Healthcare Payer Services Market by Global Demand and Latest Technology 2022 - Cognizant, United Healthcare, Inc., EXL

The Global Healthcare Payer Services Market size is estimated to be USD 45.04 billion in 2019 and is predicted to reach USD 103.95 billion by 2030 with a CAGR of 7.9% from 2020-2030.

Healthcare payer services include the information technology and other support services that help maintain payer’s business and IT strategies, allowing clients to become more efficient and productive, while improving quality of care. These services include development of solutions for claims management services, application development, web development and hosting, enterprise content management and document management amongst others. Implementation of such services help deliver healthcare value, control costs, and improve operational efficiency.

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Top Companies: Cognizant, United Healthcare, Inc., EXL, Concentrix Corporation, Anthem, Inc., Aetna, Inc., Dell, HP, and Xerox Corporation and others.

Market Dynamics and Trends:

Globally, healthcare industry is experiencing a significant boost and regulatory modifications play a vital role in its development. Due to this, payers are developing new business models, processes, and systems in order to adapt to extensive and complex laws such as the Affordable Care Act and various delivery models such as patient centred medical homes (PCMH). These changing processes and business models of payers have created opportunities for various services providers. Moreover, presence of big data in healthcare, business intelligence and analytics, and advanced machine learning techniques also open new avenues in the healthcare payer services industry.

With increasing population and growing healthcare awareness, large number of people are opting for health insurance. This has increased the customer base of healthcare payers which rises concerns such as enhancing customer communication, reducing the costs and streamlining the processes. Also, with growing prevalence of chronic diseases, there is increasing pressure to reduce healthcare cost. These factors primarily drive the demand for healthcare payer services during the forecast period. Also, increasing adoption of digital technology and growing private healthcare insurance exchanges, increasing IT investments, and government initiatives such as Affordable Care Act (ACA) also contribute to the market growth. However, growing data security concerns and high cost associated with outsourcing services is likely to restrain the growth of healthcare payer services market during the forecast period.

Payer services providers are rising to regulation challenges by offering custom-made solutions to monitor and record patient outcomes. Major players operating in this market replicates the industry’s adaptation to regulation through several strategic collaborations and acquisitions. For instance, in August 2018 Access Healthcare acquired Pacific BPO, a provider of revenue cycle management services. Also, in March 2018 Centene signed an agreement to acquire Florida-based Community Medical Holdings Corp (CMG). CMG is at-risk provider for treating Medicaid, Medicare Advantage, and marketplace plan holders, which can improve Centene members’ overall quality of care.

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Market Segmentations and Scope of the Study:

Global healthcare payer services market share is analysed on the basis of services, application, end user, and geography. On the basis of type of services, the market is segmented into business process outsourcing, information technology outsourcing, and knowledge process outsourcing. The application segment is divided 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, and HR services. By end user the market is segmented into healthcare private insurance companies, government agencies, and employers and private exchanges. The regional analysis of the healthcare payer services market comprises of North America, Europe, Asia Pacific, and Rest of the World.

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