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United States Healthcare BPO Market Size, Share, Analysis: By Payer Service: Claims Management, Customer Relationship Management (CRM), Operational/Administrative Management, Care Management, Others; By Pharmaceutical Service; By Provider Service; Regional Analysis; Market Dynamics; Competitive Landscape; 2024-2032
United States Healthcare BPO Market Outlook
The United States healthcare BPO market size was approximately USD 152.33 billion in 2023. The market is further projected to grow at a CAGR of 8.0% between 2024 and 2032, reaching a value of around USD 307.61 billion by 2032.
Key Trends in the Market
Healthcare business process outsourcing, abbreviated as healthcare BPO, involves the strategic outsourcing of non-core administrative tasks and processes in the healthcare sector to specialised external service providers. Healthcare BPO plays an important role in reducing the administrative burden of employees and improving patient care.
- The United States healthcare BPO market growth can be attributed to the increasing focus on improving operational efficiency and streamlining administrative processes within the healthcare industry. BPO also enables healthcare organisations to enhance their profitability, improve efficiency, and offer accessible and convenient services.
- One of the significant United States healthcare BPO market trends is the changing preferences of the healthcare industry towards embracing a patient-centric approach. Outsourcing supports various functions that enable healthcare organisations to concentrate on essential patient care aspects.
- Healthcare BPO can support healthcare organisations to reduce the risk of financial and legal penalties and comply with various laws. Hence, evolving regulatory compliances in the healthcare industry of the country are also anticipated to propel the United States healthcare BPO market demand in the coming years.
Market Analysis
Based on payer service, the market is segmented into claims management, customer relationship management (CRM), operational/administrative management, care management, human resource management, and provider management, among others.
On the basis of pharmaceutical service, the market can be divided into research and development, manufacturing, and non-clinical services. Based on provider service, the United States healthcare BPO market segmentation includes into patient enrollment and strategic planning, patient care service, and revenue cycle management. The major regional markets for healthcare BPO in the United States are New England, Mideast, Great Lakes, Plains, Southeast, Southwest, Rocky Mountain, and Far West.
The comprehensive EMR report provides an in-depth assessment of the market based on the Porter's five forces model along with giving a SWOT analysis. The report gives a detailed analysis of the following key players in the United States Healthcare BPO market, covering their competitive landscape and the latest developments like mergers, acquisitions, investments, and expansion plans.
- Accenture Plc
- Cognizant Technology Solutions Corporation
- Genpact Plc
- Wipro Limited
- IQVIA Inc.
- Infosys Limited
- Sutherland Global Services, Inc.
- Access Healthcare
- Global Virtuoso, Inc.
- Flatworld Solutions Inc.
- Others
Market Share by Payer Service
Claims management holds a significant portion of the United States healthcare BPO market share as it encompasses the intricate process of claims processing, encompassing submission, validation, and adjudication, through outsourcing. This approach aids healthcare organisations in improving efficiency and accuracy. Specialised BPO providers bring domain expertise, supporting these organisations in navigating the complexities of insurance regulations, coding requirements, and compliance standards.
As a result, this strategy facilitates error mitigation, reduces instances of claim denials, and expedites reimbursement cycles. This allows healthcare providers to reallocate resources and focus on patient care, freeing them from the challenges posed by administrative complexities.
Market Share by Provider Service
As per the United States healthcare BPO market analysis, outsourcing of revenue cycle management (RCM) processes, encompassing tasks like medical billing, coding, claims processing, and payment collections, supports healthcare organisations to optimise their financial operations and guarantee precise and prompt reimbursement.
Furthermore, specialised healthcare BPO providers assist in navigating intricate billing codes, insurance regulations, and compliance standards, thereby decreasing billing errors and denials. This strategy optimises revenue collection, improves cash flow, and lowers operational costs. By relieving healthcare providers of the administrative burden associated with managing the revenue cycle, it enables them to focus on delivering high-quality patient care and enhancing clinical outcomes.
Competitive Landscape
Accenture Plc, founded in 1989, is a prominent management consulting, technology services, and outsourcing company. Offering an extensive array of software products and services, the company caters to various industries, including aerospace and defence, automotive, banking, capital markets, chemicals, communications and media, consumer goods and services, energy, health, technology, industrial, insurance, life sciences, and natural resources, among others.
Genpact Plc, founded in 1997, is a renowned global professional services firm specialising in business process management services. With a robust presence in over 30 countries and a workforce exceeding 115,000 employees, the company delivers its products and services to diverse sectors such as banking and capital markets, consumer goods and retail, healthcare and life sciences, high tech, and insurance, among others.
Wipro Limited is a consulting and technology service company that is headquartered in Bengaluru, India. It is focused on creating innovative solutions that address the complex digital transformation requirements of organisations. With business partners across 65 countries, the company aims to leverage its design, consulting, operation, and engineering capabilities to drive sustainability.
Other market players operating in the United States healthcare BPO market include Cognizant Technology Solutions Corporation, IQVIA Inc., Infosys Limited, Sutherland Global Services, Inc., Access Healthcare, Global Virtuoso, Inc., and Flatworld Solutions Inc., among others.
Key Highlights of the Report
| REPORT FEATURES | DETAILS |
| Base Year | 2023 |
| Historical Period | 2018-2023 |
| Forecast Period | 2024-2032 |
| Scope of the Report |
Historical and Forecast Trends, Industry Drivers and Constraints, Historical and Forecast Market Analysis by Segment:
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| Breakup by Payer Service |
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| Breakup by Pharmaceutical Service |
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| Breakup by Provider Service |
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| Breakup by Region |
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| Market Dynamics |
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| Competitive Landscape |
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| Companies Covered |
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*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
2 Report Coverage – Key Segmentation and Scope
3 Report Description
3.1 Market Definition and Outlook
3.2 Properties and Applications
3.3 Market Analysis
3.4 Key Players
4 Key Assumptions
5 Executive Summary
5.1 Overview
5.2 Key Drivers
5.3 Key Developments
5.4 Competitive Structure
5.5 Key Industrial Trends
6 Market Snapshot
7 Opportunities and Challenges in the Market
8 North America Healthcare BPO Market Overview
8.1 Key Industry Highlights
8.2 North America Healthcare BPO Historical Market (2018-2023)
8.3 North America Healthcare BPO Market Forecast (2024-2032)
8.4 North America Healthcare BPO Market Share by Country
8.4.1 United States
8.4.2 Canada
9 United States Healthcare BPO Market Overview
9.1 Key Industry Highlights
9.2 United States Healthcare BPO Historical Market (2018-2023)
9.3 United States Healthcare BPO Market Forecast (2024-2032)
10 United States Healthcare BPO Market by Payer Service
10.1 Claims Management
10.1.1 Historical Trend (2018-2023)
10.1.2 Forecast Trend (2024-2032)
10.2 Customer Relationship Management (CRM)
10.2.1 Historical Trend (2018-2023)
10.2.2 Forecast Trend (2024-2032)
10.3 Operational/Administrative Management
10.3.1 Historical Trend (2018-2023)
10.3.2 Forecast Trend (2024-2032)
10.4 Care Management
10.4.1 Historical Trend (2018-2023)
10.4.2 Forecast Trend (2024-2032)
10.5 Human Resource Management
10.5.1 Historical Trend (2018-2023)
10.5.2 Forecast Trend (2024-2032)
10.6 Provider Management
10.6.1 Historical Trend (2018-2023)
10.6.2 Forecast Trend (2024-2032)
10.7 Others
11 United States Healthcare BPO Market by Pharmaceutical Service
11.1 Research and Development
11.1.1 Historical Trend (2018-2023)
11.1.2 Forecast Trend (2024-2032)
11.2 Manufacturing
11.2.1 Historical Trend (2018-2023)
11.2.2 Forecast Trend (2024-2032)
11.3 Non-clinical Services
11.3.1 Historical Trend (2018-2023)
11.3.2 Forecast Trend (2024-2032)
12 United States Healthcare BPO Market by Provider Service
12.1 Patient Enrollment and Strategic Planning
12.1.1 Historical Trend (2018-2023)
12.1.2 Forecast Trend (2024-2032)
12.2 Patient Care Service
12.2.1 Historical Trend (2018-2023)
12.2.2 Forecast Trend (2024-2032)
12.3 Revenue Cycle Management
12.3.1 Historical Trend (2018-2023)
12.3.2 Forecast Trend (2024-2032)
13 United States Healthcare BPO Market by Region
13.1 New England
13.1.1 Historical Trend (2018-2023)
13.1.2 Forecast Trend (2024-2032)
13.2 Mideast
13.2.1 Historical Trend (2018-2023)
13.2.2 Forecast Trend (2024-2032)
13.3 Great Lakes
13.3.1 Historical Trend (2018-2023)
13.3.2 Forecast Trend (2024-2032)
13.4 Plains
13.4.1 Historical Trend (2018-2023)
13.4.2 Forecast Trend (2024-2032)
13.5 Southeast
13.5.1 Historical Trend (2018-2023)
13.5.2 Forecast Trend (2024-2032)
13.6 Southwest
13.6.1 Historical Trend (2018-2023)
13.6.2 Forecast Trend (2024-2032)
13.7 Rocky Mountain
13.7.1 Historical Trend (2018-2023)
13.7.2 Forecast Trend (2024-2032)
13.8 Far West
13.8.1 Historical Trend (2018-2023)
13.8.2 Forecast Trend (2024-2032)
14 Market Dynamics
14.1 SWOT Analysis
14.1.1 Strengths
14.1.2 Weaknesses
14.1.3 Opportunities
14.1.4 Threats
14.2 Porter’s Five Forces Analysis
14.2.1 Supplier’s Power
14.2.2 Buyer’s Power
14.2.3 Threat of New Entrants
14.2.4 Degree of Rivalry
14.2.5 Threat of Substitutes
14.3 Key Indicators for Demand
14.4 Key Indicators for Price
15 Competitive Landscape
15.1 Market Structure
15.2 Company Profiles
15.2.1 Accenture Plc
15.2.1.1 Company Overview
15.2.1.2 Product Portfolio
15.2.1.3 Demographic Reach and Achievements
15.2.1.4 Certifications
15.2.2 Cognizant Technology Solutions Corporation
15.2.2.1 Company Overview
15.2.2.2 Product Portfolio
15.2.2.3 Demographic Reach and Achievements
15.2.2.4 Certifications
15.2.3 Genpact Plc
15.2.3.1 Company Overview
15.2.3.2 Product Portfolio
15.2.3.3 Demographic Reach and Achievements
15.2.3.4 Certifications
15.2.4 Wipro Limited
15.2.4.1 Company Overview
15.2.4.2 Product Portfolio
15.2.4.3 Demographic Reach and Achievements
15.2.4.4 Certifications
15.2.5 IQVIA Inc.
15.2.5.1 Company Overview
15.2.5.2 Product Portfolio
15.2.5.3 Demographic Reach and Achievements
15.2.5.4 Certifications
15.2.6 Infosys Limited
15.2.6.1 Company Overview
15.2.6.2 Product Portfolio
15.2.6.3 Demographic Reach and Achievements
15.2.6.4 Certifications
15.2.7 Sutherland Global Services, Inc.
15.2.7.1 Company Overview
15.2.7.2 Product Portfolio
15.2.7.3 Demographic Reach and Achievements
15.2.7.4 Certifications
15.2.8 Access Healthcare
15.2.8.1 Company Overview
15.2.8.2 Product Portfolio
15.2.8.3 Demographic Reach and Achievements
15.2.8.4 Certifications
15.2.9 Global Virtuoso, Inc.
15.2.9.1 Company Overview
15.2.9.2 Product Portfolio
15.2.9.3 Demographic Reach and Achievements
15.2.9.4 Certifications
15.2.10 Flatworld Solutions Inc.
15.2.10.1 Company Overview
15.2.10.2 Product Portfolio
15.2.10.3 Demographic Reach and Achievements
15.2.10.4 Certifications
15.2.11 Others
16 Key Trends and Developments in the Market
List of Key Figures and Tables
1. North America Healthcare BPO Market: Key Industry Highlights, 2018 and 2032
2. United States Healthcare BPO Market: Key Industry Highlights, 2018 and 2032
3. United States Healthcare BPO Historical Market: Breakup by Payer Service (USD Billion), 2018-2023
4. United States Healthcare BPO Market Forecast: Breakup by Payer Service (USD Billion), 2024-2032
5. United States Healthcare BPO Historical Market: Breakup by Pharmaceutical Service (USD Billion), 2018-2023
6. United States Healthcare BPO Market Forecast: Breakup by Pharmaceutical Service (USD Billion), 2024-2032
7. United States Healthcare BPO Historical Market: Breakup by Provider Service (USD Billion), 2018-2023
8. United States Healthcare BPO Market Forecast: Breakup by Provider Service (USD Billion), 2024-2032
9. United States Healthcare BPO Historical Market: Breakup by Region (USD Billion), 2018-2023
10. United States Healthcare BPO Market Forecast: Breakup by Region (USD Billion), 2024-2032
11. United States Healthcare BPO Market Structure
Key Questions Answered in the Report
In 2023, the market reached an approximate value of USD 152.33 billion.
The market is expected to grow at a CAGR of 8.0% between 2024 and 2032.
The market is estimated to witness a healthy growth in the forecast period of 2024-2032 to reach around USD 307.61 billion by 2032.
The major market drivers are the rising demand for operational efficiency and a shift toward cost containment and financial optimisation.
The key trends aiding the market expansion include the rapid adoption of advanced technologies and evolving regulatory compliances in the healthcare industry.
The major regional markets include New England, Mideast, Great Lakes, Plains, Southeast, Southwest, Rocky Mountain, and Far West.
The various provider services of healthcare BPO are patient enrolment and strategic planning, patient care service, and revenue cycle management.
The key players in the market include Accenture Plc, Genpact Plc, Cognizant Technology Solutions Corporation, Wipro Limited, IQVIA Inc., Infosys Limited, Sutherland Global Services, Inc., Access Healthcare, Global Virtuoso, Inc., and Flatworld Solutions Inc., among others.
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