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Healthcare Payer Services Market by Service Type (Business Process Outsourcing (BPO), Information Technology Outsourcing (ITO), Knowledge Process Outsourcing (KPO)), Application (Analytics & Fraud Management, Billing & Accounts Management, Claims Managem

Publisher 360iResearch
Published Apr 17, 2024
Length 198 Pages
SKU # IRE18713023

Description

Healthcare Payer Services Market by Service Type (Business Process Outsourcing (BPO), Information Technology Outsourcing (ITO), Knowledge Process Outsourcing (KPO)), Application (Analytics & Fraud Management, Billing & Accounts Management, Claims Management), End User - Global Forecast 2024-2030


The Healthcare Payer Services Market size was estimated at USD 70.18 billion in 2023 and expected to reach USD 76.19 billion in 2024, at a CAGR 9.03% to reach USD 128.63 billion by 2030.

The healthcare payer services encompass a wide range of third-party services provided to health insurance companies, government agencies, and other healthcare payers to help them manage their daily operations and improve the efficiency and cost-effectiveness of their services. These services include claims processing, member enrollment, benefits management, provider network management, billing and collection management, customer service support, and care management support. The rising prevalence of chronic diseases has necessitated the deployment of better healthcare facilities and efficient management systems. Additionally, the growing number of insurance claims and efforts by the government to expand access to healthcare reimbursement and insurance policies create a need for efficient claims management solutions. However, data privacy concerns due to the sensitive nature of personal health information (PHI) can make it difficult for organizations to trust third-party service providers to handle their data. Additionally, complex regulatory environments may pose entry barriers for new players in this space. However, efforts by major players to incorporate AI-enabled applications, analytics, and cloud-based services can help reduce the regulatory burden on new entrants. Emerging opportunities within this market include the integration of telehealth into payer service offerings, which can help payers expand access points and optimize care delivery through remote consultations or remote monitoring devices.



Please Note: PDF & Excel + Online Access - 1 Year

Table of Contents

198 Pages
1. Preface
1.1. Objectives of the Study
1.2. Market Segmentation & Coverage
1.3. Years Considered for the Study
1.4. Currency & Pricing
1.5. Language
1.6. Stakeholders
2. Research Methodology
2.1. Define: Research Objective
2.2. Determine: Research Design
2.3. Prepare: Research Instrument
2.4. Collect: Data Source
2.5. Analyze: Data Interpretation
2.6. Formulate: Data Verification
2.7. Publish: Research Report
2.8. Repeat: Report Update
3. Executive Summary
4. Market Overview
5. Market Insights
5.1. Market Dynamics
5.1.1. Drivers
5.1.1.1. Rising number of chronic diseases and genetic disorders and need to reduce healthcare expenditure
5.1.1.2. Increase in the outsourcing of supportive insurance services by healthcare payers
5.1.1.3. Rising government initiatives to launch health insurance programs
5.1.2. Restraints
5.1.2.1. Hidden costs associated with outsourcing healthcare payer services
5.1.3. Opportunities
5.1.3.1. Emergence of virtual health service providers and adoption of telehealth solutions
5.1.3.2. Incorporation of artificial intelligence (AI), analytics, and cloud-based service in healthcare insurance portfolio
5.1.4. Challenges
5.1.4.1. Risks of cyber theft and data breach
5.2. Market Segmentation Analysis
5.2.1. Service Type: Utilizing business process outsourcing (BPO) to streamline healthcare operations
5.2.2. Application: Requirement of claim management services to facilitate efficient insurance-related operations
5.2.3. End-user: Growing awareness about importance of efficient healthcare systems driving public and government payers’ involvement
5.3. Market Disruption Analysis
5.4. Porter’s Five Forces Analysis
5.4.1. Threat of New Entrants
5.4.2. Threat of Substitutes
5.4.3. Bargaining Power of Customers
5.4.4. Bargaining Power of Suppliers
5.4.5. Industry Rivalry
5.5. Value Chain & Critical Path Analysis
5.6. Pricing Analysis
5.7. Technology Analysis
5.8. Patent Analysis
5.9. Trade Analysis
5.10. Regulatory Framework Analysis
6. Healthcare Payer Services Market, by Service Type
6.1. Introduction
6.2. Business Process Outsourcing (BPO)
6.3. Information Technology Outsourcing (ITO)
6.4. Knowledge Process Outsourcing (KPO)
7. Healthcare Payer Services Market, by Application
7.1. Introduction
7.2. Analytics & Fraud Management
7.3. Billing & Accounts Management
7.4. Claims Management
7.5. HR Services Management
7.6. Integrated Front Office Service & Back Office Operations Member Management
7.7. Provider Network Management
8. Healthcare Payer Services Market, by End User
8.1. Introduction
8.2. Commercial
8.3. Private
8.4. Public / Government
9. Americas Healthcare Payer Services Market
9.1. Introduction
9.2. Argentina
9.3. Brazil
9.4. Canada
9.5. Mexico
9.6. United States
10. Asia-Pacific Healthcare Payer Services Market
10.1. Introduction
10.2. Australia
10.3. China
10.4. India
10.5. Indonesia
10.6. Japan
10.7. Malaysia
10.8. Philippines
10.9. Singapore
10.10. South Korea
10.11. Taiwan
10.12. Thailand
10.13. Vietnam
11. Europe, Middle East & Africa Healthcare Payer Services Market
11.1. Introduction
11.2. Denmark
11.3. Egypt
11.4. Finland
11.5. France
11.6. Germany
11.7. Israel
11.8. Italy
11.9. Netherlands
11.10. Nigeria
11.11. Norway
11.12. Poland
11.13. Qatar
11.14. Russia
11.15. Saudi Arabia
11.16. South Africa
11.17. Spain
11.18. Sweden
11.19. Switzerland
11.20. Turkey
11.21. United Arab Emirates
11.22. United Kingdom
12. Competitive Landscape
12.1. Market Share Analysis, 2023
12.2. FPNV Positioning Matrix, 2023
12.3. Competitive Scenario Analysis
12.3.1. CommonSpirit Health Launches National Value-Based Care Platform
12.3.2. DocGo and HealthCare Partners NY Expand Partnership to Enhance Proactive At-Home Care for Patients
12.3.3. CVS Health Finalizes USD 8 billion Acquisition of Signify Health
12.4. Strategy Analysis & Recommendation
13. Competitive Portfolio
13.1. Key Company Profiles
13.2. Key Product Portfolio
FIGURE 1. HEALTHCARE PAYER SERVICES MARKET RESEARCH PROCESS
FIGURE 2. HEALTHCARE PAYER SERVICES MARKET SIZE, 2023 VS 2030
FIGURE 3. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, 2018-2030 (USD MILLION)
FIGURE 4. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY REGION, 2023 VS 2030 (%)
FIGURE 5. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY REGION, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 6. HEALTHCARE PAYER SERVICES MARKET DYNAMICS
FIGURE 7. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY SERVICE TYPE, 2023 VS 2030 (%)
FIGURE 8. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY SERVICE TYPE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 9. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY APPLICATION, 2023 VS 2030 (%)
FIGURE 10. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY APPLICATION, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 11. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY END USER, 2023 VS 2030 (%)
FIGURE 12. GLOBAL HEALTHCARE PAYER SERVICES MARKET SIZE, BY END USER, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 13. AMERICAS HEALTHCARE PAYER SERVICES MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 14. AMERICAS HEALTHCARE PAYER SERVICES MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 15. UNITED STATES HEALTHCARE PAYER SERVICES MARKET SIZE, BY STATE, 2023 VS 2030 (%)
FIGURE 16. UNITED STATES HEALTHCARE PAYER SERVICES MARKET SIZE, BY STATE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 17. ASIA-PACIFIC HEALTHCARE PAYER SERVICES MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 18. ASIA-PACIFIC HEALTHCARE PAYER SERVICES MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 19. EUROPE, MIDDLE EAST & AFRICA HEALTHCARE PAYER SERVICES MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 20. EUROPE, MIDDLE EAST & AFRICA HEALTHCARE PAYER SERVICES MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 21. HEALTHCARE PAYER SERVICES MARKET SHARE, BY KEY PLAYER, 2023
FIGURE 22. HEALTHCARE PAYER SERVICES MARKET, FPNV POSITIONING MATRIX, 2023

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