Healthcare Provider Network Management (HPNM) Market to Reach New Heights, Projected to Grow at 15% CAGR by 2030

The HPNM market is expected grow at a CAGR 15% over the forecast period. The key growth drivers are increasing healthcare costs, increasing demand for efficient healthcare, expanding insurance coverage, and managed care models. Other factors include a shift to digital and cloud-based systems, an increase in value-based health models, and increased adoptions of healthcare IT.

HPNM (Healthcare Provider Network Management) is the management of a network that includes hospitals, physicians, specialists and other medical facilities. It oversees and optimizes this network to ensure high-quality healthcare services at a cost-effective price. This includes contract negotiations, credential validation, performance monitoring and network expansion. It also involves resolving issues, fostering strong relationships with healthcare providers, and resolving issues. A well-managed HPNM helps minimize administrative costs, improve healthcare accessibility, streamline reimbursements and improve patient satisfaction.

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Market growth is boosted by the rise of value-based healthcare models

As healthcare consumerism has grown, it is more important than ever for health plans to maintain patient loyalty, as members will switch providers and networks if they do not receive the care they need. Payers and providers are adopting a value-based healthcare approach to foster loyalty. This model focuses on improving individual patient care, population health management, increasing efficiencies, and reducing cost. Effective provider network management plays a crucial role in enabling value based care. Attracting and retaining the best providers, while providing them with the necessary support, helps to strengthen patient-provider communications and drive better clinical results. This leads to improved member retention and higher overall efficiency. According to a study by the Medical Group Management Association and Humana, 67% of providers think value-based care improves quality of care provided to patients. In addition, 74% of healthcare organisations have added staff and 71% have implemented new technologies to support value-based care. Data analytics and reporting (82%), and population health management tools (57%) are the most commonly adopted technologies. As payers and healthcare providers continue to focus their efforts on improving care coordination, cost-efficiency, and patient satisfaction the demand for HPNM solutions will grow.

HPNM market growth is driven by the adoption of cloud-based solutions and AI-powered solutions

Cloud technology is a cost-effective and secure platform that allows healthcare organizations and payers to manage provider networks. This helps them streamline operations, improve efficiency, and ensure compliance. Cloud-based HPNM software enables real-time data access, automates credentialing, and facilitates seamless communication between payers, healthcare providers, and other stakeholders. Artificial intelligence (AI) is transforming network management through automation of repetitive tasks, prediction of provider performance, and optimization of network utilization. AI-driven analytics can help identify gaps in coverage, assess the quality of care, and detect fraud activities. This leads to better decisions and cost savings. AI-powered virtual assistants and chatbots improve provider engagement while reducing administrative burdens. Modern HPNM systems are becoming more and more dependent on cloud and AI technologies to meet the growing demand for interoperability and data security. Healthcare organizations are investing in technology-driven solutions that improve provider onboarding, claim processing, contract management and compliance tracking. This increasing reliance on cloud and AI-powered software is expected to accelerate HPNM market expansion, making healthcare networks efficient, transparent and patient-centric.

Competitive Landscape Analysis

The global healthcare provider network management market is marked by the presence of established and emerging market players such as Infosys Limited; McKesson Corporation; Mphasis; Optum, Inc.; Atos Syntel Inc.; Cognizant (Trizetto); OSPLabs; Centene Corporation; Virtusa Corp.; Appian; Andros; Salesforce.com, Inc.; Change Healthcare; Avenga; Assured; and Certify among others. Some of the key strategies adopted by market players include new product development, strategic partnerships and collaborations, and investments.

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Market Segmentation

This report by Medi-Tech Insights provides the size of the global healthcare provider network management market at the regional- and country-level from 2023 to 2030. The report further segments the market based on component, delivery mode, and end user.

Market Size & Forecast (2023-2030), By Component, USD Million

Software
Services

Market Size & Forecast (2023-2030), By Delivery Mode, USD Million

On-Premises Delivery Mode
Cloud-Based Delivery Mode

Market Size & Forecast (2023-2030), By End User, USD Million

Private Health Insurance
Public Health Insurance
Healthcare Payers
Others

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About Medi-Tech Insights

Medi-Tech Insights is a healthcare-focused business research & insights firm. Our clients include Fortune 500 companies, blue-chip investors & hyper-growth start-ups. We have completed 100+ projects in Digital Health, Healthcare IT, Medical Technology, Medical Devices & Pharma Services in the areas of market assessments, due diligence, competitive intelligence, market sizing and forecasting, pricing analysis & go-to-market strategy. Our methodology includes rigorous secondary research combined with deep-dive interviews with industry-leading CXO, VPs, and key demand/supply side decision-makers.

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