Market Overview:
The global healthcare payer solutions market is expected to grow at a CAGR of 10.8% from 2018 to 2030. The growth in the market can be attributed to the increasing demand for healthcare payer solutions by healthcare providers and payers across the globe. In addition, the growing need for reducing administrative costs and improving operational efficiency is also contributing to the growth of this market. The global healthcare payer solutions market is segmented on the basis of type, application, and region. On the basis of type, it is divided into claims management solutions, payment management solutions, provider network management solutions, and others. Claims management solution dominates this market owing to its ability to manage complex claim processing procedures with ease.
Product Definition:
A healthcare payer solution is a type of software that helps insurance companies and other healthcare providers manage their finances. It can include features for billing, claims management, customer service, and other financial operations. Healthcare payer solutions are important because they help these organizations keep track of their money and ensure that patients are being billed correctly.
Claims Management Solutions:
Healthcare payer solutions include services and software that help to manage the claims process. It is used by insurance companies, health plans sponsor (employers & unions), healthcare providers, and others. The major function of this solution includes prevention of frauds, errors & improper payments; accurate payment processing; reduction in claim processing time; increase in revenue for the organization through effective management of customer relationships with their customers.
Payment Management Solutions:
Payment management solutions are used by healthcare payers to process and manage claims. They help in improving the overall operational efficiency of a business, which helps in gaining a competitive advantage. The key functions of payment management solutions include patient accounting, revenue cycle management, provider contracting (risk and compliance), fraud prevention/compliance (risk and compliance), payment processing (in-house or outsourced) & risk assessment & mitigation strategies.
Application Insights:
Healthcare provider application segment accounted for the largest revenue share in 2017 and is anticipated to continue its dominance over the forecast period. The increasing number of hospitals and healthcare providers across the globe is a key factor contributing to this market growth. Furthermore, an increase in investments by governments in developing healthcare infrastructure, coupled with technological advancements such as Electronic Health Records (EHRs) and Mobile Medical Applications (MMA), are expected to drive demand from this segment over the forecast period.
The growing need for managing patient information, medical records & files, laboratory data & reports along with improving clinical efficiency has driven demand from healthcare payer solutions market within providers network management solutions category. Increasing penetration of EHRs has led many organizations to outsource their claims processing needs thereby driving demand from these applications within provider network management solutions category during the forecast years 2018 - 2030 to ¢â‚¬Å“Hospital Software Solutions Inc.
Regional Analysis:
North America dominated the global market in 2017. The presence of a large number of players, high adoption rate for advanced healthcare payment solutions, and continuous investments by governments to improve healthcare infrastructure are some factors driving the growth. Moreover, increasing demand for medical tourism in countries such as Canada and U.S., due to availability of quality services at lower costs is expected to drive the regional market over the forecast period.
Asia Pacific is anticipated to witness lucrative growth during the forecast period owing to improving economic conditions in emerging countries such as India.
Growth Factors:
- Increasing demand for value-based care: The shift from volume to value-based care is one of the key growth drivers for the healthcare payer solutions market. This is because payers are looking for technology solutions that can help them manage and track patient outcomes and reimbursements.
- Rising need to curb healthcare costs: The high cost of healthcare is another major challenge that payers are facing. As a result, they are increasingly looking for technology solutions that can help them reduce costs without compromising on quality of care.
- Growing focus on population health management: Payers are now focusing on managing the health of entire populations rather than individual patients. This has led to an increase in demand for healthcare payer solutions that can help them collect and analyze data across different geographies and demographics.
- Emergence of new payment models: A number of new payment models such as bundled payments, shared savings programs, and accountable care organizations (ACOs) are emerging in the healthcare industry .This is driving demand for Healthcare Payer Solutions market as these models require sophisticated technology platforms to be successful . 5
Scope Of The Report
Report Attributes
Report Details
Report Title
Healthcare Payer Solutions Market Research Report
By Type
Claims Management Solutions, Payment Management Solutions, Provider Network Management Solutions, Others
By Application
Healthcare Provider, Healthcare Payer
By Companies
Cerner Corporation (U.S.), IBM Corporation (U.S.), UnitedHealth Group (U.S.), Aetna, Inc. (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Epic Systems Corporation (U.S.), Mckesson Corporation (U.S.), Verisk Health (U.S.), Zeomega, Inc. (U.S.), eClinicalWorks, Inc. (U.S.), NextGen Healthcare (U.S.)
Regions Covered
North America, Europe, APAC, Latin America, MEA
Base Year
2021
Historical Year
2019 to 2020 (Data from 2010 can be provided as per availability)
Forecast Year
2030
Number of Pages
200
Number of Tables & Figures
140
Customization Available
Yes, the report can be customized as per your need.
Global Healthcare Payer Solutions Market Report Segments:
The global Healthcare Payer Solutions market is segmented on the basis of:
Types
Claims Management Solutions, Payment Management Solutions, Provider Network Management Solutions, Others
The product segment provides information about the market share of each product and the respective CAGR during the forecast period. It lays out information about the product pricing parameters, trends, and profits that provides in-depth insights of the market. Furthermore, it discusses latest product developments & innovation in the market.
Applications
Healthcare Provider, Healthcare Payer
The application segment fragments various applications of the product and provides information on the market share and growth rate of each application segment. It discusses the potential future applications of the products and driving and restraining factors of each application segment.
Some of the companies that are profiled in this report are:
- Cerner Corporation (U.S.)
- IBM Corporation (U.S.)
- UnitedHealth Group (U.S.)
- Aetna, Inc. (U.S.)
- Allscripts Healthcare Solutions, Inc. (U.S.)
- Epic Systems Corporation (U.S.)
- Mckesson Corporation (U.S.)
- Verisk Health (U.S.)
- Zeomega, Inc. (U.S.)
- eClinicalWorks, Inc. (U.S.)
- NextGen Healthcare (U.S.)
Highlights of The Healthcare Payer Solutions Market Report:
- The market structure and projections for the coming years.
- Drivers, restraints, opportunities, and current trends of market.
- Historical data and forecast.
- Estimations for the forecast period 2030.
- Developments and trends in the market.
- By Type:
- Claims Management Solutions
- Payment Management Solutions
- Provider Network Management Solutions
- Others
- By Application:
- Healthcare Provider
- Healthcare Payer
- Market scenario by region, sub-region, and country.
- Market share of the market players, company profiles, product specifications, SWOT analysis, and competitive landscape.
- Analysis regarding upstream raw materials, downstream demand, and current market dynamics.
- Government Policies, Macro & Micro economic factors are also included in the report.
We have studied the Healthcare Payer Solutions Market in 360 degrees via. both primary & secondary research methodologies. This helped us in building an understanding of the current market dynamics, supply-demand gap, pricing trends, product preferences, consumer patterns & so on. The findings were further validated through primary research with industry experts & opinion leaders across countries. The data is further compiled & validated through various market estimation & data validation methodologies. Further, we also have our in-house data forecasting model to predict market growth up to 2030.
Regional Analysis
- North America
- Europe
- Asia Pacific
- Middle East & Africa
- Latin America
Note: A country of choice can be added in the report at no extra cost. If more than one country needs to be added, the research quote will vary accordingly.
The geographical analysis part of the report provides information about the product sales in terms of volume and revenue in regions. It lays out potential opportunities for the new entrants, emerging players, and major players in the region. The regional analysis is done after considering the socio-economic factors and government regulations of the countries in the regions.
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8 Reasons to Buy This Report
- Includes a Chapter on the Impact of COVID-19 Pandemic On the Market
- Report Prepared After Conducting Interviews with Industry Experts & Top Designates of the Companies in the Market
- Implemented Robust Methodology to Prepare the Report
- Includes Graphs, Statistics, Flowcharts, and Infographics to Save Time
- Industry Growth Insights Provides 24/5 Assistance Regarding the Doubts in the Report
- Provides Information About the Top-winning Strategies Implemented by Industry Players.
- In-depth Insights On the Market Drivers, Restraints, Opportunities, and Threats
- Customization of the Report Available
Frequently Asked Questions?
Healthcare Payer Solutions is a technology company that provides software and services to healthcare payers. Its products include a patient portal, claims adjudication, and data analytics. Healthcare Payer Solutions also offers consulting services to help payers improve their operations.
Some of the major players in the healthcare payer solutions market are Cerner Corporation (U.S.), IBM Corporation (U.S.), UnitedHealth Group (U.S.), Aetna, Inc. (U.S.), Allscripts Healthcare Solutions, Inc. (U.S.), Epic Systems Corporation (U.S.), Mckesson Corporation (U.S.), Verisk Health (U.S.), Zeomega, Inc. (U.S.), eClinicalWorks, Inc. (U.S.), NextGen Healthcare (U.S.).
The healthcare payer solutions market is expected to grow at a compound annual growth rate of 10.8%.
Chapter 1 Executive Summary
Chapter 2 Assumptions and Acronyms Used
Chapter 3 Research Methodology
Chapter 4 Healthcare Payer Solutions Market Overview
4.1 Introduction
4.1.1 Market Taxonomy
4.1.2 Market Definition
4.1.3 Macro-Economic Factors Impacting the Market Growth
4.2 Healthcare Payer Solutions Market Dynamics
4.2.1 Market Drivers
4.2.2 Market Restraints
4.2.3 Market Opportunity
4.3 Healthcare Payer Solutions Market - Supply Chain Analysis
4.3.1 List of Key Suppliers
4.3.2 List of Key Distributors
4.3.3 List of Key Consumers
4.4 Key Forces Shaping the Healthcare Payer Solutions Market
4.4.1 Bargaining Power of Suppliers
4.4.2 Bargaining Power of Buyers
4.4.3 Threat of Substitution
4.4.4 Threat of New Entrants
4.4.5 Competitive Rivalry
4.5 Global Healthcare Payer Solutions Market Size & Forecast, 2020-2028
4.5.1 Healthcare Payer Solutions Market Size and Y-o-Y Growth
4.5.2 Healthcare Payer Solutions Market Absolute $ Opportunity
Chapter 5 Global Market Analysis and Forecast by Type
5.1 Introduction
5.1.1 Key Market Trends & Growth Opportunities by Type
5.1.2 Basis Point Share (BPS) Analysis by Type
5.1.3 Absolute $ Opportunity Assessment by Type
5.2 Market Size Forecast by Type
5.2.1 Claims Management Solutions
5.2.2 Payment Management Solutions
5.2.3 Provider Network Management Solutions
5.2.4 Others
5.3 Market Attractiveness Analysis by Type
Chapter 6 Global Market Analysis and Forecast by Applications
6.1 Introduction
6.1.1 Key Market Trends & Growth Opportunities by Applications
6.1.2 Basis Point Share (BPS) Analysis by Applications
6.1.3 Absolute $ Opportunity Assessment by Applications
6.2 Market Size Forecast by Applications
6.2.1 Healthcare Provider
6.2.2 Healthcare Payer
6.3 Market Attractiveness Analysis by Applications
Chapter 7 Global Healthcare Payer Solutions Market Analysis and Forecast by Region
7.1 Introduction
7.1.1 Key Market Trends & Growth Opportunities by Region
7.1.2 Basis Point Share (BPS) Analysis by Region
7.1.3 Absolute $ Opportunity Assessment by Region
7.2 Healthcare Payer Solutions Market Size Forecast by Region
7.2.1 North America
7.2.2 Europe
7.2.3 Asia Pacific
7.2.4 Latin America
7.2.5 Middle East & Africa (MEA)
7.3 Market Attractiveness Analysis by Region
Chapter 8 Coronavirus Disease (COVID-19) Impact
8.1 Introduction
8.2 Current & Future Impact Analysis
8.3 Economic Impact Analysis
8.4 Government Policies
8.5 Investment Scenario
Chapter 9 North America Analysis and Forecast
9.1 Introduction
9.2 North America Market Size Forecast by Country
9.2.1 U.S.
9.2.2 Canada
9.3 Basis Point Share (BPS) Analysis by Country
9.4 Absolute $ Opportunity Assessment by Country
9.5 Market Attractiveness Analysis by Country
9.6 North America Market Size Forecast by Type
9.6.1 Claims Management Solutions
9.6.2 Payment Management Solutions
9.6.3 Provider Network Management Solutions
9.6.4 Others
9.7 Basis Point Share (BPS) Analysis by Type
9.8 Absolute $ Opportunity Assessment by Type
9.9 Market Attractiveness Analysis by Type
9.10 North America Market Size Forecast by Applications
9.10.1 Healthcare Provider
9.10.2 Healthcare Payer
9.11 Basis Point Share (BPS) Analysis by Applications
9.12 Absolute $ Opportunity Assessment by Applications
9.13 Market Attractiveness Analysis by Applications
Chapter 10 Europe Analysis and Forecast
10.1 Introduction
10.2 Europe Market Size Forecast by Country
10.2.1 Germany
10.2.2 France
10.2.3 Italy
10.2.4 U.K.
10.2.5 Spain
10.2.6 Russia
10.2.7 Rest of Europe
10.3 Basis Point Share (BPS) Analysis by Country
10.4 Absolute $ Opportunity Assessment by Country
10.5 Market Attractiveness Analysis by Country
10.6 Europe Market Size Forecast by Type
10.6.1 Claims Management Solutions
10.6.2 Payment Management Solutions
10.6.3 Provider Network Management Solutions
10.6.4 Others
10.7 Basis Point Share (BPS) Analysis by Type
10.8 Absolute $ Opportunity Assessment by Type
10.9 Market Attractiveness Analysis by Type
10.10 Europe Market Size Forecast by Applications
10.10.1 Healthcare Provider
10.10.2 Healthcare Payer
10.11 Basis Point Share (BPS) Analysis by Applications
10.12 Absolute $ Opportunity Assessment by Applications
10.13 Market Attractiveness Analysis by Applications
Chapter 11 Asia Pacific Analysis and Forecast
11.1 Introduction
11.2 Asia Pacific Market Size Forecast by Country
11.2.1 China
11.2.2 Japan
11.2.3 South Korea
11.2.4 India
11.2.5 Australia
11.2.6 South East Asia (SEA)
11.2.7 Rest of Asia Pacific (APAC)
11.3 Basis Point Share (BPS) Analysis by Country
11.4 Absolute $ Opportunity Assessment by Country
11.5 Market Attractiveness Analysis by Country
11.6 Asia Pacific Market Size Forecast by Type
11.6.1 Claims Management Solutions
11.6.2 Payment Management Solutions
11.6.3 Provider Network Management Solutions
11.6.4 Others
11.7 Basis Point Share (BPS) Analysis by Type
11.8 Absolute $ Opportunity Assessment by Type
11.9 Market Attractiveness Analysis by Type
11.10 Asia Pacific Market Size Forecast by Applications
11.10.1 Healthcare Provider
11.10.2 Healthcare Payer
11.11 Basis Point Share (BPS) Analysis by Applications
11.12 Absolute $ Opportunity Assessment by Applications
11.13 Market Attractiveness Analysis by Applications
Chapter 12 Latin America Analysis and Forecast
12.1 Introduction
12.2 Latin America Market Size Forecast by Country
12.2.1 Brazil
12.2.2 Mexico
12.2.3 Rest of Latin America (LATAM)
12.3 Basis Point Share (BPS) Analysis by Country
12.4 Absolute $ Opportunity Assessment by Country
12.5 Market Attractiveness Analysis by Country
12.6 Latin America Market Size Forecast by Type
12.6.1 Claims Management Solutions
12.6.2 Payment Management Solutions
12.6.3 Provider Network Management Solutions
12.6.4 Others
12.7 Basis Point Share (BPS) Analysis by Type
12.8 Absolute $ Opportunity Assessment by Type
12.9 Market Attractiveness Analysis by Type
12.10 Latin America Market Size Forecast by Applications
12.10.1 Healthcare Provider
12.10.2 Healthcare Payer
12.11 Basis Point Share (BPS) Analysis by Applications
12.12 Absolute $ Opportunity Assessment by Applications
12.13 Market Attractiveness Analysis by Applications
Chapter 13 Middle East & Africa (MEA) Analysis and Forecast
13.1 Introduction
13.2 Middle East & Africa (MEA) Market Size Forecast by Country
13.2.1 Saudi Arabia
13.2.2 South Africa
13.2.3 UAE
13.2.4 Rest of Middle East & Africa (MEA)
13.3 Basis Point Share (BPS) Analysis by Country
13.4 Absolute $ Opportunity Assessment by Country
13.5 Market Attractiveness Analysis by Country
13.6 Middle East & Africa (MEA) Market Size Forecast by Type
13.6.1 Claims Management Solutions
13.6.2 Payment Management Solutions
13.6.3 Provider Network Management Solutions
13.6.4 Others
13.7 Basis Point Share (BPS) Analysis by Type
13.8 Absolute $ Opportunity Assessment by Type
13.9 Market Attractiveness Analysis by Type
13.10 Middle East & Africa (MEA) Market Size Forecast by Applications
13.10.1 Healthcare Provider
13.10.2 Healthcare Payer
13.11 Basis Point Share (BPS) Analysis by Applications
13.12 Absolute $ Opportunity Assessment by Applications
13.13 Market Attractiveness Analysis by Applications
Chapter 14 Competition Landscape
14.1 Healthcare Payer Solutions Market: Competitive Dashboard
14.2 Global Healthcare Payer Solutions Market: Market Share Analysis, 2019
14.3 Company Profiles (Details – Overview, Financials, Developments, Strategy)
14.3.1 Cerner Corporation (U.S.)
14.3.2 IBM Corporation (U.S.)
14.3.3 UnitedHealth Group (U.S.)
14.3.4 Aetna, Inc. (U.S.)
14.3.5 Allscripts Healthcare Solutions, Inc. (U.S.)
14.3.6 Epic Systems Corporation (U.S.)
14.3.7 Mckesson Corporation (U.S.)
14.3.8 Verisk Health (U.S.)
14.3.9 Zeomega, Inc. (U.S.)
14.3.10 eClinicalWorks, Inc. (U.S.)
14.3.11 NextGen Healthcare (U.S.)
