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Global Healthcare Payer Services Market Size, Share, Report: By Type: BPO (Claims, Front end, Provider, Product, Development, Care Management, Billing, HR), ITO (Provider Network Accounts, Analytics, Fraud), KPO; By End User: Private, Public; Regional Analysis; Market Dynamics; Regulatory Framework; Supplier Landscape; 2024-2032
Global Healthcare Payer Services Market Outlook
The global healthcare payer services market size was valued at USD 60.5 billion in 2023, driven by the advancements in healthcare technology, telemedicine, and digital health across the globe. The market is expected to grow at a CAGR of 10.4% during the forecast period of 2024-2032, with the values likely to rise from USD 66.8 billion in 2024 to USD 146.9 billion by 2032.
Healthcare Payer Services: Introduction
Healthcare payer services refers to a bunch of functions performed by organisations, responsible for managing and financing healthcare expenses. It includes functions like claims processing, premium collection, and enrolment. Payers work at negotiating prices with healthcare providers to regulate expenses. Such services encompass insurance companies, government programs (like Medicare and Medicaid), and other entities that facilitate the payment of medical bills.
Global Healthcare Payer Services Market Analysis
The sudden outbreak of COVID-19 has highlighted the significance of having a practical and convenient healthcare coverage. Given the current economic scenario, healthcare costs have witnessed a substantial increase. With the expense hike, employers and individuals have started seeking insurance and payer services, leading to high healthcare payer services market demand.
With the convergence of artificial intelligence and data analytical tools into the healthcare ecosystem, companies have started modifying their tools to offer cost effective, rapid, and efficient services to the customers. Recently, Medicare has announced the new Medicare Advantage plan which focuses on prioritising senior healthcare. Similarly, UnitedHealthcare has also expanded their coverage area to reach 96 percent of the Medicare beneficiaries. All the latest plans prioritise customer feedback and aim at valuing their demands. Such initiatives are set to drive the healthcare payer services market growth in the future as well.
With a larger ageing population, the requirement for healthcare services is continuously evolving. As the elderly tend to have complex medical needs, prominent companies are entering as well as acquiring existing companies. India, being the world’s most populous country is observing some positive changes. In August 2023, Jio Financial Services announced their entry into the healthcare insurance segment.
Global Healthcare Payer Services Market Segmentation
Market Breakup by Type
- BPO
- Claims
- Front end
- Provider
- Product
- Development
- Care Management
- Billing
- HR
- ITO
- Provider Network
- Accounts
- Analytics
- Fraud
- KPO
Market Breakup by End User
- Private
- Public
Market Breakup by Region
- North America
- Europe
- Asia Pacific
- Latin America
- Middle East and Africa
Global Healthcare Payer Services Market Overview
With increasing adoption of digital services into the healthcare industry, the market has flourished with telehealth services, and mobile apps for policy management and claim filings. The World Health Organisation has initiated a Universal Health Coverage initiative which plans to offer a range of health services to people at any hour without any financial burden. Such initiatives will contribute to the healthcare payer services market value positively in the forecast period.
There is a shift towards preventive care and personalised treatment plans for patients. The United States having a set of well-informed patients demands more comprehensive and improved customer services. The region being home to prominent healthcare insurance companies like Medicare and Medicaid help catering the needs effectively.
Europe is also expected to lead the healthcare payer services market share in the future. Along with a significant private healthcare system, the government healthcare system is highly efficient and active at proving services to the patients. The Asia Pacific region is anticipated to grow substantially with increasing investments and developments in the medical ecosystem.
Global Healthcare Payer Services Market: Competitor Landscape
The key features of the market report include patent analysis, grants analysis, clinical trials analysis, funding and investment analysis, partnerships, and collaborations analysis by the leading key players. The major companies in the market are as follows:
- Accenture
- Cognizant
- Tata Consultancy Services
- NTT Data Corporations
- IQVIA Inc.
- Mphasis
- FIrstsource Solutions
- IBM Corporation
- HCL Technologies
- First Source Solutions
Key Highlights of the Report
| REPORT FEATURES | DETAILS |
| Base Year | 2023 |
| Historical Period | 2017-2023 |
| Forecast Period | 2024-2032 |
| Scope of the Report |
Historical and Forecast Trends, Industry Drivers and Constraints, Historical and Forecast Market Analysis by Segment:
|
| Breakup by Type |
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| Breakup by End User |
|
| Breakup by Region |
|
| Market Dynamics |
|
| Competitive Landscape |
|
| Companies Covered |
|
*At Expert Market Research, we strive to always give you current and accurate information. The numbers depicted in the description are indicative and may differ from the actual numbers in the final EMR report.
1 Preface
1.1 Objectives of the Study
1.2 Key Assumptions
1.3 Report Coverage – Key Segmentation and Scope
1.4 Research Methodology
2 Executive Summary
3 Global Healthcare Payer Services Market Overview
3.1 Global Healthcare Payer Services Market Historical Value (2017-2023)
3.2 Global Healthcare Payer Services Market Forecast Value (2024-2032)
4 Global Healthcare Payer Services Market Landscape
4.1 Global Healthcare Payer Services: Developers Landscape
4.1.1 Analysis by Year of Establishment
4.1.2 Analysis by Company Size
4.1.3 Analysis by Region
4.2 Global Healthcare Payer Services: Product Landscape
4.2.1 Analysis by Type
4.2.2 Analysis by Applications
5 Global Healthcare Payer Services Market Dynamics
5.1 Market Drivers and Constraints
5.2 SWOT Analysis
5.3 Porter’s Five Forces Model
5.4 Key Demand Indicators
5.5 Key Price Indicators
5.6 Industry Events, Initiatives, and Trends
5.7 Value Chain Analysis
6 Global Healthcare Payer Services Market Segmentation
6.1 Global Healthcare Payer Services Market by Type
6.1.1 Market Overview
6.1.2 BPO
6.1.2.1 Claims
6.1.2.2 Front end
6.1.2.3 Provider
6.1.2.4 Product
6.1.2.5 Development
6.1.2.6 Care Management
6.1.2.7 Billing
6.1.2.8 HR
6.1.3 ITO
6.1.3.1 Provider Network
6.1.3.2 Accounts
6.1.3.3 Analytics
6.1.3.4 Fraud
6.1.4 KPO
6.2 Global Healthcare Payer Services Market by End User
6.2.1 Market Overview
6.2.2 Private
6.2.3 Public
6.3 Global Healthcare Payer Services Market by Region
6.3.1 Market Overview
6.3.2 North America
6.3.3 Europe
6.3.4 Asia Pacific
6.3.5 Latin America
6.3.6 Middle East and Africa
7 North America Healthcare Payer Services Market
7.1 Market Share by Country
7.2 United States of America
7.3 Canada
8 Europe Healthcare Payer Services Market
8.1 Market Share by Country
8.2 United Kingdom
8.3 Germany
8.4 France
8.5 Italy
8.6 Others
9 Asia Pacific Healthcare Payer Services Market
9.1 Market Share by Country
9.2 China
9.3 Japan
9.4 India
9.5 ASEAN
9.6 Australia
9.7 Others
10 Latin America Healthcare Payer Services Market
10.1 Market Share by Country
10.2 Brazil
10.3 Argentina
10.4 Mexico
10.5 Others
11 Middle East and Africa Healthcare Payer Services Market
11.1 Market Share by Country
11.2 Saudi Arabia
11.3 United Arab Emirates
11.4 Nigeria
11.5 South Africa
11.6 Others
12 Regulatory Framework
12.1 Regulatory Overview
12.1.1 US FDA
12.1.2 EU EMA
12.1.3 INDIA CDSCO
12.1.4 JAPAN PMDA
12.1.5 Others
13 Supplier Landscape
13.1 Accenture
13.1.1 Financial Analysis
13.1.2 Product Portfolio
13.1.3 Demographic Reach and Achievements
13.1.4 Mergers and Acquisitions
13.1.5 Certifications
13.2 Cognizant
13.2.1 Financial Analysis
13.2.2 Product Portfolio
13.2.3 Demographic Reach and Achievements
13.2.4 Mergers and Acquisitions
13.2.5 Certifications
13.3 Tata Consultancy Services
13.3.1 Financial Analysis
13.3.2 Product Portfolio
13.3.3 Demographic Reach and Achievements
13.3.4 Mergers and Acquisitions
13.3.5 Certifications
13.4 NTT Data Corporations
13.4.1 Product Portfolio
13.4.2 Demographic Reach and Achievements
13.4.3 Mergers and Acquisitions
13.4.4 Certifications
13.5 IQVIA Inc.
13.5.1 Financial Analysis
13.5.2 Product Portfolio
13.5.3 Demographic Reach and Achievements
13.5.4 Mergers and Acquisitions
13.5.5 Certifications
13.6 Mphasis
13.6.1 Financial Analysis
13.6.2 Product Portfolio
13.6.3 Demographic Reach and Achievements
13.6.4 Mergers and Acquisitions
13.6.5 Certifications
13.7 FIrstsource Solutions
13.7.1 Product Portfolio
13.7.2 Demographic Reach and Achievements
13.7.3 Mergers and Acquisitions
13.7.4 Certifications
13.8 IBM Corporation
13.8.1 Financial Analysis
13.8.2 Product Portfolio
13.8.3 Demographic Reach and Achievements
13.8.4 Mergers and Acquisitions
13.8.5 Certifications
13.9 HCL Technologies
13.9.1 Financial Analysis
13.9.2 Product Portfolio
13.9.3 Demographic Reach and Achievements
13.9.4 Mergers and Acquisitions
13.9.5 Certifications
13.10 First Source Solutions
13.10.1 Financial Analysis
13.10.2 Product Portfolio
13.10.3 Demographic Reach and Achievements
13.10.4 Mergers and Acquisitions
13.10.5 Certifications
14 Key Opinion Leaders (KOL) Insights (Additional Insight)
15 Company Competitiveness Analysis (Additional Insight)
15.1 Very Small Companies
15.2 Small Companies
15.3 Mid-Sized Companies
15.4 Large Companies
15.5 Very Large Companies
16 Payment Methods (Additional Insight)
16.1 Government Funded
16.2 Private Insurance
16.3 Out-of-Pocket
*Additional insights provided are customisable as per client requirements.
Key Questions Answered in the Report
The market attained a value of about USD 60.5 billion in 2023, driven by increasing advancements and investment into a digitally equipped healthcare ecosystem across the globe.
The market is anticipated to grow at a CAGR of 10.4% during the forecast period of 2024-2032, likely to reach a market value of USD 146.9 billion by 2032.
As the healthcare costs are steadily increasing across the globe, especially post COVID-19, people have started adopting efficient healthcare payer services, leading to high market demand.
The current market trend is the integration of artificial intelligence and machine learning to streamline the workflow of healthcare workers. Privately owned companies like Medicare and UnitedHealthcare are launching new programs after incorporating customer feedback to facilitate better solutions. In India, leading companies like Jio Finance Services (Reliance) are entering healthcare insurance sector.
Common services include BPO which is further divided into claims, front end, provider, product, development, care management, billing, and HR. Other major services constitute ITO like provider network, accounts, analytics, fraud and KPOs.
Major end users include public and private.
The major regions of the market include North America, Europe, Asia Pacific, Latin America, Middle East, and Africa. North America is currently leading the global market.
Key players involved in the market are Accenture, Cognizant, Tata Consultancy Services, NTT Data Corporations, IQVIA Inc., Mphasis, FIrstsource Solutions, IBM Corporation, HCL Technologies and First Source Solutions.
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