Healthcare EDI Market

Healthcare EDI Market worth $7.1 billion by 2029

The report "Healthcare EDI Market by Transmission (Value added Network, Point-to-Point), Software (Claims (Submission, Status, Payment, Referral, Remittance), Supply (Procurement, Inventory), Service, End User (Hospital, ASC, Payer), Region - Global Forecast to 2029", is expected to reach USD 7.1 billion by 2029, up from USD 4.5 billion in 2024, at a CAGR of 9.7 % from 2024 to 2029.

Browse 412 market data Tables and 55 Figures spread through 353 Pages and in-depth TOC on "Healthcare EDI Market by Transmission (Value added Network, Point-to-Point), Software (Claims (Submission, Status, Payment, Referral, Remittance), Supply (Procurement, Inventory), Service, End User (Hospital, ASC, Payer), Region - Global Forecast to 2029"
View detailed Table of Content here - https://www.marketsandmarkets.com/Market-Reports/healthcare-edi-market-130571438.html

The demand for healthcare EDI is mainly driven by the growing need to standardize electronic transactions, curtail healthcare costs, and government support for HCIT. In addition, the need for the efficient management of electronic claims and reimbursement transactions for healthcare providers is expected to drive growth in the healthcare EDI market during the forecast period. The adoption of emerging Fast Healthcare Interoperability Resource (FHIR) standards, enhanced interoperability standards, use of RESTful APIs, and real-time data exchange for eligibility verification are some of the critical factors responsible for the market growth. HCIT solutions, such as electronic data interchange (EDI), are software solutions that help organizations enhance revenue growth, drive administrative efficiency, reduce costs, and improve the quality of care and patient experience.

Claims management software segment accounted for the largest share of the healthcare EDI market in 2023

Claims management is expected to account largest market share during the forecast period. The healthcare EDI transactions used in claims management provide a common platform for providers, payers, and clearinghouses to exchange data. With EDI in claims, providers can send and receive information faster, identify submission errors immediately, and avoid processing delays. The rising use of value-based payment models, increased complexities in healthcare billing, and the growing burden to enhance financial performance are some of the major factors driving the segment’s growth. Moreover, the use of payer portal scaping to exact claims-related data, as well as communication with healthcare providers to efficiently handle large volumes of claims, further augments the market growth.

The healthcare payers segment is projected to be the fastest-growing segment of the healthcare EDI market over the forecast period.

The healthcare industry is witnessing an increase in the number of insurance players due to the increasing number of private insurers entering the market. Moreover, healthcare providers are increasingly accepting these players. This is expected to drive the growth of the healthcare payers market in the coming years. The requirements set forth by HIPAA compelled healthcare payers to use electronic means for claims processing with the payer, which led to its immediate adoption by healthcare payers. In addition, interoperability with healthcare providers, focus on enhancing patient financial experience, growing need for fraud prevention and prevention, and improved claims processing are other factors responsible for the segment’s growth.

North America accounted for the largest share of the healthcare EDI segment in 2023.

The large share of the US healthcare EDI market can be attributed to the stringent legislative and accreditation requirements regarding healthcare, the high adoption rate of HCIT technologies, regulatory requirements such as HIPAA compliance, FHIR standards, implementation of ICD- 10 codes, and CMS mandates for EDI for billing. Moreover, managing the complex data flows among accountable care organizations (ACOs), payer providers collaborations, implementation of the 21st Century Cures Act, growth of bundled payment programs, and the presence of a large number of HCIT companies in the region drives market growth. The increasing adoption of healthcare EDI in supply chain management is another major factor in the market growth in North America.

The report profiles key players such as McKESSON CORPORATION (US), UnitedHealth Group Incorporated (US), Cognizant (US), IBM (US), Veradigm LLC (US), Experian Information Solutions, Inc. (US), athenahealth (US), The SSI Group, LLC (US), NTT DATA Group Corporation (Japan), Comarch SA. (Poland), Axway (US), Availity, LLC. (US), Quadax, Inc. (US), Waystar. (US), PLEXIS Healthcare Systems (US), Boomi (US), True Commerce, Inc. (US), Inovalon. (US), 123 EDI (US), Cirius Group, Inc. (US), Epicor Software Corporation (US), OSP Labs (US), Nalashaa. (US), WNS (US), PilotFish, Inc. (US), and Cleo (US).

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Healthcare EDI Market Size,  Share & Growth Report
Report Code
HIT 2464
PR Published ON
10/15/2022
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