The global healthcare payer solution market is anticipated to grow at a CAGR of around 10.2% during the forecast period 2020 to 2027 and to reach around US$ 41.8 Bn by 2027.
Market Dynamics
Increasing healthcare cost across the globe and rising awareness among consumers related to health insurance and are major factors expected to drive the growth of global market. In addition, high government spending on development of present healthcare sector and adoption of IT solution in order to implement various healthcare reforms this is expected to augment the growth of target market.
Major players focus on business expansion through strategic acquisition in order to enhance the customer base is another factors expected to augment the growth of target market.
In 2020, emids, a provider of digital engineering and transformation solutions to healthcare and life sciences industry acquired FlexTech company the deals with information technology consulting and has expertise in leading payer core administration and population health platforms. The acquisition is expected to help the company to expanded channel partnership opportunities among leading core platform vendors and position.
In 2019, Centauri Health Solutions a global provider of innovative healthcare technology and services acquired HCFS, Inc. a provider of self-pay management solutions. This acquisition is expected to help the company to enhance its market leadership in hospital revenue cycle optimization services.
In 2020, Discovery Health Partners, a global industry expert focused on helping healthcare payers solve payment and revenue integrity challenges acquired Consova’s payment integrity business. This is expected to help the company to enhance the revenue share and data mining expertise and capabilities.
In 2019, Conduent Inc. a global company that acts as a provider of business process services with expertise in transaction-intensive processing and analytics acquired Health Solutions Plus (HSP), a software provider of healthcare payer administration solutions. This is expected to help the company to better serve current and prospective commercial and government payer clients with core administration processing technology.
In 2016, WIPRO a leading global information technology, consulting and business process services acquired HealthPlan Services an independent technology and Business Process as a Service (BPaaS) provider in the U.S. Health Insurance market. This acquisition helped the company to strengthen its position in US market.
However, factor such as risk of data breach and unforeseen costs associated with outsourcing are expected to hamper the growth of global healthcare payer solution market. In addition, migration from legacy system is another factor expected to challenge the growth of target market.
Major players focus on adoption of advanced analytics and approach towards increasing the service portfolio are factors expected to create new opportunities for players operating in the target market over the forecast period. In addition, rising public-private partnership is expected to revenue support the growth of target market.
Segment Analysis by Region
The market in North America is expected to account for major revenue share due to high healthcare cost. In addition, rising awareness among consumers related to insurance is expected to support the growth of regional market.
Increasing merger and acquisition activities by major players on order to enhance the customer base and focus on increasing the product portfolio this are among factors expected to augment the growth of target market.
Competitive Landscape
The global market is high highly competitive due to presence of large number of players and innovative product offerings. In addition, business expansion activities through partnerships and agreements are factors expected to further increase the competition.
Report coverage
Market
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Global Healthcare Payer Solution Market
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Analysis Period
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2016 – 2027
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Base Year
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2019
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Forecast Data
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2020 – 2027
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Market Stratification
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Service, Application, End Use and Geography
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Regional Scope
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North America, Europe, Asia Pacific, Latin America, and Middle East & Africa
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Report Coverage
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Market Trends, Drivers, Restraints, Competitive Analysis, Player Profiling, Regulation Analysis
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Healthcare Payer Solution Market Segment Analysis, 2019
The global market is segmented into service, application, and end use. The service segment is expected to further bifurcate into business process outsourcing services, information technology outsourcing services, and knowledge process outsourcing services. Among the service segment the business process outsourcing services segment is expected to account for major revenue share.
The application segment is further divided into pharmacy audit & analysis systems, claims management services, fraud management services, computer-assisted coding (CAC) systems, member eligibility management services, provider network management services, and others.
The players profiled in the report are McKesson Corporation, HMS Holdings Corp, International Business Machines Corporation, Change Healthcare, Inc., Accenture plc, Cognizant Technology Solutions Corporation, Hinduja Global Solutions Limited, UnitedHealth Group Incorporated, Inovalon Holdings, Inc., and Wipro Limited.
Market Segmentation
Market By Service
Business Process Outsourcing Services
Information Technology Outsourcing Services
Knowledge Process Outsourcing Services
Market By Application
Pharmacy Audit & Analysis Systems
Claims Management Services
Fraud Management Services
Computer-assisted Coding (CAC) Systems
Member Eligibility Management Services
Provider Network Management Services
Others
Market By End Use
Private Provider
Public Provider
Market By Region
North America
Europe
- U.K.
- Germany
- France
- Spain
- Rest of Europe
Asia-Pacific
- China
- Japan
- India
- Australia
- South Korea
- Rest of Asia-Pacific
Latin America
- Brazil
- Mexico
- Rest of Latin America
Middle East & Africa
- GCC
- South Africa
- Rest of Middle East & Africa
Chapter 1. Industry Overview of Healthcare Payer Solution
1.1 Definition and Scope
1.1.1 Definition of Healthcare Payer Solution
1.1.2 Market Segmentation
1.1.3 Years Considered for the Study
1.1.4 Assumptions and Acronyms Used
1.1.4.1 Market Assumptions and Market Forecast
1.1.4.2 Acronyms Used In Global Healthcare Payer Solution Market
1.2 Summary
1.2.1 Executive Summery
1.2.2 Healthcare Payer Solution Market By Service
1.2.3 Global Healthcare Payer Solution Market By Application
1.2.4 Global Healthcare Payer Solution Market By End Use
1.2.5 Global Healthcare Payer Solution Market by Regions
Chapter 2. Research Approach
2.1 Methodology
2.1.1 Research Programs/By End Use
2.1.2 Market Size Estimation
2.1.3 Market Breakdown and Data Triangulation
2.2 Data Source
2.2.1 Secondary Sources
2.2.2 Primary Sources
Chapter 3. Market Dynamics and Competition Analysis
3.1 Market Drivers
3.1.1 Driver 1
3.1.2 Driver 2
3.2 Restraints and Challenges
3.2.1 Restraint 1
3.2.2 Restraint 2
3.3 Growth Opportunities
3.3.1 Opportunity 1
3.3.2 Opportunity 2
3.4 Porter’s Five Forces Analysis
3.4.1 Bargaining Power of Suppliers
3.4.2 Bargaining Power of Buyers
3.4.3 Threat of Substitute
3.4.4 Threat of New Entrants
3.4.5 Degree of Competition
3.5 Value Chain Analysis
3.6 Regulatory Compliance
3.7 Competitive Landscape, 2019
3.7.1 Player Positioning Analysis
3.7.2 Key Strategies Adopted By Leading Players
Chapter 4. Healthcare Payer Solution Market By Service
4.1 Introduction
4.2 Global Healthcare Payer Solution Revenue (US$ Mn) by Service
4.2.1 Global Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 – 2027
4.2.2 Business Process Outsourcing Services
4.2.2.1 Business Process Outsourcing Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
4.2.3 Information Technology Outsourcing Services
4.2.3.1 Information Technology Outsourcing Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
4.2.4 Knowledge Process Outsourcing Services
4.2.4.1 Knowledge Process Outsourcing Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
4.3 Market Attractive Analysis By Service 2019
Chapter 5. Healthcare Payer Solution Market By Application
5.1 Introduction
5.2 Global Healthcare Payer Solution Revenue (US$ Mn) by Application
5.2.1 Global Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 – 2027
5.2.2 Pharmacy Audit & Analysis Systems
5.2.2.1 Pharmacy Audit & Analysis Systems Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.2.3 Claims Management Services
5.2.3.1 Claims Management Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.2.4 Fraud Management Services
5.2.4.1 Fraud Management Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.2.5 Computer-assisted Coding (CAC) Systems
5.2.5.1 Computer-assisted Coding (CAC) Systems Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.2.6 Member Eligibility Management Services
5.2.6.1 Member Eligibility Management Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.2.7 Provider Network Management Services
5.2.7.1 Provider Network Management Services Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.2.8 Others
5.2.8.1 Others Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
5.3 Market Attractive Analysis By Application 2019
Chapter 6. Healthcare Payer Solution Market By End Use
6.1 Introduction
6.2 Global Healthcare Payer Solution Revenue (US$ Mn) by End Use
6.2.1 Global Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 – 2027
6.2.2 Private Provider
6.2.2.1 Private Provider Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
6.2.3 Public Provider
6.2.3.1 Public Provider Market Revenue (US$ Mn) and Growth Rate (%), 2016 - 2027
6.3 Market Attractive Analysis By End Use 2019
Chapter 7. North America Healthcare Payer Solution Market By Country
7.1 North America Healthcare Payer Solution Market Overview
7.2 U.S.
7.2.1 U.S. Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
7.2.2 U.S. Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
7.2.3 U.S. Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
7.3 Canada
7.3.1 Canada Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
7.3.2 Canada Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
7.3.3 Canada Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
7.4 North America PEST Analysis
Chapter 8. Europe Healthcare Payer Solution Market By Country
8.1 Europe Healthcare Payer Solution Market Key Overview
8.2 UK
8.2.1 UK Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
8.2.2 UK Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
8.2.3 UK Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
8.3 Germany
8.3.1 Germany Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
8.3.2 Germany Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
8.3.3 Germany Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
8.4 France
8.4.1 France Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
8.4.2 France Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
8.4.3 France Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
8.5 Spain
8.5.1 Spain Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
8.5.2 Spain Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
8.5.3 Spain Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
8.6 Rest of Europe
8.6.1 Rest of Europe Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
8.6.2 Rest of Europe Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
8.6.3 Rest of Europe Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
8.7 Europe PEST Analysis
Chapter 9. Asia-Pacific Healthcare Payer Solution Market By Country
9.1 Asia Pacific Healthcare Payer Solution Market Overview
9.2 China
9.2.1 China Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
9.2.2 China Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
9.2.3 China Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
9.3 Japan
9.3.1 Japan Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
9.3.2 Japan Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
9.3.3 Japan Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
9.4 India
9.4.1 India Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
9.4.2 India Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
9.4.3 India Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
9.5 Australia
9.5.1 Australia Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
9.5.2 Australia Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
9.5.3 Australia Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
9.6 South Korea
9.6.1 South Korea Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
9.6.2 South Korea Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
9.6.3 South Korea Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
9.7 Rest of Asia-Pacific
9.7.1 Rest of Asia Pacific Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
9.7.2 Rest of Asia Pacific Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
9.7.3 Rest of Asia Pacific Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
9.8 Asia Pacific PEST Analysis
Chapter 10. Latin America Healthcare Payer Solution Market By Country
10.1 Latin America Healthcare Payer Solution Market Overview
10.2 Brazil
10.2.1 Brazil Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
10.2.2 Brazil Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
10.2.3 Brazil Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
10.3 Mexico
10.3.1 Mexico Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
10.3.2 Mexico Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
10.3.3 Mexico Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
10.4 Rest of Latin America
10.4.1 Rest of Latin America Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
10.4.2 Rest of Latin America Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
10.4.3 Rest of Latin America Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
10.5 Latin America PEST Analysis
Chapter 11. Middle East & Africa Healthcare Payer Solution Market By Country
11.1 Middle East & Africa Healthcare Payer Solution Market Overview
11.2 Saudi Arabia
11.2.1 Saudi Arabia Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
11.2.2 Saudi Arabia Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
11.2.3 Saudi Arabia Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
11.3 UAE
11.3.1 UAE Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
11.3.2 UAE Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
11.3.3 UAE Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
11.4 Rest of Middle East & Africa
11.4.1 Rest of Middle East & Africa Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Service, 2016 - 2027
11.4.2 Rest of Middle East & Africa Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By Application, 2016 - 2027
11.4.3 Rest of Middle East & Africa Healthcare Payer Solution Market Revenue (US$ Mn) and Forecast By End Use, 2016 - 2027
11.5 Middle East & Africa PEST Analysis
Chapter 12. Player Analysis of Healthcare Payer Solution
12.1 Global Healthcare Payer Solution Market Company Share Analysis
12.2 Competition Matrix
12.2.1 Competitive Benchmarking of key players by price, presence, market share, and R&D investment
12.2.2 New Product Launches and Product Enhancements
12.2.3 Mergers And Acquisition In Global Stroke Management Market
12.2.4 Partnership, Joint Ventures and Strategic Alliances/ Sales Agreements
Chapter 13. Company Profile
13.1 McKesson Corporation
13.1.1 Company Snapshot
13.1.2 Business Overview
13.1.3 Financial Overview
13.1.3.1 Revenue (US$ Mn), 2019
13.1.3.2 McKesson Corporation 2019 Healthcare Payer Solution Business Regional Distribution
13.1.4 Product/Service and Specifications
13.1.5 Manufacturing Plant Footprint Analysis
13.2 HMS Holdings Corp
13.3 International Business Machines Corporation
13.4 Change Healthcare, Inc.
13.5 Accenture plc
13.6 Cognizant Technology Solutions Corporation
13.7 Hinduja Global Solutions Limited
13.8 UnitedHealth Group Incorporated
13.9 Inovalon Holdings, Inc.
13.10 Wipro Limited
13.11 Others