Patient Access Solutions Market - Growth, Trends, COVID-19 Impact, and Forecasts (2022 - 2027)

Patient Access Solutions Market - Growth, Trends, COVID-19 Impact, and Forecasts (2022 - 2027)

The patient access solutions involves denials management, payment estimation and Improve patient collections. Denial management has an important role to play in hospital revenue generation. Most hospitals are now dependent on third-party providers for denial management services, as they lack the expert knowledge and time to manage the reimbursement process. These providers, with dedicated and skilled professionals, handle the denied claim and resubmit them. With their expertise, these providers increase the cash flow of their clients, which is otherwise neglected by the hospitals. It is estimated that over 90% of claim denials can be prevented with support from the providers, who have systems and knowledgeable experts in the field. Thus the rising need to eradicate claim denials is expected to contribute for the growth of patient access solutions market in the forecast period.

Key Market TrendsClaim Denial and Appeal Management Segment is Expected to Dominate the Market in the Forecast Years

Based on Software, the market is segmented into Claims Denial & Appeal Management Solutions, Payment Estimation Solutions, and Others. Claim denial and appeal management involves the review of the denial procedure and determining if the denial can be appealed against. The management conducts a root cause analysis for the claim being denied by the insurer. This involves the review of patient documentation and resubmission of the claim. With more healthcare facilities under intense scrutiny and the rise in the number of healthcare claims, a large amount of hospital revenue is being declined by insurers. Hence, with the increasing acceptance of companies that provide these services, they have become more important to hospital facilities, thereby, contributing to the growth of the market studied over the forecast period.

North America Holds the Largest Share in the Patient Access Solutions Market

The Patient Access Solutions market holds the largest share in the North America region due to the presence of a high-quality healthcare system and modern medical technology. Most hospitals in United States that are serving patients, who are covered under Medicare or any privates insurances are facing difficulty in processing and submitting claims. Hospitals face challenge in accurately billing patients for a procedure or surgery done. This has created a huge opportunity for companies that provide patient access solutions to bridge the gap. Additionally, most hospitals in United States having recognized that automating the payment estimation with help of IT tools is helping both hospitals and patients to understand the costs in real time and collect payments by reducing the accounts receivable turnaround time. This is likely to contribute towards the growth of the market.

Competitive Landscape

The global players into the patient access solutions market are AccuReg Software, Cerner Corporation, Cirius Group Inc., Cognizant, Conifer Health Solutions, LLC, Epic Systems Corporation, Experian PLC, McKesson Corporation, Optum Inc. and ZirMed Inc.

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Companies Mentioned

AccuReg Software
Cerner Corporation
Cirius Group Inc.
Conifer Health Solutions, LLC
Epic Systems Corporation
Experian PLC
McKesson Corporation
Optum Inc.
ZirMed Inc.

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1.1 Study Deliverables
1.2 Study Assumptions
1.3 Scope of the Study
4.1 Market Overview
4.2 Market Drivers
4.2.1 Need to Maintain Regulatory Compliance
4.2.2 Rising Importance of Denial Management
4.2.3 Increasing Number of Insured Patients
4.3 Market Restraints
4.3.1 Data Privacy and Confidentiality
4.4 Porter's Five Forces Analysis
4.4.1 Threat of New Entrants
4.4.2 Bargaining Power of Buyers/Consumers
4.4.3 Bargaining Power of Suppliers
4.4.4 Threat of Substitute Products
4.4.5 Intensity of Competitive Rivalry
5.1 By Product and Service
5.1.1 Software Claims Denial & Appeal Management Solutions Payment Estimation Solutions Others
5.1.2 Services
5.2 By Deployment
5.2.1 Web and Cloud-based Solutions
5.2.2 On-Premise Solutions
5.3 By End User
5.3.1 Healthcare Providers
5.3.2 HCIT Outsourcing Companies
5.3.3 Other End Users
5.4 Geography
5.4.1 North America United States Canada Mexico
5.4.2 Europe Germany United Kingdom France Italy Spain Rest of Europe
5.4.3 Asia-Pacific China Japan India Australia South Korea Rest of Asia-Pacific
5.4.4 Middle-East and Africa GCC South Africa Rest of Middle-East and Africa
5.4.5 South America Brazil Argentina Rest of South America
6.1 Company Profiles
6.1.1 AccuReg Software
6.1.2 Cerner Corporation
6.1.3 Cirius Group Inc.
6.1.4 Cognizant
6.1.5 Conifer Health Solutions, LLC
6.1.6 Epic Systems Corporation
6.1.7 Experian PLC
6.1.8 McKesson Corporation
6.1.9 Optum Inc.
6.1.10 ZirMed Inc.

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