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- Global Healthcare Payer Services Market – Size, Outlook, Trends and Forecast (2023 – 2030)
Healthcare payer services are services that are outsourced by healthcare insurance payers and providers to provide better quality patient care by reducing costs and improving customer communication. The global healthcare payer services market is expected to reach $37.3 Billion by 2024 from $14.8 Billion in 2017, at a CAGR of 12.3% during the forecast period. Drivers that are influencing the market are increasing healthcare fraud and the dynamic nature of health benefit plan designs which helps to boost the market growth. Loss of managerial control and cultural differences and language barriers are the factors hampering the market growth. Major opportunities in this market are service portfolio expansion and switching to icd-10 standards which helps in market demand in future.
Research Study Objectives:
- Define, estimate, and forecast the Healthcare Payer Services market statistics by services type, end user, application areas, and regions concerning the individual growth drivers, market trends and their contribution toward the Healthcare Payer Services market growth
- Provides comprehensive information regarding the key factors influencing the market growth (Drivers, Restraints & Challenges, and Opportunities)
- Estimate & forecast the market size of all the segments concerning geographies including North America, Europe, Asia Pacific (APAC), South America and the Middle East and Africa (MEA).
- Recent competitive developments including M&A (Mergers and Acquisitions), Partnerships, and Product Innovations are provided in the Healthcare Payer Services Market Analysis
- Analysis and conclusions on the future Healthcare Payer Services market outlook.
Top-down and bottom-up approaches are used to validate the Healthcare Payer Services Market Size and are used to estimate the size of other dependent submarkets. Key players in the market are identified through various secondary sources; databases including Bloomberg Businessweek, Hoovers, Factiva, journals and associations and the market revenues are estimated and are thoroughly validated through primary and secondary research. Secondary research involves the study of annual and financial reports of top players in the market, whereas primary research includes extensive interviews with the KoL’s such as CEOs, directors, board members, VP’s, sales managers, engineers, marketing executives, technicians, account managers, investors, strategic decision makers and others. The Healthcare Payer Services Market shares and breakdowns are determined using secondary sources and are verified by the primary sources. All possible parameters/factors that are affecting the Healthcare Payer Services market demand are covered in the research study are verified through primary research, analysed and interpreted to get the final qualitative and quantitative data. This data is collected and added with detailed analysis from Envision Inteligence and presented in this report.
The scope of the Report
The Healthcare Payer Services market segmentation is as follows:
By Service Type
- Business process outsourcing services
- Information technology outsourcing services
- Knowledge process outsourcing services
By Application
- Claims management services
- Integrated front-end services and back-office operations
- Member management services
- Provider management services
- Billing and accounts management services
- Analytics and fraud management services
- HR Services
By End User
- Private payers
- Public payers
Geographical Analysis:
Healthcare payer services market is segmented by geography into North America, South America, Europe, APAC and Middle East & Africa. U.S., Canada, Mexico and Costa Rica are analysed under North American region which is usually turning as the hotspot in the market. The South American region is further segregated into Brazil, Argentina, Chile, Columbia and some other emerging economies. In Europe, the market is extensively examined by covering U.K., Germany, France, Italy, Spain, Netherlands, Poland, Switzerland and some other promising economies. APAC is further categorised by countries into China, India, Japan, South Korea, Australia & New Zealand, Malaysia, Singapore and many other emerging nations. In the Middle East & African region, Saudi Arabia, UAE, Iran, Iraq, Qatar, South Africa, Algeria, Morocco, Nigeria and so on countries are evaluated to understand the market growth lucidly.
Customization Options:
With the given research report, Envision Inteligence offers customisations as per the client’s specific requirements. The following customisation options offered for the Healthcare Payer Services Market include:
- Scope Revision
- Geographic Analysis
- Company Profiles
- Historical Data & Forecasting
- Key Contact Persons in companies
Global Healthcare Payer Services Market Research Report Includes:
- An executive summary condensing the whole report such that essential authority can rapidly twist up doubtlessly acquainted with brief overview and conclusion.
- To have a complete market analysis through industry value chain analysis, Porter’s Five Force Model, PESTLE, SWOT analysis, and Y-o-Y analysis.
- Regional and global diversity is analysed with the major countries and the unions. Scrutinizing the revenue generation on Year-On-Year
- Identifying DROC in the current market and their impact on altering market dynamics.
- Competitive landscape analysis to identify the merger and acquisition which will have a comparative financial study with significant competitors.
- Expertise investment opportunities by an analyst to the individual and organisation to have a better foothold in the market.
- Identify the latest developments, market shares and strategies that are employed by the significant Healthcare Payer Services market players, such as
- Cognizant Technology Solutions.
- Accenture PLC
- Concentrix Corporation.
- Dell, Inc.
- Xerox Corporation.
- Along with these companies, many other companies are considered in the report while analysing the Global Healthcare Payer Services competitive strategies and environment. These companies held substantial share-owning to the nature of the industry whereas, the rest of the market shares are marginal chunks to regional and local level manufacturers. Other players also have considerable presence owing to its robust brand image, geographical reach and stable customer base.
CHAPTER 1 INTRODUCTION
1.1. Market Definition
1.2. Executive Summary
1.3. The Scope of the Study
CHAPTER 2 RESEARCH METHODOLOGY
2.1. Secondary Research
2.2. Primary Research
2.3. Analytic Tools and Model
2.4. Economic Indicator
2.4.1. Base Year, Base Currency, Forecasting Period
2.5. Expert Validation
2.6. Study Timeline
CHAPTER 3 MARKET ANALYSIS
3.1. Industry Value Chain Analysis
3.2. Porter’s Five Force Analysis
3.2.1. Bargaining Power of Buyers
3.2.2. Bargaining Power of Suppliers
3.2.3. Threats of Substitutes
3.2.4. Threats of New Entrants
3.2.5. Degree of Competition
3.3. PESTLE Analysis
3.3.1. Political
3.3.2. Economical
3.3.3. Social
3.3.4. Technological
3.3.5. Legal
3.3.6. Environmental
3.4. SWOT Analysis
3.4.1. Strengths
3.4.2. Weakness
3.4.3. Opportunities
3.4.4. Threats
3.5. Y-O-Y Analysis
CHAPTER 4 MARKET DYNAMICS
4.1. Market Drivers
4.1.1. Increasing healthcare frauds
4.1.2. In-house shortage of skilled personnel
4.1.3. Dynamic nature of health benefit plan designs
4.1.4. Federal mandates in the U.S increasing payer workload
4.2. Market Restraints & Challenges
4.2.1. Loss of managerial control
4.2.2. Rising incidences of data breaches and loss of confidentiality
4.3. Market Opportunities
4.3.1. Service portfolio expansion
4.3.2. Switching to icd-10 standards
4.3.3. Advanced Data Analytics
CHAPTER 5 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY SERVICE TYPE
5.1. Introduction
5.2. Business process outsourcing services
5.3. Information technology outsourcing services
5.4. Knowledge process outsourcing services
CHAPTER 6 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY APPLICATION
6.1 Introduction
6.2 Claims management services
6.2.1 Claims adjudication services
6.2.2 Claims settlement
6.2.3 Information management services
6.2.4 Claims repricing
6.2.5 Claims investigation services
6.2.6 Claims indexing services
6.2.7 Litigation management
6.3 Integrated front-end services and back-office operations
6.4 Member management services
6.5 Provider management services
6.6 Billing and accounts management services
6.7 Analytics and fraud management services
6.8 HR Services
CHAPTER 7 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY END USER
7.1 Introduction
7.2 Private Payers
7.3 Public Payers
CHAPTER 8 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY GEOGRAPHY
8.1. Introduction
8.2. North America
8.2.1. U.S.
8.2.2. Canada
8.2.3. Mexico
8.2.4. Costa Rica
8.3. South America
8.3.1. Brazil
8.3.2. Argentina
8.3.3. Chile
8.3.4. Columbia
8.3.5. Others
8.4. Europe
8.4.1. U.K.
8.4.2. Germany
8.4.3. France
8.4.4. Italy
8.4.5. Spain
8.4.6. Russia
8.4.7. Netherlands
8.4.8. Switzerland
8.4.9. Poland
8.4.10. Others
8.5. Asia Pacific
8.5.1. China
8.5.2. Japan
8.5.3. India
8.5.4. South Korea
8.5.5. Australia & New Zealand
8.5.6. Malaysia
8.5.7. Singapore
8.5.8. Others
8.6. Middle East & Africa
8.6.1. UAE
8.6.2. Saudi Arabia
8.6.3. Iran
8.6.4. Iraq
8.6.5. Qatar
8.6.6. South Africa
8.6.7. Algeria
8.6.8. Morocco
8.6.9. Nigeria
8.6.10. Egypt
8.6.11. Others
CHAPTER 9 GLOBAL HEALTHCARE PAYER SERVICES MARKET – COMPANY PROFILES
9.1. Cognizant Technology Solutions
9.2. Accenture PLC
9.3. Exlservice Holdings, Inc.
9.4. Concentrix Corporation
9.5. Dell, Inc.
9.6. Hinduja Global Solutions Limited.
9.7. Xerox Corporation.
9.8. The Hewlett-Packard Company.
9.9. Genpact Limited.,
9.10. HCL Technologies Ltd.
9.11. Wipro Limited.
9.12. Tele performance Group.
9.13. Hexa ware Technologies Limited
9.14. First Source Solutions Limited
9.15. CenturyLink, Inc.
CHAPTER 10 GLOBAL HEALTHCARE PAYER SERVICES MARKET – COMPETITIVE LANDSCAPE
10.1. Market Share Analysis
10.2. Strategies adopted by top companies
10.3. Mergers, Acquisitions, Collaborations & Agreements
CHAPTER 11 MARKET INSIGHTS
11.1. Industry Experts Insights
11.2. Analysts Opinions
11.3. Investment Opportunities
CHAPTER 12 APPENDIX
12.1. List of Tables
12.2. List of Figures
- Competitive Analysis in marketing and strategic management is an assessment of the strengths and weaknesses of current and potential competitors.
- Monitoring the external and internal factors which affect the market dynamics with the aid of PESTLE analysis.
- The Regional and Global Variety is taken care of in the report.
- Year on Year basis generation of revenue is studied.
- Porter's Five Forces analyze the intensity of competition in an industry and its profitability level.
- The overview and the sustainability of the market are analyzed through SWOT.
- DROC (Drivers, Restraints, Opportunities and Challenges) is recognized in the current market scenario and see how its effect on market dynamics.
- The segment-level analysis in terms of type and technology.
- The value chain analysis, value that's created and captured by a company is the profit margin.
- Value Created and Captured – Cost of Creating that Value = Margin
- An executive summary consists of the whole report and the outcome is been given in the report to have brief knowledge about the report.
- Basis on the depth of the study we approach using analytical tools
- Expertise investment opportunities are given after analyzing the market to give the organization and the individual to have perfect knowledge about the market.
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Additional information
Report Type | Extensive Report, Miniature report, Snapshot Report |
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Licence | Single User License, Team License, Corporate License |
Healthcare payer services are services that are outsourced by healthcare insurance payers and providers to provide better quality patient care by reducing costs and improving customer communication. The global healthcare payer services market is expected to reach $37.3 Billion by 2024 from $14.8 Billion in 2017, at a CAGR of 12.3% during the forecast period. Drivers that are influencing the market are increasing healthcare fraud and the dynamic nature of health benefit plan designs which helps to boost the market growth. Loss of managerial control and cultural differences and language barriers are the factors hampering the market growth. Major opportunities in this market are service portfolio expansion and switching to icd-10 standards which helps in market demand in future.
Research Study Objectives:
- Define, estimate, and forecast the Healthcare Payer Services market statistics by services type, end user, application areas, and regions concerning the individual growth drivers, market trends and their contribution toward the Healthcare Payer Services market growth
- Provides comprehensive information regarding the key factors influencing the market growth (Drivers, Restraints & Challenges, and Opportunities)
- Estimate & forecast the market size of all the segments concerning geographies including North America, Europe, Asia Pacific (APAC), South America and the Middle East and Africa (MEA).
- Recent competitive developments including M&A (Mergers and Acquisitions), Partnerships, and Product Innovations are provided in the Healthcare Payer Services Market Analysis
- Analysis and conclusions on the future Healthcare Payer Services market outlook.
Top-down and bottom-up approaches are used to validate the Healthcare Payer Services Market Size and are used to estimate the size of other dependent submarkets. Key players in the market are identified through various secondary sources; databases including Bloomberg Businessweek, Hoovers, Factiva, journals and associations and the market revenues are estimated and are thoroughly validated through primary and secondary research. Secondary research involves the study of annual and financial reports of top players in the market, whereas primary research includes extensive interviews with the KoL’s such as CEOs, directors, board members, VP’s, sales managers, engineers, marketing executives, technicians, account managers, investors, strategic decision makers and others. The Healthcare Payer Services Market shares and breakdowns are determined using secondary sources and are verified by the primary sources. All possible parameters/factors that are affecting the Healthcare Payer Services market demand are covered in the research study are verified through primary research, analysed and interpreted to get the final qualitative and quantitative data. This data is collected and added with detailed analysis from Envision Inteligence and presented in this report.
The scope of the Report
The Healthcare Payer Services market segmentation is as follows:
By Service Type
- Business process outsourcing services
- Information technology outsourcing services
- Knowledge process outsourcing services
By Application
- Claims management services
- Integrated front-end services and back-office operations
- Member management services
- Provider management services
- Billing and accounts management services
- Analytics and fraud management services
- HR Services
By End User
- Private payers
- Public payers
Geographical Analysis:
Healthcare payer services market is segmented by geography into North America, South America, Europe, APAC and Middle East & Africa. U.S., Canada, Mexico and Costa Rica are analysed under North American region which is usually turning as the hotspot in the market. The South American region is further segregated into Brazil, Argentina, Chile, Columbia and some other emerging economies. In Europe, the market is extensively examined by covering U.K., Germany, France, Italy, Spain, Netherlands, Poland, Switzerland and some other promising economies. APAC is further categorised by countries into China, India, Japan, South Korea, Australia & New Zealand, Malaysia, Singapore and many other emerging nations. In the Middle East & African region, Saudi Arabia, UAE, Iran, Iraq, Qatar, South Africa, Algeria, Morocco, Nigeria and so on countries are evaluated to understand the market growth lucidly.
Customization Options:
With the given research report, Envision Inteligence offers customisations as per the client’s specific requirements. The following customisation options offered for the Healthcare Payer Services Market include:
- Scope Revision
- Geographic Analysis
- Company Profiles
- Historical Data & Forecasting
- Key Contact Persons in companies
Global Healthcare Payer Services Market Research Report Includes:
- An executive summary condensing the whole report such that essential authority can rapidly twist up doubtlessly acquainted with brief overview and conclusion.
- To have a complete market analysis through industry value chain analysis, Porter’s Five Force Model, PESTLE, SWOT analysis, and Y-o-Y analysis.
- Regional and global diversity is analysed with the major countries and the unions. Scrutinizing the revenue generation on Year-On-Year
- Identifying DROC in the current market and their impact on altering market dynamics.
- Competitive landscape analysis to identify the merger and acquisition which will have a comparative financial study with significant competitors.
- Expertise investment opportunities by an analyst to the individual and organisation to have a better foothold in the market.
- Identify the latest developments, market shares and strategies that are employed by the significant Healthcare Payer Services market players, such as
- Cognizant Technology Solutions.
- Accenture PLC
- Concentrix Corporation.
- Dell, Inc.
- Xerox Corporation.
- Along with these companies, many other companies are considered in the report while analysing the Global Healthcare Payer Services competitive strategies and environment. These companies held substantial share-owning to the nature of the industry whereas, the rest of the market shares are marginal chunks to regional and local level manufacturers. Other players also have considerable presence owing to its robust brand image, geographical reach and stable customer base.
CHAPTER 1 INTRODUCTION
1.1. Market Definition
1.2. Executive Summary
1.3. The Scope of the Study
CHAPTER 2 RESEARCH METHODOLOGY
2.1. Secondary Research
2.2. Primary Research
2.3. Analytic Tools and Model
2.4. Economic Indicator
2.4.1. Base Year, Base Currency, Forecasting Period
2.5. Expert Validation
2.6. Study Timeline
CHAPTER 3 MARKET ANALYSIS
3.1. Industry Value Chain Analysis
3.2. Porter’s Five Force Analysis
3.2.1. Bargaining Power of Buyers
3.2.2. Bargaining Power of Suppliers
3.2.3. Threats of Substitutes
3.2.4. Threats of New Entrants
3.2.5. Degree of Competition
3.3. PESTLE Analysis
3.3.1. Political
3.3.2. Economical
3.3.3. Social
3.3.4. Technological
3.3.5. Legal
3.3.6. Environmental
3.4. SWOT Analysis
3.4.1. Strengths
3.4.2. Weakness
3.4.3. Opportunities
3.4.4. Threats
3.5. Y-O-Y Analysis
CHAPTER 4 MARKET DYNAMICS
4.1. Market Drivers
4.1.1. Increasing healthcare frauds
4.1.2. In-house shortage of skilled personnel
4.1.3. Dynamic nature of health benefit plan designs
4.1.4. Federal mandates in the U.S increasing payer workload
4.2. Market Restraints & Challenges
4.2.1. Loss of managerial control
4.2.2. Rising incidences of data breaches and loss of confidentiality
4.3. Market Opportunities
4.3.1. Service portfolio expansion
4.3.2. Switching to icd-10 standards
4.3.3. Advanced Data Analytics
CHAPTER 5 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY SERVICE TYPE
5.1. Introduction
5.2. Business process outsourcing services
5.3. Information technology outsourcing services
5.4. Knowledge process outsourcing services
CHAPTER 6 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY APPLICATION
6.1 Introduction
6.2 Claims management services
6.2.1 Claims adjudication services
6.2.2 Claims settlement
6.2.3 Information management services
6.2.4 Claims repricing
6.2.5 Claims investigation services
6.2.6 Claims indexing services
6.2.7 Litigation management
6.3 Integrated front-end services and back-office operations
6.4 Member management services
6.5 Provider management services
6.6 Billing and accounts management services
6.7 Analytics and fraud management services
6.8 HR Services
CHAPTER 7 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY END USER
7.1 Introduction
7.2 Private Payers
7.3 Public Payers
CHAPTER 8 GLOBAL HEALTHCARE PAYER SERVICES MARKET – BY GEOGRAPHY
8.1. Introduction
8.2. North America
8.2.1. U.S.
8.2.2. Canada
8.2.3. Mexico
8.2.4. Costa Rica
8.3. South America
8.3.1. Brazil
8.3.2. Argentina
8.3.3. Chile
8.3.4. Columbia
8.3.5. Others
8.4. Europe
8.4.1. U.K.
8.4.2. Germany
8.4.3. France
8.4.4. Italy
8.4.5. Spain
8.4.6. Russia
8.4.7. Netherlands
8.4.8. Switzerland
8.4.9. Poland
8.4.10. Others
8.5. Asia Pacific
8.5.1. China
8.5.2. Japan
8.5.3. India
8.5.4. South Korea
8.5.5. Australia & New Zealand
8.5.6. Malaysia
8.5.7. Singapore
8.5.8. Others
8.6. Middle East & Africa
8.6.1. UAE
8.6.2. Saudi Arabia
8.6.3. Iran
8.6.4. Iraq
8.6.5. Qatar
8.6.6. South Africa
8.6.7. Algeria
8.6.8. Morocco
8.6.9. Nigeria
8.6.10. Egypt
8.6.11. Others
CHAPTER 9 GLOBAL HEALTHCARE PAYER SERVICES MARKET – COMPANY PROFILES
9.1. Cognizant Technology Solutions
9.2. Accenture PLC
9.3. Exlservice Holdings, Inc.
9.4. Concentrix Corporation
9.5. Dell, Inc.
9.6. Hinduja Global Solutions Limited.
9.7. Xerox Corporation.
9.8. The Hewlett-Packard Company.
9.9. Genpact Limited.,
9.10. HCL Technologies Ltd.
9.11. Wipro Limited.
9.12. Tele performance Group.
9.13. Hexa ware Technologies Limited
9.14. First Source Solutions Limited
9.15. CenturyLink, Inc.
CHAPTER 10 GLOBAL HEALTHCARE PAYER SERVICES MARKET – COMPETITIVE LANDSCAPE
10.1. Market Share Analysis
10.2. Strategies adopted by top companies
10.3. Mergers, Acquisitions, Collaborations & Agreements
CHAPTER 11 MARKET INSIGHTS
11.1. Industry Experts Insights
11.2. Analysts Opinions
11.3. Investment Opportunities
CHAPTER 12 APPENDIX
12.1. List of Tables
12.2. List of Figures
- Competitive Analysis in marketing and strategic management is an assessment of the strengths and weaknesses of current and potential competitors.
- Monitoring the external and internal factors which affect the market dynamics with the aid of PESTLE analysis.
- The Regional and Global Variety is taken care of in the report.
- Year on Year basis generation of revenue is studied.
- Porter's Five Forces analyze the intensity of competition in an industry and its profitability level.
- The overview and the sustainability of the market are analyzed through SWOT.
- DROC (Drivers, Restraints, Opportunities and Challenges) is recognized in the current market scenario and see how its effect on market dynamics.
- The segment-level analysis in terms of type and technology.
- The value chain analysis, value that's created and captured by a company is the profit margin.
- Value Created and Captured – Cost of Creating that Value = Margin
- An executive summary consists of the whole report and the outcome is been given in the report to have brief knowledge about the report.
- Basis on the depth of the study we approach using analytical tools
- Expertise investment opportunities are given after analyzing the market to give the organization and the individual to have perfect knowledge about the market.
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