Healthcare Payer Services Market Size, Share | Industry Report 2024

The global healthcare payer services market was valued at $40.6 bn in 2016 and is forecast to grow at a CAGR of 11.1% between 2017 and 2024, culminating in 2024 global market size of $106 bn.

BPO services represent 45% of total services, followed by IT Outsourcing and KPO services. There is a lot of automation going on to streamline the services. Hence the demand for work around machine learning, AI will further boost the IT and IT-enabled services. Lack of adequate resources in U.S. market and cost arbitrage will further boost the outsourcing.

We have segmented the market on the basis of services, applications and end use. On the basis of applications, it is segmented into 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. Within applications, claim management, billing and account management services and analytics will lead the market. From end-user perspective, we have segmented the service market from public and private insurance players.

The journey towards value-based reimbursement: The major disruptive force shaping the commercial payer’s space is the transition to value-based reimbursement from the traditional fee for service payment model. To achieve the same, they are using predictive analytics, advanced software and machine learning.

The key regions analyzed in the study include North America, Europe, Asia-Pacific, Latin America and the Middle East and Africa. In 2016, North America dominated the market with a revenue share of over 75%. Increasing health insurance enrolment, presence of robust framework like ACA (Affordable Care Act), HIPPA (Health Insurance Portability and Accountability Act of 1996), ICD-10 reporting will drive the need for more and more advanced software and business process.

With changing landscape, Asia-Pacific is expected to emerge as the fastest growing region with a CAGR of 8.5% over the forecast period. Growing demand for health insurance, availability of trained resources and demand for customized insurance products will further drive the market for solutions.

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Key findings from the study: -
• BPO services represent 45% of total services, followed by IT Outsourcing and KPO services. There is lot of automation going on to streamline the services. Hence demand for work around machine learning, AI will further boost the IT and IT enabled services. Lack of adequate resources in U.S. market and cost arbitrage will further boost the outsourcing
• The journey towards value-based reimbursement: The major disruptive force shaping the commercial payer's space is the transition to value-based reimbursement from the traditional fee for service payment model. To achieve the same, they are using predictive analytics, advanced software and machine learning.
• The Advisory Board Company (Healthcare research, technology and consulting firm) sell its healthcare business to Optum and its education division to Vista Equity Partners in a duo of deals worth $2.58 billion. Our report tracks all such merger and acquisition in this space.
• Major players in the market include United HealthCare Services Inc., Anthem Inc., Aetna Inc., Accenture, Cognizant, Xerox Corporation, EXL, Concentrix Corporation, HP Development Company, L.P., HGS Limited, Dell, HCL Technologies Ltd., Wipro Limited, United Healthcare, CIGNA Corp. and Genpact.

Ameri Research has segmented the Healthcare Payer Services Market by Service Type, Application, End User and Regional Outlook.

Market Segmentation:

Healthcare Payer Services (Outsourcing) Market, by Service Type (Revenue, USD Million, 2014- 2024)
• BPO
• ITO
• KPO

Healthcare Payer Services Market, by Application (Revenue, USD Million, 20124- 2024)
• 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, by End User (Revenue, USD Million, 20124- 2024)
• Private Payers
• Public Payers

Healthcare Payer Services Market, Regional Outlook (Revenue, USD Million, 20124- 2024)
• North America
o U.S.
o Canada

• Europe
o UK
o Germany
o France
o Italy
o Spain

• Asia Pacific
o Japan
o China
o India
o Australia

• Latin America
o Brazil
o Mexico
o Columbia

• Middle East and Africa
o South Africa
o Saudi Arabia

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