HOME Top Market Reports Patient Access Solutions Market by Product & Service (Eligibility Verification, Medical Necessity, Prior-authorization, Denial Management), Delivery Mode (Web & Cloud, On-premise), End User (Providers, Outsourcing Companies) - Global Forecast to 2022

Patient Access Solutions Market by Product & Service (Eligibility Verification, Medical Necessity, Prior-authorization, Denial Management), Delivery Mode (Web & Cloud, On-premise), End User (Providers, Outsourcing Companies) - Global Forecast to 2022

By: marketsandmarkets.com
Publishing Date: January 2018
Report Code: HIT 5875

 

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


Patient access solutions include software and services that help healthcare organizations to maintain their financial balance by reducing operational costs and minimizing claims rejection. These solutions are used to verify a patient’s insurance coverage eligibility, enable efficient claims processing, and manage medical necessity & denials. The patient access solutions market is expected to reach USD 1.74 Billion by 2022 from an estimated USD 1.14 Billion in 2016, at a CAGR of 7.6%. Regulatory compliance encouraging the use of patient access solutions, increasing patient volume and the subsequent growth in the demand for health insurance, growing importance of denials management, declining reimbursement rates, and the need to curtail escalating healthcare costs are the major factors driving the growth of the patient access solutions market. The base year considered for the study is 2016 and the forecast period includes 2017 to 2022.

Objectives of the Study

  • To define, describe, segment and forecast the global patient access solutions market on the basis of product & service, delivery mode, end user, and region
  • To forecast the size of the patient access solutions market with respect to five main regions, namely, North America, Europe, Asia Pacific (APAC), and the Rest of the World (RoW)
  • To provide detailed information regarding the major factors influencing the growth of the global patient access solutions market (drivers, restraints, opportunities, and industry-specific challenges)
  • To analyze micromarkets with respect to individual growth trends, prospects, and contributions to the overall market
  • To analyze the opportunities in the market for stakeholders and provide details of the competitive leadership mapping for market leaders
  • To profile key players in the global patient access solutions market and comprehensively analyze their core competencies and market shares
  • To track and analyze competitive developments such as acquisitions; product launches; collaborations, partnerships, and agreements; and expansions in the market

Research Methodology

Top-down and bottom-up approaches were used to validate the size of the global patient access solutions market and estimate the size of other dependent submarkets. Various secondary sources such as directories, industry journals, databases such as Bloomberg Business, Factiva, and Dun & Bradstreet; white papers; annual reports; company house documents; and SEC filings 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:

Patient Access Solutions Market

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

Prominent players in the patient access solutions market are McKesson (US), Epic Systems (US), Cerner (US), Cognizant (US), Experian plc (Ireland), Optum, Inc. (US), Conifer (US), The Advisory Board Company (US), The 3M Company (US), Craneware, Inc. (UK), The SSI Group, LLC (US), ZirMed, Inc. (US), Cirius Group, Inc. (US), and AccuReg Software (US).

Target Audience

  • Healthcare service providers
  • Healthcare service payers/insurance companies
  • Patient access solutions software and service providers
  • Healthcare IT outsourcing companies
  • Clearing houses
  • Venture capitalists
  • Government bodies
  • Business research and consulting firms

Scope of the Report

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

Patient Access Solutions Market, by Product & Service

  • Services
  • Software

By Services

  • Support & Maintenance
  • Implementation
  • Training & Education

By Software

  • Eligibility Verification Software
  • Medical Necessity Management Software
  • Pre-certification & Authorization Software
  • Claims Denial & Appeal Management Software
  • Payment Estimation Software
  • Medical Claims Payment Processing Software
  • Other Software

Patient Access Solutions Market, by Delivery Mode

  • Web & Cloud-based Solutions
  • On-premise Solutions

Patient Access Solutions Market, by End User

  • Healthcare Providers
  • HCIT Outsourcing Companies
  • Other End Users

Patient Access Solutions Market, by Region

  • North America
    • US
    • Canada
  • Europe
  • Asia Pacific
  • Rest of the World

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:

Product Analysis

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

Geographic Analysis

Further breakdown of the European patient access solutions market into Germany, France, and the UK

Company Information

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

Table of Contents

1 Introduction (Page No. - 13)
    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. - 17)
    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
           2.2.1 Bottom-Up Approach
           2.2.2 Top-Down Approach
    2.3 Data Triangulation
    2.4 Assumptions for the Study

3 Executive Summary (Page No. - 25)

4 Premium Insights (Page No. - 30)
    4.1 Patient Access Solutions: Market Overview
    4.2 Patient Access Solutions Market, By End Users & Region
    4.3 Healthcare Access Management Solutions Market: Geographic Snapshot
    4.4 Healthcare Access Management Solutions Market: North America Snapshot
    4.5 Global Healthcare Access Management Solutions Market for Software

5 Market Overview (Page No. - 35)
    5.1 Introduction
    5.2 Market Dynamics
           5.2.1 Market Drivers
                    5.2.1.1 Need to Maintain Regulatory Compliance
                    5.2.1.2 Increasing Patient Volume and Subsequent Growth in the Demand for Health Insurance
                    5.2.1.3 Growing Importance of Denials Management
                    5.2.1.4 Declining Reimbursement Rates
                    5.2.1.5 Rising Need to Curtail Healthcare Costs
           5.2.2 Market Restraints
                    5.2.2.1 Data Breaches and Loss of Confidentiality
           5.2.3 Market Opportunities
                    5.2.3.1 Huge Growth Potential in Emerging Healthcare IT Markets
           5.2.4 Market Challenges
                    5.2.4.1 Dearth of Skilled IT Professionals in the Healthcare Industry
                    5.2.4.2 Reluctance to Adopt Patient Access Solutions
                    5.2.4.3 High Deployment Costs

6 Industry Insights (Page No. - 42)
    6.1 Introduction
    6.2 Current Scenario of Healthcare Claims Management in the US
           6.2.1 Manual vs Electronic Claims Management Processes
           6.2.2 Lack of Standardization Between Payer Policies
    6.3 Adoption Trends for Patient Access Solutions in the US

7 Global Patient Access Solutions Market, By Product and Service (Page No. - 47)
    7.1 Introduction
    7.2 Services
           7.2.1 Support & Maintenance Services
           7.2.2 Implementation Services
           7.2.3 Training & Education Services
    7.3 Software
           7.3.1 Eligibility Verification Software
           7.3.2 Medical Necessity Management Software
           7.3.3 Pre-Certification & Authorization Software
           7.3.4 Claims Denial & Appeal Management
           7.3.5 Payment Estimation Software
           7.3.6 Claims Payment Assessment & Processing Software
           7.3.7 Other Software

8 Patient Access Solutions Market, By Delivery Mode (Page No. - 60)
    8.1 Introduction
    8.2 Web & Cloud-Based Solutions
    8.3 On-Premise Solutions

9 Global Patient Access Solutions Market, By End Users (Page No. - 65)
    9.1 Introduction
    9.2 Healthcare Providers
    9.3 Hcit Outsourcing Companies
    9.4 Other End Users

10 Patient Access Solutions Market, By Region (Page No. - 71)
     10.1 Introduction
     10.2 North America
             10.2.1 US
             10.2.2 Canada
     10.3 Europe
     10.4 Asia Pacific
     10.5 Rest of the World

11 Competitive Landscape (Page No. - 98)
     11.1 Overview
     11.2 Ranking of Market Players
     11.3 Competitive Scenario
             11.3.1 Alliances, Partnerships, Collaborations, and Agreements
             11.3.2 Mergers and Acquisitions
             11.3.3 Product Launches and Enhancements
             11.3.4 Expansions

12 Company Profiles (Page No. - 104)
(Business Overview, Products and Services, Recent Developments, SWOT Analysis & MnM View)*
     12.1 Mckesson
     12.2 Epic Systems
     12.3 Cerner
     12.4 Cognizant
     12.5 Experian
     12.6 3M
     12.7 Conifer Health
     12.8 Optum
     12.9 The Advisory Board
     12.10 Craneware
     12.11 Zirmed
     12.12 The Ssi Group
     12.13 Cirius Group
     12.14 Accureg Software

*Details on Business Overview, Products and Services, Recent Developments, SWOT Analysis & MnM View Might Not Be Captured in Case of Unlisted Companies.

13 Appendix (Page No. - 134)
     13.1 Insights of Industry Experts
     13.2 Discussion Guide
     13.3 Knowledge Store: Marketsandmarkets’ Subscription Portal
     13.4 Introducing RT: Real-Time Market Intelligence
     13.5 Available Customizations
     13.6 Related Reports
     13.7 Author Details


List of Tables (62 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 Estimated Spending on Regulatory Compliance By A Healthcare Provider in the US
Table 6 Average Cost Per Transaction and Saving Opportunity for Healthcare Payers & Providers: Manual vs Electronic
Table 7 Average Time Spent Per Transaction on Manual vs Electronic Claims Management Processes
Table 8 Global Patient Access Solutions Market, By Product and Service, 2015-2022 (USD Million)
Table 9 Global Healthcare Access Management Solutions Market for Services, By Type, 2015-2022 (USD Million)
Table 10 Global Support & Maintenance Services Market, By Country, 2015-2022 (USD Million)
Table 11 Global Implementation Services Market, By Country, 2015-2022 (USD Million)
Table 12 Global Training & Education Services Market, By Country, 2015-2022 (USD Million)
Table 13 Global Patient Access Solutions Market for Software, By Type, 2015-2022 (USD Million)
Table 14 Global Eligibility Verification Software Market, By Country, 2015-2022 (USD Million)
Table 15 Global Medical Necessity Management Software Market, By Country, 2015-2022 (USD Million)
Table 16 Global Pre-Certification & Authorization Software Market, By Country, 2015-2022 (USD Million)
Table 17 Global Claims Denial & Appeal Management Software Market, By Country, 2015-2022 (USD Million)
Table 18 Global Payment Estimation Software Market, By Country, 2015-2022 (USD Million)
Table 19 Global Claims Payment Assessment & Processing Software Market, By Country, 2015-2022 (USD Million)
Table 20 Global Other Software Market, By Country, 2015-2022 (USD Million)
Table 21 Patient Access Solution Market, By Delivery Mode, 2015–2022 (USD Million)
Table 22 Web & Cloud-Based Healthcare Access Management Solutions Market, By Region, 2015–2022 (USD Million)
Table 23 On-Premise Patient Access Solution Market, By Region, 2015–2022 (USD Million)
Table 24 Global Healthcare Access Management Solutions Market, By End Users, 2015-2022 (USD Million)
Table 25 Patient Access Solution Market for Healthcare Providers, By Region, 2015–2022 (USD Million)
Table 26 Healthcare Access Management Solutions Market for Hcit Outsourcing Companies, By Region, 2015–2022 (USD Million)
Table 27 Patient Access Solution Market for Other End Users, By Region, 2015–2022 (USD Million)
Table 28 Healthcare Access Management Solutions Market, By Region, 2015–2022 (USD Million)
Table 29 North America: Patient Access Solution Market, By Country, 2015–2022 (USD Million)
Table 30 North America: Healthcare Access Management Solutions Market, By Product & Service, 2015–2022 (USD Million)
Table 31 North America: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 32 North America: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 33 North America: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 34 North America: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 35 US: Major Reasons for Claims Denials
Table 36 US: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 37 US: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 38 US: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 39 US: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 40 US: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 41 Canada: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 42 Canada: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 43 Canada: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 44 Canada: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 45 Canada: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 46 Europe: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 47 Europe: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 48 Europe: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 49 Europe: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 50 Europe: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 51 APAC: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 52 APAC: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 53 APAC: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 54 APAC: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 55 APAC: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 56 RoW: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 57 RoW: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 58 RoW: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 59 RoW: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 60 RoW: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 61 Growth Strategy Matrix (2014–2017)
Table 62 Global Healthcare Access Management Solutions Market Ranking, By Key Player, 2016


List of Figures (34 Figures)

Figure 1 Patient Access Solution Market Segmentation
Figure 2 Research Design
Figure 3 Breakdown of Primary Interviews: By Company Type, Designation, and Region
Figure 4 Data Triangulation Methodology
Figure 5 Global Patient Access Solution Market, By Product & Service, 2017 vs 2022 (USD Million)
Figure 6 Global Healthcare Access Management Solutions Market for Services, 2017 vs 2022 (USD Million)
Figure 7 Global Healthcare Access Management Solutions Market, By Delivery Mode, 2017 vs 2022 (USD Million)
Figure 8 Global Healthcare Access Management Solutions Market, By End Users, 2017 vs 2022 (USD Million)
Figure 9 Geographical Snapshot of the Healthcare Access Management Solutions Market
Figure 10 Healthcare Access Management Solutions Market to Witness High Single-Digit Growth Rate in the Forecast Period
Figure 11 Healthcare Providers Commanded the Largest Share of the Healthcare Access Management Solutions Market in 2016
Figure 12 US Accounted for the Largest Share of the Healthcare Access Management Solutions Market in 2016
Figure 13 US Accounts for the Largest Share in North America
Figure 14 Eligibility Verification Accounts for the Largest Share of Software Market
Figure 15 Healthcare Access Management Solutions Market: Drivers, Restraints, Opportunities, and Challenges
Figure 16 Adoption of Electronic Systems for Commercial Medical Health Plans in the US
Figure 17 Adoption and Volume of Electronic Eligibility & Benefit Verifications for Commercial Medical Health Plans and Providers in the US
Figure 18 Adoption of Electronic Prior Authorization for Commercial Medical Health Plans and Providers in the US
Figure 19 Services Segment to Command the Largest Market Share in 2022
Figure 20 Web & Cloud-Based Solutions to Dominate the Healthcare Access Management Solutions Market in 2017
Figure 21 Healthcare Providers to Dominate the Healthcare Access Management Solutions Market in 2017
Figure 22 Healthcare Access Management Solutions Market Growth: Regional Snapshot
Figure 23 North America: Healthcare Access Management Solutions Market Snapshot
Figure 24 Asia Pacific: Healthcare Access Management Solutions Market Snapshot
Figure 25 Key Growth Strategies Adopted Between 2014 and 2017
Figure 26 Mckesson: Company Snapshot
Figure 27 Cerner: Company Snapshot
Figure 28 Cognizant: Company Snapshot
Figure 29 Experian: Company Snapshot
Figure 30 3M: Company Snapshot
Figure 31 Conifer Health: Company Snapshot
Figure 32 Optum: Company Snapshot
Figure 33 The Advisory Board: Company Snapshot
Figure 34 Craneware: Company Snapshot

The global patient access solutions market is projected to reach USD 1.74 Billion by 2022 from USD 1.21 Billion in 2017, at a CAGR of 7.6%. The transition of the healthcare insurance market to high-deductible plans led to the increase in patient liability is expected to boost the adoption of patient access solutions such as eligibility verification and prior-authorization. Moreover, declining reimbursement rates and growing importance of denial management are some of the major factors driving the growth of the patient access solutions market. However, the high cost of deployment and lack of proper IT infrastructure in many emerging nations are hindering the adoption of these solutions among healthcare providers.

The report analyzes the global patient access solutions market by product & service, delivery mode, end user, and region. On the basis of product & service, the services segment accounted for the largest share of the global patient access solutions market in 2016. The introduction of complex software and the need for system integration are expected to boost the services market in the near future.

Based on delivery mode, the patient access solutions market is classified into web & cloud-based solutions and on-premise solutions. The web & cloud-based solutions segment accounted for the largest share of the patient access solutions market in 2016. The flexibility of working from remote areas, affordability, and automated updating features are some of the factors attributing to the larger share of the web & cloud-based solutions segment.

The global patient access solutions market by end user is segmented into healthcare providers, healthcare IT outsourcing companies, and other end users. In 2016, the healthcare providers segment accounted for the largest share of the market. The high share of this segment is mainly attributed to the growing healthcare IT adoption, increasing healthcare costs, significant growth in healthcare spending worldwide, and declining reimbursement rates.

Geographically, the global patient access solutions market is segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa. In 2016, North America accounted for the largest share of the patient access solutions market in 2016, followed by Europe and Asia Pacific. North America’s large share in the global market is attributed to factors such as stringent regulations, increasing government support for improving healthcare infrastructure, the need for reducing healthcare costs, increasing volume of claims denials, high number of private healthcare payers and well-established government payers, and the presence of a large number of healthcare IT companies. The Asia Pacific market is comparatively new to patient access solutions; however, this region is expected to register the highest growth in the coming years. Countries such as Japan, Australia, New Zealand, South Korea, and Singapore are expected to provide significant growth opportunities for patient access solutions vendors.

Patient Access Solutions Market

Rising incidence of patient data breaches, high cost of deployment, shortage of IT skilled clinicians, and inadequacy of proper IT infrastructure in some emerging economies may hinder the adoption of patient access solutions among healthcare providers. Prominent players in the patient access solutions market are McKesson (US), Epic Systems (US), Cerner (US), Cognizant (US), Experian plc (Ireland), Optum (US), Conifer Health (US), The Advisory Board (US), 3M (US), Craneware (UK), The SSI Group (US), ZirMed (US), Cirius Group (US), and AccuReg Software (US).

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

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


-
Request for FREE Sample of this report Send Request