Healthcare Payer Services Market

Healthcare Payer Services Market by Service Type (BPO (Claims, Front end, Provider, Product Development, Care Management, Billing, HR), ITO (Provider Network, Accounts, Analytics, Fraud), & KPO), End User (Public and Private) & Region - Global Forecast to 2027

Report Code: HIT 3877 Feb, 2023, by marketsandmarkets.com

The global healthcare payer services market in terms of revenue was estimated to be worth $69.9 billion in 2022 and is poised to reach $118.2 billion by 2027, growing at a CAGR of 11.1% from 2022 to 2027. The new research study consists of an industry trend analysis of the market. The new research study consists of industry trends, pricing analysis, patent analysis, conference and webinar materials, key stakeholders, and buying behaviour in the market. Increased health insurance enrollment, rising incidences of healthcare fraud, increased usage of outsourcing, federal mandates, and rising cases of chronic diseases are driving growth in this market. However, the risks of data breaches, loss of managerial control, cultural and linguistic hurdles, and high outsourcing costs are projected to limit the market's growth to some extent.

Healthcare Payer Services Market Trends

Healthcare Payer Services Market

To know about the assumptions considered for the study, Request for Free Sample Report

Healthcare Payer Services Market Dynamics

Driver: Outsourcing of services to reduce costs and increase efficiency

Over the past few decades, healthcare costs have been extremely increasing. Rising health insurance costs fuel the rising cost of healthcare, the increasing need for healthcare services, the rising geriatric population worldwide, and the subsequent increase in chronic conditions. Additional factors contributing to healthcare expenses include wasteful use of resources, inflated claims, and administrative costs. Due to the increasing costs associated with healthcare, payers are focusing on leveraging the advantages of outsourcing. The need of outsourcing services to reduce costs and increase efficiency is one of the key growth drivers for the global market.

Restraint: Data breaches and loss of confidentiality

Working with healthcare payer servicing firms increases the danger of security breaches and data leaks. Extremely sensitive and legally protected information such as patient contact information, medical history, insurance plans, and illnesses can significantly impact demand. The healthcare provider could be extremely impacted due to a breach or leak of this data, as it would undermine patient confidence. Additionally, it can result in legal actions, costing the business more losses. Incidents of healthcare data breaches rose by 55% in 2020 over 2019. In 2020, there were around 600 breaches that affected over 26 million people.

Opportunity: Adoption of advanced data analytics

The increasing volume of patient data created by electronic records and various other sources, including connected technologies and devices, has also fueled the expansion of this industry. Since the data is unstructured and raw, analytics is necessary to draw useful conclusions. Business intelligence (BI) tools are used more frequently to interpret this data. Pharma companies, healthcare providers, payers, and patients, continuously produce digital data; using BI technologies not only suggests the best course of action to follow throughout the treatment process but also helps reduce the risk of disease. With a focus on managing medical loss ratios, payers must use data analytics to retain current members and implement effective care management programs. Many payers have started using analytics that extensively uses data, enables statistical and quantitative analysis, and uses predictive models to drive better fact-based decision-making. Due to the benefits of advanced data analytics and its applications, its adoption can be expected to increase; this provides major growth opportunities for the healthcare payer outsourcing market.

Challenge: Migration from legacy systems

A legacy system is an old method, technology, or application program that continues to be used, typically because it still caters to users’ needs, even though newer technologies and more efficient methods are available. Nearly all companies in the insurance sector offer the same goods. Therefore, one of the most crucial market differentiators is customer service. Bringing consumers closer to the business, providing facilities for easy information and transaction access, and ensuring continuous distributor support are new trends driving this market. Since these platforms are intrinsically limited and unable to support business simplicity and enterprise-wide data interpretation, the legacy landscape is rapidly shifting to support this business change. Legacy systems present difficulties since the application software is typically built in out-of-date programming languages and is typically mainframe-based. Moreover, there also exists a lack of resources with the knowledge of these systems.

The BPO services segment accounted for the largest share of the healthcare payer services industry, by type of service.

On the basis of service type, the healthcare payer services market is bifurcated into ITO services, BPO services, and KPO services. The BPO services segment accounted for the largest market share. The large share of this segment is primarily attributed to the lower costs, higher efficiency, and ability to concentrate on essential business operations provided by BPO services. This greatly contributes to the fact that BPO services offer administration in important administrative domains. This thus makes it possible for payers to cut costs and accelerate time to market, which is primarily the target of any payer organisation.

The private payer segment is expected to grow at the highest CAGR in the healthcare payer services industry during the forecast period, by end user.

On the basis of the end user, the healthcare payer services market is bifurcated into private payers and public payers. During the forecast period, the private payer segment is expected to grow at the highest CAGR. The high growth of this segment is attributed to the rising competitiveness among private payers, the rising demand for private health insurance due to increasing healthcare costs, and the growing prevalence of chronic diseases.

North America was the most populous region in the healthcare payer services industry.

On the basis of region, the healthcare payer services market is bifurcated into North America, Europe, Asia Pacific, and the Rest of the World (RoW). North America dominated the global market, followed by Asia Pacific. However, Asia Pacific is expected to grow at the highest CAGR during the forecast period. This highest growth in Asia Pacific can be attributed to the implementation of new ICT guidelines in Japan, investments and reforms to modernize China’s healthcare infrastructure, and the rapidly growing healthcare industry in India.

Healthcare Payer Services Market by Region

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

Prominent players in the healthcare payer services market include Accenture (Ireland), Cognizant (US), Tata Consultancy Services (India), XEROX Corporation (US), WNS (Holdings) Limited (India), NTT Data Corporation (Japan), IQVIA Inc. (US), Mphasis (India), Genpact (US), Wipro (India), Infosys BPM (India), Firstsource Solutions (India), IBM Corporation (US), HCL Technologies (India), Solutions (US), Lonza (Switzerland), Omega Healthcare (India), R1 RCM, INC. (US), Invensis Technologies (India), UnitedHealth Group (US), Paraxel Corporation International (US),

Scope of the Healthcare Payer Services Industry

Report Metrics

Details

Market Revenue in 2022

$69.9 billion

Projected Revenue by 2027

$118.2 billion

Revenue Rate

Poised to grow at a CAGR of 11.1%

Market Driver

Outsourcing of services to reduce costs and increase efficiency

Market Opportunity

Adoption of advanced data analytics

The research report categorizes the healthcare payer services market to forecast revenue and analyze trends in each of the following submarkets:

By Service Type

  • BPO Services
    • Claims Management Services
    • Integrated Front-End Services and Back-Office Operations
    • Member Management Services
    • Product Development and Business Acquisition Services
    • Provider Management Services
    • Care Management Services
    • Billing And Accounts Management Services
    • HR Services
  • ITO Services
    • Claims Management Services
    • Provider Network Management
    • Billing and Accounts Management Services
    • Fraud Management Analytics Services
    • Other ITO Services
  • KPO Services

By End User

  • Private Payers
  • Public Payers

Recent Developments of Healthcare Payer Services Industry

  • In July 2021, Cognizant (US) collaborated with Royal Philips (Netherlands) to create Philips HealthSuite, a cloud-based platform, to deliver and maintain leading-edge digital health solutions, providing advanced connectivity and using big data to create actionable insights.
  • In April 2021, Xerox Corporation (US) acquired Groupe CT (Canada), an independent document management provider in Eastern Canada, to accelerate a digital transformation roadmap by combining its document management services expertise and leadership with Xerox’s portfolio of workplace solutions to expand its reach in the North American market.
  • In December 2020, Accenture (Ireland) acquired OpusLine (France) to help clients innovate and deliver digital innovation across their organizations.
  • In June 2018, WNS (Holdings) Limited (India) entered into a global shared services partnership with Hyperion Insurance Group (UK), which enabled WNS to highlight its position as an industry leader in high-end global insurance BPM.

Frequently Asked Questions (FAQ):

To speak to our analyst for a discussion on the above findings, click Speak to Analyst

TABLE OF CONTENTS
 
1 INTRODUCTION (Page No. - 26)
    1.1 STUDY OBJECTIVES 
    1.2 HEALTHCARE PAYER SERVICES INDUSTRY DEFINITION 
           1.2.1 INCLUSIONS AND EXCLUSIONS
    1.3 MARKET SCOPE 
    1.4 YEARS CONSIDERED 
    1.5 CURRENCY CONSIDERED 
          TABLE 1 EXCHANGE RATES UTILIZED FOR CONVERSION TO USD
    1.6 STAKEHOLDERS 
    1.7 SUMMARY OF CHANGES 
    1.8 LIMITATIONS 
 
2 RESEARCH METHODOLOGY (Page No. - 30)
    2.1 RESEARCH APPROACH 
    2.2 RESEARCH METHODOLOGY DESIGN 
          FIGURE 1 HEALTHCARE PAYER SERVICES MARKET: RESEARCH DESIGN
           2.2.1 SECONDARY RESEARCH
                    2.2.1.1 Key data from secondary sources
           2.2.2 PRIMARY DATA
                    FIGURE 2 PRIMARY SOURCES
                    2.2.2.1 Key data from primary sources
                    2.2.2.2 Insights from primary experts
                                 FIGURE 3 BREAKDOWN OF PRIMARY INTERVIEWS: BY COMPANY TYPE, DESIGNATION, AND REGION
    2.3 MARKET SIZE ESTIMATION 
          FIGURE 4 SUPPLY-SIDE MARKET SIZE ESTIMATION: REVENUE SHARE ANALYSIS
          FIGURE 5 TOP-DOWN APPROACH
          FIGURE 6 CAGR PROJECTION FROM ANALYSIS OF DRIVERS, RESTRAINTS, OPPORTUNITIES, AND CHALLENGES (2022–2027)
          FIGURE 7 CAGR PROJECTION: SUPPLY-SIDE ANALYSIS
    2.4 MARKET BREAKDOWN AND DATA TRIANGULATION 
          FIGURE 8 DATA TRIANGULATION METHODOLOGY
    2.5 MARKET SHARE ESTIMATION 
    2.6 STUDY ASSUMPTIONS 
    2.7 LIMITATIONS 
           2.7.1 METHODOLOGY-RELATED LIMITATIONS
           2.7.2 SCOPE-RELATED LIMITATIONS
    2.8 RISK ASSESSMENT 
          TABLE 2 GLOBAL MARKET: RISK ANALYSIS
    2.9 RECESSION IMPACT 
 
3 EXECUTIVE SUMMARY (Page No. - 44)
    FIGURE 9 GLOBAL HEALTHCARE PAYER SERVICES INDUSTRY, BY SERVICE TYPE, 2022 VS. 2027 (USD MILLION)
    FIGURE 10 GLOBAL MARKET, BY END USER, 2022 VS. 2027 (USD MILLION)
    FIGURE 11 GLOBAL MARKET: GEOGRAPHICAL SNAPSHOT
 
4 PREMIUM INSIGHTS (Page No. - 47)
    4.1 HEALTHCARE PAYER SERVICES MARKET OVERVIEW 
          FIGURE 12 RISING NEED TO CURB HEALTHCARE COSTS TO DRIVE MARKET
    4.2 GLOBAL MARKET: GEOGRAPHIC GROWTH OPPORTUNITIES 
          FIGURE 13 JAPAN TO WITNESS HIGHEST GROWTH RATE DURING FORECAST PERIOD
    4.3 NORTH AMERICA: MARKET, BY SERVICE TYPE AND COUNTRY (2021) 
          FIGURE 14 BPO SEGMENT IN THE US ACCOUNTED FOR LARGEST MARKET SHARE IN 2021
    4.4 GLOBAL MARKET: REGIONAL MIX 
          FIGURE 15 ASIA PACIFIC TO REGISTER HIGHEST GROWTH RATE DURING FORECAST PERIOD
 
5 MARKET OVERVIEW (Page No. - 50)
    5.1 INTRODUCTION 
    5.2 MARKET DYNAMICS 
          FIGURE 16 HEALTHCARE PAYER SERVICES MARKET: DRIVERS, RESTRAINTS, OPPORTUNITIES, AND CHALLENGES
           5.2.1 DRIVERS
                    5.2.1.1 Rising number of healthcare insurance enrollments
                    5.2.1.2 Outsourcing of services to reduce healthcare costs
                    5.2.1.3 Stringent federal mandates to increase payer workloads
                    5.2.1.4 Increasing cases of healthcare fraud
                    5.2.1.5 Rising incidence of chronic diseases
           5.2.2 RESTRAINTS
                    5.2.2.1 Data breaches and loss of confidentiality
                    5.2.2.2 High costs associated with outsourcing healthcare payer services
                    5.2.2.3 Loss of managerial control
           5.2.3 OPPORTUNITIES
                    5.2.3.1 Adoption of advanced data analytics
                    5.2.3.2 Gradual shift to ICD-11 standards
                    5.2.3.3 Service portfolio expansion for vendors
                    5.2.3.4 Rising need for cost-effective solutions
           5.2.4 CHALLENGES
                    5.2.4.1 Migration from legacy systems
                    5.2.4.2 Concerns regarding data security
                    5.2.4.3 Cultural differences and language barriers
    5.3 PRICING ANALYSIS 
           5.3.1 GLOBAL MARKET: BPO PRICING ANALYSIS
                    TABLE 3 GLOBAL MARKET: AVERAGE SELLING PRICE FOR BPO SERVICES
           5.3.2 GLOBAL MARKET: IT OUTSOURCING PRICING ANALYSIS
                    TABLE 4 HEALTHCARE IT INTEGRATION SOLUTIONS: PRICING MODEL
    5.4 REGULATORY ANALYSIS 
           5.4.1 NORTH AMERICA
           5.4.2 EUROPE
           5.4.3 ASIA PACIFIC
           5.4.4 MIDDLE EAST AND AFRICA
           5.4.5 LATIN AMERICA
    5.5 VALUE CHAIN ANALYSIS 
          FIGURE 17 GLOBAL HEALTHCARE PAYER SERVICES INDUSTRY: VALUE-CHAIN ANALYSIS
    5.6 PORTER’S FIVE FORCES ANALYSIS 
          FIGURE 18 HIGH INTENSITY OF COMPETITIVENESS AMONG PLAYERS
          TABLE 5 GLOBAL MARKET: PORTER’S FIVE FORCES ANALYSIS
    5.7 ECOSYSTEM ANALYSIS 
          FIGURE 19 GLOBAL MARKET: ECOSYSTEM ANALYSIS MAP
    5.8 TECHNOLOGY ANALYSIS 
           5.8.1 MACHINE LEARNING
           5.8.2 ARTIFICIAL INTELLIGENCE
           5.8.3 INTERNET OF THINGS
           5.8.4 BLOCKCHAIN
           5.8.5 AUGMENTED REALITY
    5.9 GLOBAL MARKET: APPROACHES TO BPO SERVICES 
           5.9.1 BUNDLED SERVICES
           5.9.2 FEE-FOR-SERVICE
           5.9.3 FLEXIBLE CONTRACTS
           5.9.4 BEST-SHORE
    5.10 GLOBAL MARKET: APPROACHES TO BPO MODELS 
           5.10.1 MULTI-SOURCING
           5.10.2 CAPTIVE CENTER
           5.10.3 HYBRID DELIVERY MODEL
           5.10.4 PREFERRED PROVIDERS
           5.10.5 STRATEGIC PARTNERSHIPS
           5.10.6 GLOBAL DELIVERY MODEL
    5.11 KEY STAKEHOLDERS AND BUYING CRITERIA 
           5.11.1 KEY STAKEHOLDERS IN BUYING PROCESS
                     FIGURE 20 INFLUENCE OF STAKEHOLDERS ON BUYING PROCESS
                     TABLE 6 INFLUENCE OF STAKEHOLDERS ON END USERS FOR BUYING PROCESS (%)
           5.11.2 BUYING CRITERIA
                     FIGURE 21 KEY BUYING CRITERIA FOR HEALTHCARE PAYER COMPONENTS
                     TABLE 7 KEY BUYING CRITERIA FOR HCIT COMPONENTS
    5.12 RECESSION IMPACT ON GLOBAL MARKET 
           5.12.1 MACRO INDICATORS OF RECESSION
                     FIGURE 22 GLOBAL GDP: 2011-2021 (USD TRILLION)
 
6 HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE (Page No. - 75)
    6.1 INTRODUCTION 
          TABLE 8 GLOBAL HEALTHCARE PAYER SERVICES INDUSTRY, BY SERVICE TYPE, 2020–2027 (USD MILLION)
    6.2 BUSINESS PROCESS OUTSOURCING (BPO) SERVICES 
          TABLE 9 GLOBAL MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
          TABLE 10 GLOBAL MARKET FOR BPO SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.1 CLAIMS MANAGEMENT SERVICES
                    6.2.1.1 Voluntary agreements between healthcare providers & payers to fuel uptake
                                TABLE 11 COMMERCIALLY AVAILABLE CLAIMS MANAGEMENT SOLUTIONS
                                TABLE 12 GLOBAL MARKET FOR BPO CLAIMS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.2 INTEGRATED FRONT-END SERVICES AND BACK-OFFICE OPERATIONS
                    6.2.2.1 Reduced overhead expenses and improved efficiency offered by outsourcing companies to support market growth
                                TABLE 13 GLOBAL MARKET FOR BPO INTEGRATED FRONT-END SERVICES AND BACK-OFFICE OPERATIONS, BY REGION, 2020–2027 (USD MILLION)
           6.2.3 MEMBER MANAGEMENT SERVICES
                    6.2.3.1 Ability to manage member-related eligibility data strategically across enterprises to drive market
                                TABLE 14 COMMERCIALLY AVAILABLE MEMBER MANAGEMENT SOLUTIONS
                                TABLE 15 GLOBAL MARKET FOR BPO MEMBER MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.4 PROVIDER MANAGEMENT SERVICES
                    6.2.4.1 Outsourcing provider management services to third-party vendors for operational efficiency to drive market
                                TABLE 16 GLOBAL MARKET FOR BPO PROVIDER MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.5 PRODUCT DEVELOPMENT AND BUSINESS ACQUISITION SERVICES (PDBA)
                    6.2.5.1 Rising focus on customer engagement and retention to drive market
                                TABLE 17 HEALTHCARE PAYERS MARKET FOR BPO PRODUCT DEVELOPMENT AND BUSINESS ACQUISITION SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.6 CARE MANAGEMENT SERVICES
                    6.2.6.1 Ability to execute appropriate clinical coverage decisions to support market growth
                                TABLE 18 GLOBAL MARKET FOR BPO CARE MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.7 BILLING AND ACCOUNTS MANAGEMENT SERVICES
                    6.2.7.1 Reduced process time and minimal burden on payer staff to drive market
                                TABLE 19 GLOBAL MARKET FOR BPO BILLING AND ACCOUNTS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.2.8 HR SERVICES
                    6.2.8.1 Outsourcing of human resource services for improved employee experiences to support market growth
                                TABLE 20 GLOBAL MARKET FOR BPO HR SERVICES, BY REGION, 2020–2027 (USD MILLION)
    6.3 INFORMATION TECHNOLOGY OUTSOURCING (ITO) SERVICES 
          TABLE 21 GLOBAL MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
          TABLE 22 GLOBAL MARKET FOR ITO SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.3.1 CLAIMS MANAGEMENT SERVICES
                    6.3.1.1 Rapid turnaround time with low errors & costs to drive outsourcing of operations
                                TABLE 23 GLOBAL MARKET FOR ITO CLAIMS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.3.2 PROVIDER NETWORK MANAGEMENT SERVICES
                    6.3.2.1 Rising focus on core functions to support market growth
                                TABLE 24 GLOBAL MARKET FOR ITO PROVIDER NETWORK MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.3.3 BILLING AND ACCOUNTS MANAGEMENT SERVICES
                    6.3.3.1 Rising cash flow and low space requirements to drive market
                                TABLE 25 GLOBAL MARKET FOR ITO BILLING AND ACCOUNTS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.3.4 FRAUD ANALYTICS SERVICES
                    6.3.4.1 Rising volume of fraudulent claims to drive adoption of analytics
                                TABLE 26 GLOBAL MARKET FOR ITO FRAUD ANALYTICS SERVICES, BY REGION, 2020–2027 (USD MILLION)
           6.3.5 OTHER ITO SERVICES
                    TABLE 27 GLOBAL MARKET FOR OTHER ITO SERVICES, BY REGION, 2020–2027 (USD MILLION)
    6.4 KNOWLEDGE PROCESS OUTSOURCING SERVICES 
           6.4.1 RISING NUMBER OF FRAUD CLAIMS TO DRIVE KPO SERVICES
                    TABLE 28 GLOBAL MARKET FOR KPO SERVICES, BY REGION, 2020–2027 (USD MILLION)
 
7 HEALTHCARE PAYER SERVICES MARKET, BY END USER (Page No. - 98)
    7.1 INTRODUCTION 
                    TABLE 29 GLOBAL HEALTHCARE PAYER SERVICES INDUSTRY, BY END USER, 2020–2027 (USD MILLION)
    7.2 PRIVATE PAYERS 
           7.2.1 PROVISION OF CONSUMER-FOCUSED HEALTHCARE PLANS TO FUEL UPTAKE OF SOLUTIONS
                    TABLE 30 GLOBAL MARKET FOR PRIVATE PAYERS, BY REGION, 2020–2027 (USD MILLION)
    7.3 PUBLIC PAYERS 
           7.3.1 RISING NEED FOR DIVERSE HEALTHCARE IT SOLUTIONS TO DRIVE MARKET
                    TABLE 31 GLOBAL MARKET FOR PUBLIC PAYERS, BY REGION, 2020–2027 (USD MILLION)
 
8 HEALTHCARE PAYER SERVICES MARKET, BY REGION (Page No. - 102)
    8.1 INTRODUCTION 
          TABLE 32 GLOBAL MARKET, BY REGION, 2020–2027 (USD MILLION)
    8.2 NORTH AMERICA 
          TABLE 33 NORTH AMERICA: MARKET, BY COUNTRY, 2020–2027 (USD MILLION)
          FIGURE 23 NORTH AMERICA: MARKET SNAPSHOT
           8.2.1 NORTH AMERICA: RECESSION IMPACT ANALYSIS
                    TABLE 34 NORTH AMERICA: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                    TABLE 35 NORTH AMERICA: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 36 NORTH AMERICA: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 37 NORTH AMERICA: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.2.2 US
                    8.2.2.1 Increasing insurance enrolments and rising need to curb healthcare expenditure to drive market
                                TABLE 38 US: MACROECONOMIC INDICATORS FOR HEALTHCARE
                                TABLE 39 US: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 40 US: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 41 US: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 42 US: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.2.3 CANADA
                    8.2.3.1 Rising focus on delivering improved services to drive market uptake
                                TABLE 43 CANADA: MACROECONOMIC INDICATORS FOR HEALTHCARE
                                TABLE 44 CANADA: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 45 CANADA: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 46 CANADA: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 47 CANADA: MARKET, BY END USER, 2020–2027 (USD MILLION)
    8.3 EUROPE 
           8.3.1 EUROPE: RECESSION IMPACT ANALYSIS
                    TABLE 48 EUROPE: HEALTHCARE PAYER SERVICES INDUSTRY, BY REGION, 2020–2027 (USD MILLION)
                    TABLE 49 EUROPE: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                    TABLE 50 EUROPE: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 51 EUROPE: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 52 EUROPE: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.3.2 GERMANY
                    8.3.2.1 High adoption of EHR systems among primary care physicians to drive market
                                TABLE 53 GERMANY: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 54 GERMANY: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 55 GERMANY: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 56 GERMANY: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.3.3 UK
                    8.3.3.1 Rising government support for healthcare digitalization to drive market
                                TABLE 57 UK: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 58 UK: MARKET FOR BPO SERVICE, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 59 UK: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 60 UK: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.3.4 FRANCE
                    8.3.4.1 Shortage of skilled personnel to drive demand
                                TABLE 61 FRANCE: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 62 FRANCE: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 63 FRANCE: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 64 FRANCE: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.3.5 ITALY
                    8.3.5.1 Rising need to improve patient care to drive adoption of healthcare payer solutions
                                TABLE 65 ITALY: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 66 ITALY: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 67 ITALY: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 68 ITALY: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.3.6 SPAIN
                    8.3.6.1 High level of mobile phone penetration to fuel uptake of risk management compliance services
                                TABLE 69 SPAIN: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 70 SPAIN: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 71 SPAIN: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 72 SPAIN: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.3.7 REST OF EUROPE
                    TABLE 73 REST OF EUROPE: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                    TABLE 74 REST OF EUROPE: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 75 REST OF EUROPE: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 76 REST OF EUROPE: MARKET, BY END USER, 2020–2027 (USD MILLION)
    8.4 ASIA PACIFIC 
          TABLE 77 ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY COUNTRY, 2020–2027 (USD MILLION)
          FIGURE 24 ASIA PACIFIC: MARKET SNAPSHOT
           8.4.1 ASIA PACIFIC: RECESSION IMPACT ANALYSIS
                    TABLE 78 ASIA PACIFIC: HEALTHCARE PAYER SERVICES INDUSTRY, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                    TABLE 79 ASIA PACIFIC: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 80 ASIA PACIFIC: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 81 ASIA PACIFIC: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.4.2 INDIA
                    8.4.2.1 Availability of highly skilled personnel at low cost to support market growth
                                TABLE 82 INDIA: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 83 INDIA: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 84 INDIA: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 85 INDIA: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.4.3 JAPAN
                    8.4.3.1 Rising geriatric population to drive adoption of payer solutions for EHRs
                                TABLE 86 JAPAN: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 87 JAPAN: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 88 JAPAN: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 89 JAPAN: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.4.4 CHINA
                    8.4.4.1 Strong government support for HCIT to drive market
                                TABLE 90 CHINA: MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                                TABLE 91 CHINA: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 92 CHINA: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                                TABLE 93 CHINA: MARKET, BY END USER, 2020–2027 (USD MILLION)
           8.4.5 REST OF ASIA PACIFIC
                    TABLE 94 REST OF ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                    TABLE 95 REST OF ASIA PACIFIC: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD THOUSAND)
                    TABLE 96 REST OF ASIA PACIFIC: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 97 REST OF ASIA PACIFIC: MARKET, BY END USER, 2020–2027 (USD MILLION)
    8.5 REST OF THE WORLD 
           8.5.1 REST OF THE WORLD: RECESSION IMPACT ANALYSIS
                    TABLE 98 REST OF THE WORLD: HEALTHCARE PAYER SERVICES INDUSTRY, BY SERVICE TYPE, 2020–2027 (USD MILLION)
                    TABLE 99 REST OF THE WORLD: MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 100 REST OF THE WORLD: MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION)
                    TABLE 101 REST OF THE WORLD: MARKET, BY END USER, 2020–2027 (USD MILLION)
 
9 COMPETITIVE LANDSCAPE (Page No. - 157)
    9.1 OVERVIEW 
    9.2 STRATEGIES ADOPTED BY KEY PLAYERS 
          TABLE 102 HEALTHCARE PAYER SERVICES MARKET: OVERVIEW OF STRATEGIES ADOPTED BY KEY PLAYERS
          FIGURE 25 HEALTHCARE PAYERS SERVICES MARKET: KEY DEVELOPMENTS (2019–2022)
          FIGURE 26 GLOBAL MARKET: REVENUE ANALYSIS OF KEY PLAYERS
    9.3 GEOGRAPHIC REVENUE ASSESSMENT OF KEY PLAYERS 
          FIGURE 27 GLOBAL MARKET: GEOGRAPHIC REVENUE MIX
    9.4 MARKET RANKING 
          FIGURE 28 GLOBAL MARKET: MARKET RANKING OF LEADING COMPANIES (2022)
    9.5 MARKET SHARE ANALYSIS 
          TABLE 103 GLOBAL MARKET: INTENSITY OF COMPETITIVE RIVALRY
          FIGURE 29 GLOBAL MARKET: MARKET SHARE ANALYSIS
    9.6 COMPANY EVALUATION QUADRANT 
           9.6.1 STARS
           9.6.2 EMERGING LEADERS
           9.6.3 PARTICIPANTS
           9.6.4 PERVASIVE PLAYERS
          FIGURE 30 GLOBAL MARKET: COMPANY EVALUATION QUADRANT (2021)
    9.7 COMPANY EVALUATION QUADRANT FOR STARTUPS 
           9.7.1 PROGRESSIVE COMPANIES
           9.7.2 RESPONSIVE COMPANIES
           9.7.3 STARTING BLOCKS
           9.7.4 DYNAMIC COMPANIES
          FIGURE 31 GLOBAL MARKET: COMPANY EVALUATION QUADRANT FOR STARTUPS (2021)
    9.8 COMPETITIVE BENCHMARKING 
           9.8.1 COMPANY PRODUCT FOOTPRINT
                    TABLE 104 COMPANY PRODUCT FOOTPRINT
           9.8.2 COMPANY REGION FOOTPRINT
                    TABLE 105 COMPANY REGION FOOTPRINT
    9.9 COMPETITIVE SCENARIO 
           9.9.1 SERVICE LAUNCHES & APPROVALS
                    TABLE 106 GLOBAL MARKET: KEY SERVICE LAUNCHES & APPROVALS
           9.9.2 DEALS
                    TABLE 107 GLOBAL MARKET: KEY DEALS
           9.9.3 OTHER DEVELOPMENTS
                    TABLE 108 GLOBAL HEALTHCARE PAYER SERVICES INDUSTRY: OTHER KEY DEVELOPMENTS
 
10 COMPANY PROFILES (Page No. - 178)
     10.1 KEY PLAYERS 
(Business Overview, Products/Services/Solutions Offered, MnM View, Key Strengths and Right to Win, Strategic Choices Made, Weaknesses and Competitive Threats, Recent Developments)*
             10.1.1 ACCENTURE
                        TABLE 109 ACCENTURE: BUSINESS OVERVIEW
                        FIGURE 32 ACCENTURE: COMPANY SNAPSHOT (2022)
             10.1.2 COGNIZANT
                        TABLE 110 COGNIZANT: BUSINESS OVERVIEW
                        FIGURE 33 COGNIZANT: COMPANY SNAPSHOT (2021)
             10.1.3 TATA CONSULTANCY SERVICES
                        TABLE 111 TATA CONSULTANCY SERVICES: BUSINESS OVERVIEW
                        FIGURE 34 TATA CONSULTANCY SERVICES: COMPANY SNAPSHOT (2021)
             10.1.4 XEROX CORPORATION
                        TABLE 112 XEROX CORPORATION: BUSINESS OVERVIEW
                        FIGURE 35 XEROX CORPORATION: COMPANY SNAPSHOT (2021)
             10.1.5 WNS (HOLDINGS) LTD.
                        TABLE 113 WNS (HOLDINGS) LTD.: BUSINESS OVERVIEW
                        FIGURE 36 WNS (HOLDINGS) LTD.: COMPANY SNAPSHOT (2021)
             10.1.6 NTT DATA CORPORATION
                        TABLE 114 NTT DATA CORPORATION: BUSINESS OVERVIEW
                        FIGURE 37 NTT DATA CORPORATION: COMPANY SNAPSHOT (2021)
             10.1.7 MPHASIS
                        TABLE 115 MPHASIS: BUSINESS OVERVIEW
                        FIGURE 38 MPHASIS: COMPANY SNAPSHOT (2021)
             10.1.8 GENPACT LIMITED
                        TABLE 116 GENPACT: BUSINESS OVERVIEW
                        FIGURE 39 GENPACT: COMPANY SNAPSHOT (2020)
             10.1.9 WIPRO LIMITED
                        TABLE 117 WIPRO LIMITED: BUSINESS OVERVIEW
                        FIGURE 40 WIPRO LIMITED: COMPANY SNAPSHOT (2022)
             10.1.10 INFOSYS BPM
                        TABLE 118 INFOSYS BPM: BUSINESS OVERVIEW
                        FIGURE 41 INFOSYS BPM: COMPANY SNAPSHOT (2022)
             10.1.11 FIRSTSOURCE SOLUTIONS
                        TABLE 119 FIRSTSOURCE SOLUTIONS: BUSINESS OVERVIEW
                        FIGURE 42 FIRSTSOURCE SOLUTIONS: COMPANY SNAPSHOT (2021)
             10.1.12 DELL INC.
                        TABLE 120 DELL INC.: BUSINESS OVERVIEW
                        FIGURE 43 DELL INC.: COMPANY SNAPSHOT (2021)
             10.1.13 ORACLE CORPORATION
                        TABLE 121 ORACLE CORPORATION: BUSINESS OVERVIEW
                        FIGURE 44 ORACLE CORPORATION: COMPANY SNAPSHOT (2021)
             10.1.14 IBM
                        TABLE 122 IBM: BUSINESS OVERVIEW
                                                FIGURE 45 IBM: COMPANY SNAPSHOT (2021)
             10.1.15 IQVIA INC.
                        TABLE 123 IQVIA INC.: BUSINESS OVERVIEW
                        FIGURE 46 IQVIA INC.: COMPANY SNAPSHOT (2021)
*Business Overview, Products/Services/Solutions Offered, MnM View, Key Strengths and Right to Win, Strategic Choices Made, Weaknesses and Competitive Threats, Recent Developments might not be captured in case of unlisted companies.
     10.2 OTHER PLAYERS 
             10.2.1 CONDUENT, INC.
             10.2.2 CONIFER HEALTH SOLUTIONS, LLC
             10.2.3 OMEGA HEALTHCARE
             10.2.4 INOVALON
             10.2.5 SAS INSTITUTE, INC.
             10.2.6 UNITEDHEALTH GROUP
             10.2.7 HCL TECHNOLOGIES LIMITED
             10.2.8 PAREXEL INTERNATIONAL CORPORATION
             10.2.9 R1RCM, INC.
             10.2.10 ALLSCRIPTS HEALTHCARE, LLC.
 
11 APPENDIX (Page No. - 236)
     11.1 DISCUSSION GUIDE 
     11.2 KNOWLEDGESTORE: MARKETSANDMARKETS’ SUBSCRIPTION PORTAL 
     11.3 CUSTOMIZATION OPTIONS 
     11.4 RELATED REPORTS 
     11.5 AUTHOR DETAILS 

The study involved four major activities in estimating the current size of the global healthcare payer services market. Exhaustive secondary research was done to collect information on the market, its peer markets, and its parent market. The next step was to validate these findings, assumptions, and sizing values with industry experts across the value chain through primary research. Both top-down and bottom-up approaches were employed to estimate the complete market size. Thereafter, market breakdown and data triangulation procedures were used to estimate the market size of segments and subsegments.

Secondary Research

Secondary research was mainly used to identify and collect information for the extensive, technical, market-oriented, and commercial study of the market. Secondary sources include directories; databases such as Bloomberg Business, Factiva, and Wall Street Journal; white papers; and annual reports were also used to obtain key information about major players, market classification, and segmentation according to industry trends, regional/country-level markets, market developments, and technology perspectives.

Primary Research

In-depth interviews were conducted with various primary respondents, including key industry participants, subject-matter experts (SMEs), C-level executives of key market players, and industry consultants, among other experts, to obtain and verify the critical qualitative and quantitative information as well as assess the prospects of the market. Various primary sources from both the supply and demand sides of the market were interviewed to obtain qualitative and quantitative information. The following is a breakdown of primary respondents:

Healthcare  Payer Services Market Size, and Share

Note: Tiers are defined based on a company’s total revenue. As of 2021, Tier 1 = >USD 5 billion, Tier 2 = USD 500 million to USD 5 billion, and Tier 3 = <USD 500 million.

* Others include sales managers, marketing managers, and product manager

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

Market Size Estimation

Both top-down and bottom-up approaches were used to estimate and validate the total size of the healthcare payer services market. These methods were also used extensively to estimate the size of various subsegments in the market. The research methodology used to estimate the market size includes the following:

  • The key players in the industry and markets have been identified through extensive secondary research
  • The revenue generated from the sale of healthcare payer services solutions and services by leading players has been determined through primary and secondary research
  • All percentage shares, splits, and breakdowns have been determined using secondary sources and verified through primary sources

Data Triangulation

After arriving at the overall market size from the market size estimation process, the total market was split into several segments and subsegments. To complete the overall market engineering process and arrive at the exact statistics for all segments and subsegments, data triangulation and market breakdown procedures were employed, wherever applicable. The data was triangulated by studying various factors and trends from both the demand and supply sides.

Report Objectives

  • To define, describe, and forecast the market based on service type, end user, and region.
  • To provide detailed information regarding the major factors influencing the growth of the market (such as drivers, restraints, opportunities, and industry-specific challenges)
  • To strategically analyze micromarkets1 with respect to individual growth trends, prospects, and contributions to the overall market
  • To analyze opportunities in the market for stakeholders and provide details of the competitive landscape for market leaders
  • To forecast the size of the global market with respect to five geographic regions—North America, Europe, the Asia Pacific, and the Rest of the World
  • To profile key players and comprehensively analyze their core competencies2 and market shares
  • To track and analyze competitive developments such as agreements, partnerships, collaborations, acquisitions, service launches, and R&D activities of leading players
  • To analyze the impact of the recession on the healthcare payers market

Available Customizations

With the given market data, MarketsandMarkets offers customizations as per the company’s specific needs.

The following customization options are available for this report.

Product Analysis

  • Product matrix, which gives a detailed comparison of the product portfolios of the top companies

Geographic Analysis

  • Further breakdown of the RoAPAC market into South Korea, Australia, New Zealand, and others
  • Further breakdown of the RoE market into Belgium, Russia, the Netherlands, Switzerland, and others
  • Further breakdown of the RoW market into Latin America (LATAM), Middle East, and Africa (MEA)

Company Information

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

Request Customization

Instant Answers with GPT - Ask Now!

Ask real questions. Get complete answers !
Report Code
HIT 3877
Published ON
Feb, 2023
Choose License Type
BUY NOW
  • SHARE
X
Request Customization
Speak to Analyst
Speak to Analyst
OR FACE-TO-FACE MEETING
PERSONALIZE THIS RESEARCH
  • Triangulate with your Own Data
  • Get Data as per your Format and Definition
  • Gain a Deeper Dive on a Specific Application, Geography, Customer or Competitor
  • Any level of Personalization
REQUEST A FREE CUSTOMIZATION
LET US HELP YOU!
  • What are the Known and Unknown Adjacencies Impacting the Healthcare Payer Services Market
  • What will your New Revenue Sources be?
  • Who will be your Top Customer; what will make them switch?
  • Defend your Market Share or Win Competitors
  • Get a Scorecard for Target Partners
CUSTOMIZED WORKSHOP REQUEST
+1-888-600-6441
  • Call Us
  • +1-888-600-6441 (Corporate office hours)
  • +1-888-600-6441 (US/Can toll free)
  • +44-800-368-9399 (UK office hours)
CONNECT WITH US
ABOUT TRUST ONLINE
©2024 MarketsandMarkets Research Private Ltd. All rights reserved
DMCA.com Protection Status Website Feedback