Outlook on the Global Healthcare Payer Services Market Size, Share & Growth 2022 - 2028 | Estimated to Achieve a Revenue of $87.7 Billion with Growing at a CAGR 7.50% - Industry Trends, Demand, Value, Analysis & Forecast Report by ZMR

NEW YORK, Aug. 8, 2022 /PRNewswire/ -- As per Zion Market Research study, The global healthcare payer services market size was worth USD 56.8 billion in 2021 and is estimated to grow to USD 87.7 billion by 2028, with a compound annual growth rate (CAGR) of approximately 7.50% over the forecast period.

Healthcare Payer Services Market: Overview

The vendors of healthcare payer services assist healthcare insurers, public & private payers, as well as members in managing claims, member engagement, audits, medical records, and customer relations. These companies have specialized divisions that enhance the performance of the entire healthcare system by optimizing care quality, cutting costs, enhancing patient satisfaction and care provider effectiveness, utilizing unique competencies in data & analytics, pharmacy care services, population health, healthcare delivery, and healthcare operations. Healthcare payer services providers assist their clients in increasing operational effectiveness and lowering operational costs by offering all these services. Healthcare insurance payers and providers employ a variety of outsourcing options to streamline their operations and provide better customer service. Outsourcing has become a feasible business strategy to reduce administrative, logistical, procurement & other obligations, and create cost-effective company operations. The rise in healthcare system costs and the desire to reduce wasteful expenditure are the main reasons driving the market growth for healthcare payer services. However, it is projected that the rise in data breaches, loss of confidentiality, and linguistic and cultural obstacles will restrain the market's expansion.

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Key Industry Insights & Findings of the Healthcare Payer Services Market Reports:

• As per the analysis shared by our research analyst, the Healthcare Payer Services Market is expected to grow annually at a CAGR of around 7.50 % (2022-2028).
• Through the primary research, it was established that the Healthcare Payer Services Market was valued at approximately USD 56.8 billion in 2021 and is projected to reach roughly USD 87.7 billion by 2028.
• The FDI cap in insurance was raised from 49 to 74 % as part of the Union Budget of 2021, and state-owned general insurance businesses received an infusion of USD 413.13 million to help them become more financially stable.
• Healthcare businesses might overestimate the amount of work done by BPO providers, which could lead to greater overall expenditures than anticipated.
• North America dominated the global healthcare payer services market in 2021 because significant businesses in the region provide healthcare payer services and a considerable need for healthcare payer solutions.

Zion Market Research published the latest report titled "Healthcare Payer Services Market By Service (BPO Services, ITO Services, and KPO Services), By Application (Claims Management Services, Integrated Front Office Service & Back Office Operations, Member Management Services, Provider Management Services, Billing & Accounts Management Services, Analytics & Fraud Management Services, and HR Services), By End-Use (Private Payers and Public Payers), and By Region - Global and Regional Industry Overview, Market Intelligence, Comprehensive Analysis, Historical Data, and Forecasts 2022 – 2028." into their research database.

Industry Dynamics:

Healthcare Payer Services Market: Growth Drivers

• Increase in insurance coverage among the population is likely to pave the way for market growth.

The global population's rising insurance coverage is driving the demand for healthcare payer services. Due to favorable government policies, it is also projected that developing nations like India will see a rise in health insurance coverage. For instance, the FDI cap in insurance was raised from 49 to 74 % as part of the Union Budget of 2021, and state-owned general insurance businesses received an infusion of USD 413.13 million to help them become more financially stable. Additionally, the substantial losses from the rise in healthcare frauds enhance the demand for healthcare payer services, fueling the global market expansion. A noticeable increase in health insurance enrollment has been noted, which benefits the global healthcare payer services market's development.

Healthcare Payer Services Market: Restraints

• The hidden cost of healthcare payer services may hamper the global market growth.

The market's main obstacle is the unadvertised expenses of outsourcing healthcare payer services. Healthcare businesses might overestimate the amount of work done by BPO providers, which could lead to greater overall expenditures than anticipated. Additionally, if there are any issues between the healthcare provider and service provider, the likelihood of legal fees for using BPO services increases. Other factors include variations in the caliber of the work and excessive reliance on the provider of healthcare payer services.

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Healthcare Payer Services Market: Challenges

• Rising data security concerns are likely to limit the global market growth.

Working with healthcare payer servicing firms greatly increases the danger of security breaches and data leaks. Extremely sensitive and legally protected information such as patient contact information, medical history, insurance plans, and illnesses can have a significant negative impact on demand. The healthcare provider could suffer significantly due to a breach or leak of this data because it would undermine patient confidence.

Global Healthcare Payer Services Market: Segmentation

• The global healthcare payer services market is segregated on the basis of service, application, end-use, and region.

By service, the market is divided into BPO services, ITO services, and KPO services. Among these, the ITO services segment dominates the market and accounted for 51.1% of the overall revenue share in 2021. The primary growth factors include increased demand for novel and advanced technologies, more investment in AI technology, conveniently accessible information, and increased engagement in healthcare decisions.

By application, the market is divided into claims management services, integrated front office service & back office operations, member management services, provider management services, billing & accounts management services, analytics & fraud management services, and HR services. Over the forecast period, the claims management services segment is expected to grow significantly. It accounted for 29.9% of the overall revenue share in 2021. The presence of the Affordable Care Act (ACA) and rising overall healthcare spending are two critical factors influencing the number of people registered in the Centers for Medicare and Medicaid Services. The most data-intensive procedures are claims processing services, which account for most of the payer's effort.

By end-use, the market is classified into private payers and public payers. The private payers segment dominates the market and accounts for 52.1% of the overall revenue share. This is due to expanding government assistance to encourage private investment in the healthcare sector and increased private investment in the healthcare payer vertical.

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List of Key Players in Healthcare Payer Services Market:

• Congziant
• EXL
• HGS Ltd.
• Accenture
• Xerox Corporation
• Concentric Corporation
• HCL Technologies
• Genpact
• WIPRO Ltd.

Key questions answered in this report:

• What are the growth rate forecast and market size for Healthcare Payer Services Market?
• What are the key driving factors propelling the Healthcare Payer Services Market forward?
• What are the most important companies in the Healthcare Payer Services Market Industry?
• What segments does the Healthcare Payer Services Market cover?
• How can I receive a free copy of the Healthcare Payer Services Market sample report and company profiles?

Report Scope:

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Recent Developments

• In March 2022, the collection, aggregation, dissemination, and reporting of healthcare data became the focus of a new service from IMAT Systems, a pioneer in real-time healthcare data management and population health reporting solutions. Its new clustering and SaaS-based solutions, as well as the business's new Data Aggregator Validation (DAV) designation from the National Committee for Quality Assurance, will help payers, state-wide organizations, and Health Information Exchanges (HIEs) (NCQA).
• In August 2020, Holy Cross Health and Oscar, a tech-based health insurance provider, jointly unveiled a Medicare Advantage Plan. With the help of the new plan, Oscar's highly tailored member experience may be combined with the broad physician network of Holy Cross Health and Memorial Healthcare System. A premier provider of healthcare services, Memorial Healthcare Systems and Holy Cross Health are institutions conducting research and education.

Regional Dominance:

• Rising number of people signing up for health insurance likely to help North America dominate the global market.

North America dominated the global healthcare payer services market in 2021 because significant businesses in the region provide healthcare payer services and a considerable need for healthcare payer solutions. Currently, the United States is the leading driver of healthcare payer services. This is due to the expanding number of people signing up for health insurance, and a useful reimbursement mechanism. High national healthcare spending will result in increased healthcare payer services and fuel market expansion.

Global Healthcare Payer Services Market is segmented as follows:

Healthcare Payer Services Market: By Service Outlook (2022-2028)

• BPO Services
• ITO Services
• KPO Services

Healthcare Payer Services Market: By Application Outlook (2022-2028)

• Claims Management Services
• Integrated Front Office Service and Back Office Operations
• Member Management Services
• Provider Management Services
• Billing and Accounts Management Services
• Analytics and Fraud Management Services
• HR Services

Healthcare Payer Services Market: By End-use Outlook (2022-2028)

• Private Payers
• Public Payers

Healthcare Payer Services Market: By Region Outlook (2022-2028)

North America

• The U.S.
• Canada

Europe

• France
• The UK
• Spain
• Germany
• Italy
• Rest of Europe

Asia Pacific

• China
• Japan
• India
• South Korea
• Southeast Asia
• Rest of Asia Pacific

Latin America

• Brazil
• Mexico
• Rest of Latin America

Middle East & Africa

• GCC
• South Africa
• Rest of Middle East & Africa

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