Healthcare Payer Services Market Size, Share, Trends, Growth, Production, Consumption, Revenue, Company Analysis and Forecast 2021-2030

Published Date : May 2021 | No. of Pages : 250 Pages | Category : Healthcare

The global Healthcare Payer Services market size is expected to be worth around US$ 79.2 billion by 2030, according to a new report by Vision Research Reports.

The global Healthcare Payer Services market size was valued at US$ 42.5 billion in 2020 and is anticipated to grow at a CAGR of 18.5% during forecast period 2021 to 2030.

Growth Factors

 The key factors driving the market include the increasing demand for streamlined business processes and better customer services through the adoption of cost effective strategies. 

The growing usage of advanced technologies to deliver economical business process services, rising adoption of digital technology, increasing focus on consumerism, and the presence of stringent healthcare regulatory policies are certain crucial factors boosting the healthcare payer services market in the coming years. Some of the key participants, such as Accenture, Cognizant, EXL, HP Development Company, L.P., Concentrix Corporation, and others, are primarily focusing on incorporating mobility technology with health plans to engage enrolled members. 

Moreover, the growing private healthcare insurance exchanges, increasing IT investments, and with the Affordable Care Act (ACA) in effect, the market is set to grow. The increasing demand to curb the overall administrative costs of member management services, increasing demand for cost effective solutions for the healthcare payer services, and the growing number of healthcare fraud cases are few determinants that are expected to propel the market growth over the forecast period. 

Report Highlights

BPO held a share of 51.7% of the overall vertical in 2020. The growing healthcare cost and the increasing focus to reduce the overall administrative cost of member services & claim management services are anticipated to boost the healthcare payer BPO sector over the forecast period. Moreover, the high demand to incorporate health insurance exchanges in the private healthcare insurance enrollment procedures and the presence of the ACA are factors that are driving the healthcare payer BPO segment.

However, the healthcare payer KPO segment is expected to grow at a lucrative CAGR of 17.9% due to the upsurge in the demand for highly skilled professionals and the cost advantage associated with outsourcing the high-end processes at a low cost to the developing countries. Moreover, the growing need in the emerging economies for low-cost high skilled professionals for domain-specific core and non-core activities of the payer vertical is one of the crucial factors anticipated to propel the sector growth in the coming years.

Claims management services held a majority share of over 44.6% in 2020. The presence of ACA and increasing overall healthcare expenditure are among some crucial factors that are driving the number of members enrolled in the Centers for Medicare and Medicaid Services. In 2015, the number of ACA enrollment was approximately 11.7 million and over 8 million people were stated to signed up for health insurance coverage in the insurance marketplace.

However, the analytics and fraud management services segment is expected to grow at the highest CAGR of 9.7%. The growing demand for predictive modeling and claim analytics is one of the main factors that is expected to drive the segment in the coming years. Some of the key operations such as fraud monitoring analytics, and risk management analytics data analysis are mainly a part of KPO services. The increasing demand for low-cost skilled professionals in the developed economies to share the workload and to cater to high-end healthcare payer analytical applications, and growing outsourcing of infrastructural management, application management, and data architecture are expected to positively reinforce this segment’s growth over the forecast period.

private payers accounted for the majority revenue share of 52.3% owing to the increasing private investment in the healthcare payer vertical and growing government support to promote private investment in the healthcare industry.

However, the public payers segment is expected to emerge as the fastest growing with a CAGR of 8.6% over the forecast period. The increasing presence of international health insurance acts such as ACA, HIPAA, and ICD-10, growing healthcare expenditure, rapidly decreasing out of pocket expenditure are some of the pivotal factors expected to positively reinforce the sector growth over the forecast period.

In 2015, North America accounted for the maximum revenue share of 77.3%, followed by Asia Pacific. The U.S. is the most important sector and captured the majority share of the North America segment. The increasing health insurance enrollment, the favorable individual mandate levied by the ACA, the presence of favorable reimbursement framework, and the lack of skilled professionals are some of the factors that are accountable for the sizable market share.

Asia Pacific is also expected to emerge as the fastest growing region touting a cumulative growth of 10.8% over the forecast period. India is one of the leading nations that captured the global KPO vertical. Moreover, some of the economies, such as Mexico, Brazil, Japan, China, are expected to contribute strongly toward the global ITO over the forecast period.

Key Players

United HealthCare Services Inc., Anthem Inc., Aetna Inc., Accenture, Cognizant, Xerox Corporation, and Genpact.  Healthcare, Inc., Anthem, Inc., Aetna, Inc., Accenture, Cognizant, Dell, HP Development Company, L.P., and Xerox Corporation 

Market Segmentation

Healthcare Payer Services Market Outsourcing Services Outlook 

  • BPO

  • KPO

  • ITO

Healthcare Payer Services Market Application Outlook 

  • Claims Management Services

  • Integrated Front Office Service and Back Office Operations

  • Member Management Services

  • Provider Management Services

  • Billing and Accounts Management Services

  • Analytics and Fraud Management Services

  • HR Services 

Healthcare Payer Services Market End-use Outlook 

  • Private Payer

  • Public Payer

Healthcare Payer Services Market Regional Outlook 

  • North America

    • U.S.

    • Canada

  • Europe

    • UK

    • Germany

  • Asia Pacific

    • Japan

    • China

    • India

  • Latin America

    • Brazil

    • Mexico

  • Middle East and Africa

    • South Africa

The Healthcare Payer Services market research report covers definition, classification, product classification, product application, development trend, product technology, competitive landscape, industrial chain structure, industry overview, national policy and planning analysis of the industry, the latest dynamic analysis, etc., and also includes major. The study includes drivers and restraints of the global market. It covers the impact of these drivers and restraints on the demand during the forecast period. The report also highlights opportunities in the market at the global level.

The report provides size (in terms of volume and value) of Healthcare Payer Services market for the base year 2020 and the forecast between 2021 and 2030. Market numbers have been estimated based on form and application. Market size and forecast for each application segment have been provided for the global and regional market.

This report focuses on the global Healthcare Payer Services market status, future forecast, growth opportunity, key market and key players. The study objectives are to present the Healthcare Payer Services market development in United States, Europe and China.

It is pertinent to consider that in a volatile global economy, we haven’t just conducted Healthcare Payer Services market forecasts in terms of CAGR, but also studied the market based on key parameters, including Year-on-Year (Y-o-Y) growth, to comprehend the certainty of the market and to find and present the lucrative opportunities in market.

In terms of production side, this report researches the Healthcare Payer Services capacity, production, value, ex-factory price, growth rate, market share for major manufacturers, regions (or countries) and type.

In terms of consumption side, this report focuses on the consumption of Healthcare Payer Services by regions (countries) and application.

Buyers of the report will have access to verified market figures, including global market size in terms of revenue and volume. As part of production analysis, the authors of the report have provided reliable estimations and calculations for global revenue and volume by Type segment of the global Healthcare Payer Services market. These figures have been provided in terms of both revenue and volume for the period 2017 to 2030. Additionally, the report provides accurate figures for production by region in terms of revenue as well as volume for the same period. The report also includes production capacity statistics for the same period.

With regard to production bases and technologies, the research in this report covers the production time, base distribution, technical parameters, research and development trends, technology sources, and sources of raw materials of major Healthcare Payer Services market companies.

Regarding the analysis of the industry chain, the research of this report covers the raw materials and equipment of Healthcare Payer Services market upstream, downstream customers, marketing channels, industry development trends and investment strategy recommendations. The more specific analysis also includes the main application areas of market and consumption, major regions and Consumption, major Chinese producers, distributors, raw material suppliers, equipment providers and their contact information, industry chain relationship analysis.

The research in this report also includes product parameters, production process, cost structure, and data information classified by region, technology and application. Finally, the paper model new project SWOT analysis and investment feasibility study of the case model.

Overall, this is an in-depth research report specifically for the Healthcare Payer Services industry. The research center uses an objective and fair way to conduct an in-depth analysis of the development trend of the industry, providing support and evidence for customer competition analysis, development planning, and investment decision-making. In the course of operation, the project has received support and assistance from technicians and marketing personnel in various links of the industry chain.

The Healthcare Payer Services market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, global presence, production sites and facilities, production capacities, company strengths and weaknesses, product launch, product width and breadth, application dominance. The above data points provided are only related to the companies’ focus related to Healthcare Payer Services market.

Prominent players in the market are predicted to face tough competition from the new entrants. However, some of the key players are targeting to acquire the startup companies in order to maintain their dominance in the global market. For a detailed analysis of key companies, their strengths, weaknesses, threats, and opportunities are measured in the report by using industry-standard tools such as the SWOT analysis. Regional coverage of key companies is covered in the report to measure their dominance. Key manufacturers of Healthcare Payer Services market are focusing on introducing new products to meet the needs of the patrons. The feasibility of new products is also measured by using industry-standard tools.

Key companies are increasing their investments in research and development activities for the discovery of new products. There has also been a rise in the government funding for the introduction of new Healthcare Payer Services market. These factors have benefited the growth of the global market for Healthcare Payer Services. Going forward, key companies are predicted to benefit from the new product launches and the adoption of technological advancements. Technical advancements have benefited many industries and the global industry is not an exception.

New product launches and the expansion of already existing business are predicted to benefit the key players in maintaining their dominance in the global market for Healthcare Payer Services. The global market is segmented on the basis of region, application, en-users and product type. Based on region, the market is divided into North America, Europe, Asia-Pacific, Latin America and Middle East and Africa (MEA).

In this study, the years considered to estimate the market size of Healthcare Payer Services are as follows:

  • Historic Year: 2017-2020
  • Base Year: 2021
  • Forecast Year 2021 to 2030

Reasons to Purchase this Report:

- Market segmentation analysis including qualitative and quantitative research incorporating the impact of economic and policy aspects
- Regional and country level analysis integrating the demand and supply forces that are influencing the growth of the market.
- Market value USD Million and volume Units Million data for each segment and sub-segment
- Competitive landscape involving the market share of major players, along with the new projects and strategies adopted by players in the past five years
- Comprehensive company profiles covering the product offerings, key financial information, recent developments, SWOT analysis, and strategies employed by the major market players

Research Methodology:

In-depth interviews and discussions were conducted with several key market participants and opinion leaders to compile the research report.

This research study involved the extensive usage of both primary and secondary data sources. The research process involved the study of various factors affecting the industry, including the government policy, market environment, competitive landscape, historical data, present trends in the market, technological innovation, upcoming technologies and the technical progress in related industry, and market risks, opportunities, market barriers and challenges. The following illustrative figure shows the market research methodology applied in this report.

Market Size Estimation

Top-down and bottom-up approaches are used to estimate and validate the global market size for company, regional division, product type and application (end users).

The market estimations in this report are based on the selling price (excluding any discounts provided by the manufacturer, distributor, wholesaler or traders). Market share analysis, assigned to each of the segments and regions are achieved through product utilization rate and average selling price.

Major manufacturers & their revenues, percentage splits, market shares, growth rates and breakdowns of the product markets are determined through secondary sources and verified through the primary sources.

All possible factors that influence the markets included in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data. The market size for top-level markets and sub-segments is normalized, and the effect of inflation, economic downturns, and regulatory & policy changes or others factors are accounted for in the market forecast. This data is combined and added with detailed inputs and analysis from Vision Research Reports and presented in this report.

Market Breakdown and Data Triangulation

After complete market engineering with calculations for market statistics; market size estimations; market forecasting; market breakdown; and data triangulation. Extensive primary research was conducted to gather information and verify and validate the critical numbers arrived at. In the complete market engineering process, both top-down and bottom-up approaches were extensively used, along with several data triangulation methods, to perform market estimation and market forecasting for the overall market segments and sub-segments listed in this report.

Secondary Sources

Secondary Sources occupies approximately 25% of data sources, such as press releases, annual reports, Non-Profit organizations, industry associations, governmental agencies and customs data, and so on. This research study includes secondary sources; directories; databases such as Bloomberg Business, Wind Info, Hoovers, Factiva (Dow Jones & Company), TRADING ECONOMICS, and avention; Investing News Network; statista; Federal Reserve Economic Data; annual reports; investor presentations; and SEC filings of companies.

Primary Sources

 In the primary research process, various sources from both the supply and demand sides were interviewed to obtain qualitative and quantitative information for this report. The primary sources from the supply side include product manufacturers (and their competitors), opinion leaders, industry experts, research institutions, distributors, dealer and traders, as well as the raw materials suppliers and producers, etc.

The primary sources from the demand side include industry experts such as business leaders, marketing and sales directors, technology and innovation directors, supply chain executive, end users (product buyers), and related key executives from various key companies and organizations operating in the global market.

The study objectives of this report are:

  • To analyze and study the global market capacity, production, value, consumption, status (2017-2020) and forecast (2021-2030);
  • Focuses on the key manufacturers, to study the capacity, production, value, market share and development plans in future.
  • Comprehensive company profiles covering the product offerings, key financial information, recent developments, SWOT analysis, and strategies employed by the major market players
  • To define, describe and forecast the market by type, application and region.
  • To analyze the global and key regions market potential and advantage, opportunity and challenge, restraints and risks.
  • To identify significant trends and factors driving or inhibiting the market growth.
  • To analyze the opportunities in the market for stakeholders by identifying the high growth segments.
  • To strategically analyze each submarket with respect to individual growth trend and their contribution to the market
  • To analyze competitive developments such as expansions, agreements, new product launches, and acquisitions in the market
  • To strategically profile the key players and comprehensively analyze their growth strategies.

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