Delivery Mode & By End User
    4.3 Healthcare EDI: Market: Geographic Snapshot
    4.4 Healthcare EDI: Geographic Mix

5 Market Overview (Page No. - 36)
    5.1 Introduction
    5.2 Market Dynamics
           5.2.1 Key Market Drivers
                    5.2.1.1 Regulations for Transaction Processes
                    5.2.1.2 Rising Need to Curtail Healthcare Costs
                    5.2.1.3 Government Support for Hcit
           5.2.2 Market Restraints
                    5.2.2.1 Data Security—A Major Concern for Patients and EDI Users
                    5.2.2.2 High Implementation Cost of EDI Software
           5.2.3 Market Opportunities
                    5.2.3.1 Increase in Outsourcing of EDI Services
                    5.2.3.2 Introduction of ICD-11 Guidelines
           5.2.4 Market Challenges
                    5.2.4.1 Hesitancy to Switch From Conventional Methods
                    5.2.4.2 End-User Limitations and Requirements

6 Industry Insights (Page No. - 43)
    6.1 Evolution of EDI
    6.2 Healthcare EDI Standards
           6.2.1 Ansi X12
           6.2.2 EDIfact
           6.2.3 Others
    6.3 Healthcare EDI and Value Based Care
    6.4 Industry Trends
           6.4.1 Growing Focus on Integration Platform as A Service (IPAAS)
           6.4.2 Increasing Use of EDI in Healthcare Manufacturing/ Distribution Industry
           6.4.3 Budgetary Constraints and Cost Cutting Measures are Driving European Hospitals to Adopt EDI Solutions in Order to Optimize Their Procurement Operations and Improve Efficiency

7 Global Healthcare EDI Market, By Component (Page No. - 49)
    7.1 Introduction
    7.2 Services
    7.3 Solutions

8 Global Healthcare EDI Market, By Delivery Mode (Page No. - 54)
    8.1 Introduction
    8.2 Web & Cloud-Based EDI
    8.3 EDI Van
    8.4 Point-To-Point EDI
    8.5 Mobile EDI

9 Global Healthcare EDI Market, By Transaction Type (Page No. - 61)
    9.1 Introduction
    9.2 Claims Management
           9.2.1 Claims Submission
           9.2.2 Claim Status
           9.2.3 Eligibility Verification
           9.2.4 Claim Payment
           9.2.5 Referral Certification & Authorization
           9.2.6 Payment Remittance
           9.2.7 Other EDI Transaction
    9.3 Healthcare Supply Chain

10 Global Healthcare EDI Market, By End User (Page No. - 77)
     10.1 Introduction
     10.2 Healthcare Providers
     10.3 Healthcare Payers
     10.4 Medical Device & Pharmaceutical Industries
     10.5 Pharmacies

11 Global Healthcare EDI Market, By Region (Page No. - 86)
     11.1 Introduction
     11.2 North America
             11.2.1 U.S.
             11.2.2 Canada
     11.3 Europe
     11.4 Asia-Pacific
     11.5 Rest of the World

12 Competitive Landscape (Page No. - 109)
     12.1 Vendor Dive Overview
             12.1.1 Vanguards
             12.1.2 Innovators
             12.1.3 Emerging
             12.1.4 Dynamic
     12.2 Product Matrix: Healthcare EDI Market
     12.3 Competitive Benchmarking
             12.3.1 Analysis of Product Portfolio of Major Players in the Healthcare EDI Market (25 Players)
             12.3.2 Business Strategies Adopted By Major Players in the Healthcare EDI Market (25 Players)

*Top 25 Companies Analysed for This Study are - Mckesson Corporation (U.S.), Ge Healthcare (U.S.), Allscripts Healthcare Solutions Inc. (U.S.), and Cognizant Technology Corporation (U.S.), the SSI Group, LLC (U.S.), Comarch Sa (Poland), Axway Software Sa (France), Amosoft, LLC (U.S.), and Zirmed Inc. (U.S.), Experian PLC (Ireland), B2bgateway (U.S.), Dicentral Corporation (U.S.), EDIcom International (Spain), 123 EDI (U.S.), Esker Sa (France), Healthasyst Pvt. Ltd. (India), Ebridge Connections (Canada), EDItel Group (Austria), Plexis Healthcare Systems, Inc. (U.S.), Quality Systems Inc. (U.S.), Synnex Corporation (U.S.), and Covalentworks, Lp (U.S.), Cerner Corporation (U.S.), Optum Inc. (U.S.), and Dell Technologies Inc. (U.S.)

13 Company Profiles (Page No. - 115)
(Overview, Products and Services, Financials, Strategy & Development)*
     13.1 GE Healthcare
     13.2 Mckesson Corporation
     13.3 Optum, Inc. (A Subsidiary of Unitedhealth Group Inc.)
     13.4 Experian PLC
     13.5 Cerner Corporation
     13.6 Allscripts Healthcare Solutions, Inc.
     13.7 Cognizant Technology Solutions Corporation
     13.8 Quality Systems Inc.
     13.9 Synnex Corporation
     13.10 Dell Technologies Inc.
     13.11 SSI Group LLC
     13.12 Zirmed Inc.

*Details on Overview, Products and Services, Financials, Strategy & Development Might Not Be Captured in Case of Unlisted Companies.

14 Appendix (Page No. - 161)
     14.1 Insights of Industry Experts
     14.2 Discussion Guide
     14.3 Knowledge Store: Marketsandmarkets’ Subscription Portal
     14.4 Introducing RT: Real-Time Market Intelligence
     14.5 Available Customizations
     14.6 Related Reports
     14.7 Author Details


List of Tables (81 Tables)

Table 1 Impact Analysis: Market Drivers
Table 2 Impact Analysis: Market Restraints
Table 3 Impact Analysis: Market Opportunities
Table 4 Impact Analysis: Market Challenges
Table 5 Healthcare EDI: Major Transaction Types
Table 6 Global Healthcare EDI Market Size, By Component, 2015-2022 (USD Million)
Table 7 Global Healthcare EDI Services Market Size, By Region, 2015-2022 (USD Million)
Table 8 North America Healthcare EDI Services Market Size, By Country, 2015-2022 (USD Million)
Table 9 Global Healthcare EDI Solutions Market Size, By Region, 2015-2022 (USD Million)
Table 10 North America Healthcare EDI Solutions Market Size, By Country, 2015-2022 (USD Million)
Table 11 Global Market Size, By Delivery Mode, 2015-2022 (USD Million)
Table 12 Global Web & Cloud-Based EDI Market Size, By Region, 2015-2022 (USD Million)
Table 13 North America Web & Cloud-Based EDI Market Size, By Country, 2015-2022 (USD Million)
Table 14 Global EDI Van Market Size, By Region, 2015-2022 (USD Million)
Table 15 North America EDI Van Market Size, By Country, 2015-2022 (USD Million)
Table 16 Global Point-To-Point EDI Market Size, By Region, 2015-2022 (USD Million)
Table 17 North America Point-To-Point EDI Market Size, By Country, 2015-2022 (USD Million)
Table 18 Global Mobile EDI Market Size, By Region, 2015-2022 (USD Million)
Table 19 North America Mobile EDI Market Size, By Country, 2015-2022 (USD Million)
Table 20 Global Market Size, By Transaction Type, 2015-2022 (USD Million)
Table 21 Global Claims Management EDI Market Size, By Transaction Type, 2015-2022 (USD Million)
Table 22 Claims Management EDI Market Size, By Region, 2015-2022 (USD Million)
Table 23 North America Claims Management EDI Market Size, By Country, 2015-2022 (USD Million)
Table 24 Claims Submission EDI Market Size, By Region, 2015-2022 (USD Million)
Table 25 North America Claims Submission EDI Market Size, By Country, 2015-2022 (USD Million)
Table 26 Global Claim Status EDI Market Size, By Region, 2015-2022 (USD Million)
Table 27 North America Claim Status EDI Market Size, By Country, 2015-2022 (USD Million)
Table 28 Global Eligibility Verification EDI Market Size, By Region, 2015-2022 (USD Million)
Table 29 North America Eligibility Verification EDI Market Size, By Country, 2015-2022 (USD Million)
Table 30 Global Claim Payment EDI Market Size, By Region, 2015-2022 (USD Million)
Table 31 North America Claim Payment EDI Market Size, By Country, 2015-2022 (USD Million)
Table 32 Global Referral Certification & Authorization EDI Market Size, By Region, 2015-2022 (USD Million)
Table 33 North America Referral Certification & Authorization EDI Market Size, By Country, 2015-2022 (USD Million)
Table 34 Global Payment Remittance EDI Market Size, By Region, 2015-2022 (USD Million)
Table 35 North America Payment Remittance EDI Market Size, By Country, 2015-2022 (USD Million)
Table 36 Global Other EDI Transactions Market Size, By Region, 2015-2022 (USD Million)
Table 37 North America Other EDI Transactions Market Size, By Country, 2015-2022 (USD Million)
Table 38 Global Healthcare Supply Chain EDI Market Size, By Region, 2015-2022 (USD Million)
Table 39 North America Healthcare Supply Chain EDI Market Size, By Country, 2015-2022 (USD Million)
Table 40 Global Market Size, By End User, 2015-2022 (USD Million)
Table 41 Global Market Size for Healthcare Providers, By Region, 2015–2022 (USD Million)
Table 42 North America Market Size for Healthcare Providers, By Country, 2015–2022 (USD Million)
Table 43 Global Market Size for Healthcare Payers, By Region, 2015–2022 (USD Million)
Table 44 North America Market Size for Healthcare Payers, By Country, 2015–2022 (USD Million)
Table 45 Global Market Size for Medical Device & Pharmaceutical Industries, By Region, 2015–2022 (USD Million)
Table 46 North America Market Size for Medical Device & Pharmaceutical Industries, By Country, 2015–2022 (USD Million)
Table 47 Global Healthcare EDI Market Size for Pharmacies, By Region, 2015–2022 (USD Million)
Table 48 North America Market Size for Pharmacies, By Country, 2015–2022 (USD Million)
Table 49 Global Market Size, By Region, 2015–2022 (USD Million)
Table 50 North America: Healthcare Expenditure Analysis, By Country
Table 51 North America: Healthcare EDI Market Size, By Country, 2015–2022 (USD Million)
Table 52 North America: Market Size, By Component, 2015–2022 (USD Million)
Table 53 North America: EDI Market Size, By Delivery Mode, 2015–2022 (USD Million)
Table 54 North America: EDI Market Size, By Transaction Type, 2015–2022 (USD Million)
Table 55 North America: Healthcare Claims Management Transaction Market Size, By Type, 2015–2022 (USD Million)
Table 56 North America: Healthcare EDI Market Size, By End User, 2015–2022 (USD Million)
Table 57 U.S.: Healthcare EDI Market Size, By Component, 2015–2022 (USD Million)
Table 58 U.S.: Market Size, By Delivery Mode, 2015–2022 (USD Million)
Table 59 U.S.: Market Size, By Transaction Type, 2015–2022 (USD Million)
Table 60 U.S.: Healthcare Claims Management Transaction Market Size, By Type, 2015–2022 (USD Million)
Table 61 U.S.: Market Size, By End User, 2015–2022 (USD Million)
Table 62 Canada: Healthcare EDI Market Size, By Component, 2015–2022 (USD Million)
Table 63 Canada: Market Size, By Delivery Mode, 2015–2022 (USD Million)
Table 64 Canada: Market Size, By Transaction Type, 2015–2022 (USD Million)
Table 65 Canada: Healthcare Claims Management Transaction Market Size, By Type, 2015–2022 (USD Million)
Table 66 Canada: Market Size, By End User, 2015–2022 (USD Million)
Table 67 Europe: Market Size, By Component, 2015–2022 (USD Million)
Table 68 Europe: Market Size, By Delivery Mode, 2015–2022 (USD Million)
Table 69 Europe: Market Size, By Transaction Type, 2015–2022 (USD Million)
Table 70 Europe: Healthcare Claims Management Transaction Market Size, By Type, 2015–2022 (USD Million)
Table 71 Europe: Market Size, By End User, 2015–2022 (USD Million)
Table 72 APAC: Healthcare EDI Market Size, By Component, 2015–2022 (USD Million)
Table 73 APAC: Market Size, By Delivery Mode, 2015–2022 (USD Million)
Table 74 APAC: Market Size, By Transaction Type, 2015–2022 (USD Million)
Table 75 APAC: Healthcare Claims Management Transaction Market Size, By Type, 2015–2022 (USD Million)
Table 76 APAC: Market Size, By End User, 2015–2022 (USD Million)
Table 77 RoW: Healthcare EDI Market Size, By Component, 2015–2022 (USD Million)
Table 78 RoW: Market Size, By Delivery Mode, 2015–2022 (USD Million)
Table 79 RoW: Market Size, By Transaction Type, 2015–2022 (USD Million)
Table 80 RoW: Healthcare Claims Management Transaction Market Size, By Type, 2015–2022 (USD Million)
Table 81 RoW: Market Size, By End User, 2015–2022 (USD Million)


List of Figures (39 Figures)

Figure 1 Healthcare EDI Market Segmentation
Figure 2 Research Design
Figure 3 Breakdown Of Primary interviews: By Company Type, Designation,
and Region 
Figure 4 Bottom-Up Approach
Figure 5 top-Down Approach
Figure 6 Data Triangulation Methodology
Figure 7 Global Healthcare EDI Market Size, By Component,
2017 Vs. 2022 (USD Million) 
Figure 8 Global Healthcare EDI Market Size, By Delivery Mode,
2017 Vs. 2022 (USD Million) 
Figure 9 Global Healthcare EDI Market Size, By Transaction Type,
2017 Vs. 2022 (USD Million) 
Figure 10 Global Healthcare EDI Market, By End User, 2017 Vs. 2022 (USD Million)
Figure 11 Geographic Snapshot Of Global Healthcare EDI Market
Figure 13 Web & Cloud-Based EDI Commanded The Largest Share Of The Healthcare EDI Market in 2016
Figure 14 U.S. Accounted For The Largest Share Of
The Healtcare EDI Market in 2016 
Figure 16 Healthcare EDI Market: Drivers, Restraints, Opportunities,
& Challenges 
Figure 17 Healthcare EDI Spending On Claims-Related Business Transactions
Figure 18 Evolution Of Healthcare EDI
Figure 19 Value Based Care Through Efficient Data Exchange
Figure 20 Focus On EDI in Healthcare Manufacturing & Distribution industry and Ipaas Are The Major Trends in The Market
Figure 21 Services Segment Will Continue to Dominate The Healthcare EDI Market in 2022
Figure 22 Web & Cloud-Based EDI Segment to Dominate The Healthcare EDI Market in 2017
Figure 23 Claims Management Segment to Dominate
The Healthcare EDI Market in 2017 
Figure 24 Claims Submission Segment to Dominate The Claims Management Market in 2017
Figure 25 Healthcare Providers to Dominate The Healthcare EDI Market in 2017
Figure 26 Healthcare EDI Market: Geographic Snapshot
Figure 27 North America: Healthcare EDI Market Snapshot
Figure 28 Europe: Healthcare EDI Market Snapshot
Figure 29 Dive Chart
Figure 30 Ge Healthcare: Company Snapshot (2016)
Figure 31 Mckesson Corporation: Company Snapshot (2016)
Figure 32 Optum, Inc.: Company Snapshot (2016)
Figure 33 Experian Plc: Company Snapshot (2016)
Figure 34 Cerner Corporation: Company Snapshot (2016)
Figure 35 Allscripts Healthcare Solutions Inc.: Company Snapshot (2016)
Figure 36 Cognizant Technology Solutions Corporation:
Company Snapshot (2016) 
Figure 37 Quality Systems Inc.: Company Snapshot (2016)
Figure 38 Synnex Corporation: Company Snapshot (2016)
Figure 39 Dell Technologies Inc.: Company Snapshot (2016)

The global healthcare EDI market is projected to reach USD 3.77 Billion by 2022 from USD 2.56 Billion in 2017, at a CAGR of 8.1%. The growth of this market is majorly driven by the development of regulations for transaction processes, the rising need to curtail healthcare costs, and government support for HCIT implementation.

The report analyzes the global healthcare EDI market by component, delivery mode, transaction type, end user, and region. On the basis of component, the services segment accounted for the largest share in 2016, owing to the outsourcing of EDI services by healthcare organizations and growing demand for scalability of EDI solutions. Based on delivery mode, the global healthcare EDI market is categorized into web & cloud-based EDI, point-to-point EDI, EDI VAN, and mobile EDI. In 2016, the web & cloud-based EDI segment accounted for the largest share of the market, this is primarily attributed to its benefits including affordable solution for small and medium-sized healthcare providers, improved flexibility, and scalability.

Geographically, the global healthcare EDI market is segmented into North America, Europe, Asia-Pacific, and the Rest of the World. In 2016, North America held the largest share of this market and this is primarily attributed to the increasing adoption of healthcare EDI in claims & supply chain management, growing number of HCIT companies, and favorable regulations. The Asia-Pacific region is expected to witness the highest CAGR during the forecast period, owing to the rising patient volume, growing need to manage large volume of patient data, need to curb healthcare costs, and implementation of HCIT programs in this region.

Healthcare EDI Market

Data security, which poses a major concern for patients & EDI users and high implementation cost of EDI software are some of the factors restraining the growth of this market during the forecast period.

McKesson Corporation (U.S.) dominated the global healthcare EDI market in 2016. The company has a comprehensive range of EDI solutions and services, and a significant global presence in the U.S. followed by Canada, Germany, the U.K., and Ireland. The company offers a wide portfolio of EDI solutions mainly through its subsidiary, Change Healthcare (U.S.), of which it holds 70% of shares. The company operates worldwide through channel partners and distribution network. The company emphasizes on increasing its market presence through acquisitions and collaborations.

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