Payer Services Global Market Report 2023

NEW YORK, Feb. 20, 2023 /PRNewswire/ -- Major players in the payer services market are United Health Group, Anthem, Concentrix Corporation, United Healthcare, Anthem Inc., Aetna, Inc., CIGNA Corp., HealthPartners, Blue Cross Blue Shield of Massachusetts and Group Health Cooperative.

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The global payer services market is expected to grow from $101.76 billion in 2021 to $116.52 billion in 2022 at a compound annual growth rate (CAGR) of 14.5%. The Russia-Ukraine war disrupted the chances of global economic recovery from the COVID-19 pandemic, at least in the short term. The war between these two countries has led to economic sanctions on multiple countries, surge in commodity prices, and supply chain disruptions, causing inflation across goods and services effecting many markets across the globe. The payer services market is expected to reach $209.73 billion in 2026 at a CAGR of 15.8%.

The payer services market includes revenues earned by entities by providing BPO services, ITO services, and KPO services.The market value includes the value of related goods sold by the service provider or included within the service offering.

Only goods and services traded between entities or sold to end consumers are included.

Payer services help the payers to streamline their business processes and deliver better services to their customers.Organizations that determine service prices, collect payments, handle claims, and pay provider claims are known as payers in the health care sector.

Examples of payers include Medicare, Medicaid, and health plan providers.

North America was the largest region in the payer services market in 2022.Western Europe was the second largest region in the payer services market.

The regions covered in the payer services market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa.

The main outsourcing services in payer services are business process outsourcing services, knowledge process outsourcing services and information technology outsourcing services.The practise of contracting a specific work process or procedures to an external service provider is known as business process outsourcing (BPO).

The different applications include revenue cycle management, healthcare reimbursement, medical billing outsourcing, others and is used by various sectors such as public payers, private payers.

The increase in healthcare frauds is expected to drive the payer services market for tightening its security systems.Healthcare fraud includes malpractices such as individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit billing by practitioners for care that they never rendered, filing duplicate claims for the same service rendered, altering the dates and modifying medical records.

The healthcare industry continues to suffer losses attributed to frauds and errors.For instance, according to the National Health Care Anti-Fraud Association, in the USA the loss from healthcare fraud was estimated to be $300 billion.

Therefore, increasing healthcare fraud in the healthcare industry is propelling the demand for rigid security systems, thereby driving the growth of the payer services market.

The rising incidences of data breaches and loss of confidentiality have always been a major challenge in the payer service industry.In recent years, the healthcare sector has always been at the forefront in cases of breaching privacy and the resulting loss of confidential data.

For instance, according to Hippa Journal, the official publication of the American Health Information Management Association, the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) received 347 reports of healthcare data breaches involving 500 or more records between January 1, 2022, and June 30, 2022. Rising incidences of data breaches and loss of confidentiality are thus hampering the growth of the payer service market.

Increased adoption of technologically advanced products is gaining substantial popularity in the payer services market.This has led to improved price transparency, affordable payer services, higher utilization of resources, increasing quality reach, and member satisfaction and loyalty towards the service provider.

For instance, in January 2022, Jopari, a US-based customer-focused health information technology company supplying advanced medical EDI solutions to payers, launched an All-Payer Attachments model. This is a cost-effective solution that allows a standardized, efficient, and compliant approach that enables providers to deliver electronic Attachments to All Payers, regardless of the payer's preference for electronic or paper submission.This has led to greater transparency and economical alternative for payers.

In April 2020, Molina, a US-based company engaged in providing managed care in the field of medicare and medicaid programs, announced that it will purchase Magellan Complete Care (MCC), a managed healthcare organization, in a deal worth about $820 million.The acquisition is expected to expand Molina's geographic footprint in its core businesses of managed medicaid.

Magellan Complete Care (MCC) is a US-based company offering care management solutions.

The countries covered in the payer services market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

The market value is defined as the revenues that enterprises gain from goods and/or services sold within the specified market and geography through sales, grants, or donations in terms of currency (in USD ($) unless otherwise specified).

The revenues for a specified geography are consumption values – that is, they are revenues generated by organizations in the specified geography within the specified market, irrespective of where they are produced.It does not include revenues from resales either further along the supply chain or as part of other products.

The payer services market research report is one of a series of new reports that provides payer services market statistics, including payer services industry global market size, regional shares, competitors with a payer services market share, detailed payer services market segments, market trends and opportunities, and any further data you may need to thrive in the payer services industry. This payer services market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenario of the industry.

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