Categories: Market Research

Healthcare Payer Solution Market Market Segmentation, Scope And Drivers Report To 2033 | Cognizant Technical Solutions, Concentrix Corporation, Accenture PLC, HCL Technologies Ltd.

Overview and Scope
The healthcare payer solution refers to solutions that assist healthcare insurers, public and private payers, and members in managing claims, member engagement, audits, medical records, and customer relations. These solutions improve the overall performance of the healthcare system by improving care quality, lowering costs, increasing patient satisfaction and provider effectiveness, and leveraging unique competencies.

Sizing and Forecast
The healthcare payer solution market size has grown rapidly in recent years. It will grow from $40.94 billion in 2023 to $45.06 billion in 2024 at a compound annual growth rate (CAGR) of 10.1%. The growth in the historic period can be attributed to introduction of managed care, regulatory changes (hipaa, aca, etc.), emphasis on data analytics, focus on member engagement and experience, transition towards interoperability..

The healthcare payer solution market size is expected to see strong growth in the next few years. It will grow to $65.66 billion in 2028 at a compound annual growth rate (CAGR) of 9.9%. The growth in the forecast period can be attributed to shift towards patient-centric care, rise in telemedicine and remote care, increased emphasis on data security, value-based payment models.. Major trends in the forecast period include financial transparency and cost management, risk stratification and population health management, data interoperability and exchange, rise of value-based care models, integration of ai and predictive analytics..

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Segmentation & Regional Insights
1) By Services: Business Process Outsourcing Services, Information Technology Outsourcing Services, Knowledge Process Outsourcing Services
2) By Application: Pharmacy Audit And Analysis Systems, Claims Management Services, Fraud Management Services, Computer-assisted Coding (CAC) Systems, Member Eligibility Management Services, Provider Network Management Services, Payment Management Services, Customer Relationship Management Services, Medical Document Management Services, General Ledger And Payroll Management
3) By End User: Private Provider, Public Provider

North America was the largest region in the healthcare payer solution market in 2023. The regions covered in the healthcare payer solution market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa

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Major Driver Impacting Market Growth
Rising insurance enrolments are expected to propel the growth of the healthcare payer solutions market going forward. Insurance enrolment is the procedure through which a qualified applicant registers with the insurance provider and becomes a member of the plan. Healthcare payer solutions in the insurance market provide solid enterprise core administration and claim management platform solutions that enable and inspire expansion, innovation, and cost savings for payer organizations across a wide range of business lines. For instance, according to Centers for Medicare & Medicaid Services, a US-based Department of Health and Human Services that provides health coverage to people through Medicare, and Medicaid, in the USA, more than 13.6 million Americans signed up for health insurance coverage for 2022 through HealthCare.gov and State-based Marketplaces marking 92% of those who registered for plans until December 15, 2021. Therefore, the rising insurance enrolments are driving the demand for the healthcare payer solutions market.

Key Industry Players
Major companies operating in the healthcare payer solution market are focused on developing advanced solutions, such as Payer Exchange, to address the escalating volumes of medical records and clinical data. Payer Exchange is a technology solution designed to facilitate clinical data exchange between healthcare providers and payers. For instance, in June 2023, MRO Corp, a US-based clinical data exchange company, with specification-grade architectural lighting, launched a Payer Exchange solution. The technology digitizes and automates the patient information request and fulfillment process, reducing manual burdens for hospital staff and improving workflows. Payer Exchange focuses on managing the growing demand from payers for high-quality and timely clinical data, offering a secure, electronic connection for efficient communication between providers and payers. The solution emphasizes patient privacy, data quality, and risk adjustment premium accuracy.

The healthcare payer solution market report table of contents includes:

1. Executive Summary

2. Healthcare Payer Solution Characteristics

3. Healthcare Payer Solution Trends And Strategies

4. Healthcare Payer Solution – Macro Economic Scenario

5. Global Healthcare Payer Solution Size and Growth

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32. Global Healthcare Payer Solution Competitive Benchmarking

33. Global Healthcare Payer Solution Competitive Dashboard

34. Key Mergers And Acquisitions In The Healthcare Payer Solution

35. Healthcare Payer Solution Future Outlook and Potential Analysis

36. Appendix