Fairfield Market Research Healthcare Payer Services Market Size, Share, Forecast 2030

Healthcare Payer Services Market

Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2023-2030 - By Product, Technology, Grade, Application, End-user, Region: (North America, Europe, Asia Pacific, Latin America and Middle East and Africa)

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Industry: Healthcare IT


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The healthcare payer services market revenue stood around US$60 Bn in 2022 and is projected to attain impressive growth in the years to come. Increasing healthcare spending is predominantly driving the market ahead.  

Market Analysis in Brief

The global healthcare payer services market is tracing an upward growth trajectory, primarily owing to rising healthcare expenditure. As healthcare costs continue to rise, payers including government agencies and insuring firms are seeking efficient ways to reduce expenses. This in turn is anticipated to translate into revolutionary opportunities for the healthcare payer services market. Besides, the increase in the number of individuals and organisations seeking insurance coverage is further fuelling the demand for healthcare payer services.

Furthermore, the global healthcare industry has witnessed a shift from fee-for-service to value-based care models. This transition has pushed payer services to level up and support care coordination, perform risk assessment, and implement advanced analytics to improve healthcare outcomes. Against this backdrop, the global healthcare payers services market is set to reach new growth levels.

Key Report Findings

  • The increasing healthcare expenditure and technological advancements are playing a critical role in the expansion of the healthcare payer services market
  • A paradigm shift of industry to the value-based care model will augur well for the healthcare payer services industry
  • Demand for IT outsourcing services will be the strongest through 2030
  • Claims management represents a leading area of application
  • North America is projected to hold a lion’s share in the global market
  • XEROX Corporation (US), Accenture (Ireland), Tata Consultancy Services (India), Cognizant (US), and WNS (Holdings) Limited (India) are some of the key industry participants

Growth Drivers

Trend of Outsourcing for Cost Savings, and Better Efficiency

In the past few decades, healthcare costs have undergone a significant surge owing to numerous factors including an increase in the geriatric population, and a subsequent rise in chronic disease incidence. In addition to this, the inefficient utilisation of resources, administrative costs, and inflated claims are escalating costs. These trends have led to payers taking the outsourcing approach to manage costs associated with healthcare and increase efficiency. This growing need for outsourcing healthcare payer services is unlocking revolutionary opportunities for the global healthcare payer services market.

Technological Advancements

The advent of technological advancements such as cloud computing, electronic health records (EHRs), big data analytics, and robotic process automation (RPA), are revolutionising the healthcare payer services market. This mainly attributes to the fact that such technologies streamline operations, improve accuracy, mitigate costs, enhance decision-making, and increase the availability of services for healthcare payer service providers.

Growth Challenges

Risk of Data Breaches, and Loss of Confidentiality

Leveraging the services of healthcare payer servicing firms exposes organisations and individuals to the danger of security breaches and data leaks. Legally protected information and extremely sensitive information such as patient contact information, medical history, and insurance plans, run the risk of being leaked. Such consequences could have an extremely adverse impact on the reputational image of the healthcare provider. Moreover, it could also lead to legal actions, costing substantial losses to businesses.

Overview of Key Segments

IT Outsourcing Services Most Sought-after

Based on service, the global healthcare payer services market is segmented into business process outsourcing, IT outsourcing services, and knowledge process outsourcing (KPO) services. Over the forecast period, the IT outsourcing services segment is poised to take a major market share. The growing need for innovative and advanced technologies, increasing investments in AI, and the need for easy accessibility are key growth catalysts for the segment. That said, the KPO services segment is projected to grow at the highest rate due to a surge in demand for skilled professionals, and cost advantages.

Claims Management Services Witness Robust Demand

Based on the application, the claims management services segment is expected to remain popular. The rising complexity and volume of healthcare claims are acting as a key driving force for the growth of this segment. The complexity often requires specialised knowledge and expertise to accurately process and adjudicate claims. Now, with the advent of the digital era, the procedures are being streamlined, significantly improving turnaround times.

Backed by Government Support, Private Players Continue to Dominate

The end user in the global healthcare payer services market compromises private and public payers. The private players are anticipated to hold the lion’s share, mainly owing to government support for private investment in the healthcare industry. That said, the public payers are expected to grow at a rapid pace over the forecast period. The advent of international health insurance such as ACA, and rapidly increasing healthcare expenditure, is positively influencing the segment’s growth.

Growth Opportunities Across Regions

North America Maintains a Dominant Position

North America is anticipated to maintain supremacy in the global healthcare payer services market in the upcoming years. Various macro factors such as rapid technological advancements, a well-defined regulatory environment, and growing demand for outsourcing capabilities, are promoting robust growth across the regional market.

On the other hand, Asia Pacific’s healthcare payer services market is projected to advance at the fastest CAGR. The growing prevalence of chronic diseases and burgeoning demand for resources in developing countries are primary key growth drivers.

Key Industry Players 

Some of the leading participants that are steering the worldwide healthcare payer services market competition include -

  • Cognizant
  • Accenture
  • XEROX Corporation
  • Tata Consultancy Services
  • NTT Data Corporation
  • WNS (Holdings) Limited
  • Mphasis
  • IQVIA Inc.
  • Wipro
  • Genpact
  • Infosys BPM
  • UnitedHealth Group
  • IBM Corporation (US),
  • Firstsource Solutions
  • HCL Technologies
  • Omega Healthcare
  • Lonza
  • Invensis Technologies
  • R1 RCM, INC.
  • Paraxel Corporation International

Regional Classification of the Global Healthcare Payer Services Market is Described Below:

North America

  • U.S.
  • Canada

Europe

  • Germany
  • France
  • Spain
  • U.K.
  • Italy
  • Russia
  • Rest of Europe

Asia Pacific

  • China
  • Japan
  • India
  • Southeast Asia
  • Rest of Asia Pacific

Latin America

  • Brazil
  • Mexico
  • Rest of Latin America

Middle East and Africa

  • GCC
  • South Africa
  • Rest of Middle East and Africa

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Our Research Methodology

Considering the volatility of business today, traditional approaches to strategizing a game plan can be unfruitful if not detrimental. True ambiguity is no way to determine a forecast. A myriad of predetermined factors must be accounted for such as the degree of risk involved, the magnitude of circumstances, as well as conditions or consequences that are not known or unpredictable. To circumvent binary views that cast uncertainty, the application of market research intelligence to strategically posture, move, and enable actionable outcomes is necessary.

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