Healthcare Payer Services Market worth $118.2 Billion | Cognizant (US), Tata Consultancy Services (India), XEROX Corporation (US), WNS (Holdings) Limited (India), NTT Data Corporation (Japan), IQVIA Inc. (US), Mphasis (India), Genpact (US), Wipro (India),

Healthcare Payer Services Market in terms of revenue was estimated to be worth $69.9 billion in 2022 and is poised to reach $118.2 Billion by 2027, growing at a CAGR of 11.1% from 2022 to 2027 according to a new report by MarketsandMarkets™. The healthcare payer services market is mainly driven by the increasing health insurance enrolments, rising incidences of healthcare frauds, federal mandates, and rising cases of chronic diseases. However, the risk of data breaches, a loss of managerial control, cultural and language barriers, and high costs associated with outsourcing are expected to restrain the growth of this market to a certain extent.

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"BPO services type segment is expected to account for the largest share of the healthcare payer services market in 2022"

Based on service type, the healthcare payer services market is bifurcated into ITO services, BPO services and KPO services. In 2022, the BPO services segment is expected to hold the largest market share. The large share of this segment is primarily attributed to the fact that BPO services can help payers reduce operational costs by outsourcing administrative and non-core functions such as claims processing, member enrolment, and customer support to specialized BPO service providers. This allows payers to focus on their core business of providing healthcare coverage and managing risk.

"Private payers segment to grow at the highest CAGR in the healthcare payer services market during the forecast period, by end user"

Based on end user, the healthcare payer services market is bifurcated into private payers & public payers. In 2022, the private payers segment is expected to account for the largest market share of the healthcare payer services market. During the forecast period, the private payers' segment is expected to grow at the highest CAGR. The high growth of this segment is attributed the increasing adoption of private health insurance by individuals and employers, along with advancements in technology and the need for better healthcare services and rising competitiveness among private payers.

"North America is expected to hold the largest share of the healthcare payer services market in 2022"

Based on region, the healthcare payer services market is divided into North America, Europe, Asia Pacific, and the Rest of the World (RoW). Factors such as rise in insurance enrolments due to PPACA, federal healthcare mandates to drive the demand for outsourcing of services, rising healthcare costs, increasing chronic disease prevalence, technological advancements, shifting consumer preferences, and rising need to curb healthcare expenditure are driving the growth in North American market.

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Healthcare Payer Services Market Dynamics:

Drivers:

Outsourcing: a cost-effective solution for healthcare payers
Federal mandates in the U.S. increasing payer workload
Increasing healthcare fraud
Dynamic nature of health benefit plan designs
In-house shortage of skilled personnel

Restraints:

Rising incidences of data breaches and loss of confidentiality
Unforeseen costs associated with outsourcing
Loss of managerial control

Opportunities:

Advanced data analytics
Switching to ICD-10 standards
Service portfolio expansion

Challenges:

Migration from legacy systems
Cultural differences and language barriers

Key Market Players:

Prominent players in this market include, Cognizant (US), Tata Consultancy Services (India), XEROX Corporation (US), WNS (Holdings) Limited (India), NTT Data Corporation (Japan), IQVIA Inc. (US), Mphasis (India), Genpact (US), Wipro (India), Infosys BPM (India), Firstsource Solutions (India), IBM Corporation (US), HCL Technologies (India), Solutions (US), Lonza (Switzerland), Omega Healthcare (India), R1 RCM, INC. (US), Invensis Technologies (India), UnitedHealth Group (US), Sykes Enterprises (US), Paraxel Corporation International (US), Access Healthcare (US), and Akurate Management Solutions (US).

Recent Developments

In July 2021, Cognizant (US) collaborated with Royal Philips (Netherlands) to create Philips HealthSuite, a cloud-based platform, to deliver and maintain leading-edge digital health solutions, providing advanced connectivity and using big data to create actionable insights.

In April 2021, Xerox Corporation (US) acquired Groupe CT (Canada), an independent document management provider in Eastern Canada, to accelerate a digital transformation roadmap by combining its document management services expertise and leadership with Xerox's portfolio of workplace solutions to expand its reach in the North American market.

In June 2018, WNS (Holdings) Limited (India) entered into a global shared services partnership with Hyperion Insurance Group (UK), which enabled WNS to highlight its position as an industry leader in high-end global insurance BPM.

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Healthcare Payer Services Market Advantages:

Increased Efficiency: Healthcare payer services can provide more efficient services through automation and the use of advanced technologies, such as data analysis and machine learning. This can help to improve the accuracy of claims processing, reduce costs, and improve overall administrative efficiency.

Improved Customer Service: Healthcare payer services can help to improve customer service by providing more comprehensive and accurate customer service. These services can also help to simplify billing and payment processes, as well as providing additional information and support to customers.

Cost Reduction: Healthcare payer services can help to reduce costs by streamlining processes, reducing paperwork, and automating claims processing. This can help to reduce overhead costs and improve profitability.

Risk Management: Healthcare payer services can help to reduce risk by providing improved data analysis and fraud detection capabilities. This can help to identify potential risks and take appropriate measures to mitigate them.

Increased Transparency: Healthcare payer services can help to provide more transparency into the healthcare system. This can help to ensure that the decisions being made are fair and accurate, and that all stakeholders are informed of any changes or updates.

Healthcare Payer Services Market - Report Highlights:

The updated version of the report covers the historical market for the healthcare payer services market for the years 2020 and 2021, the estimated market for 2022, and the forecast for 2027, along with CAGR from 2022 to 2027.

The new research study consists of industry trends of the market, value chain analysis, and ecosystem analysis.

The new research study consists of pricing analysis, porters five forces analysis, regulatory analysis, case study analysis, technology analysis

The new research study consists of conferences and webinars, key stakeholders, and buying behavior in the market

The new research study consists of the revenue share analysis

The new research study consists of competitive benchmarking.

Updated financial information/service portfolio of players: The new edition of the report provides updated financial information in the context of the healthcare payer services market from 2019 to 2021 for each listed company in a graphical representation.

Updated market developments of profiled players: The current report includes the market developments from 2019 to 2022.

The competitive landscape chapter has been updated with the market evaluation matrix of major players.

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