헬스케어 BPO(비즈니스 프로세스 아웃소싱) 시장 - 규모, 점유율, 성장률, 산업 분석 : 유형별, 용도별, 지역별 인사이트 및 예측(2026-2034년)

Growth Factors of healthcare BPO (Business Process Outsourcing) Market

The global healthcare BPO (Business Process Outsourcing) market is witnessing rapid expansion, driven by rising operational complexities, regulatory pressures, and digital transformation initiatives. According to Fortune Business Insights, the market was valued at USD 396.80 billion in 2025 and is projected to grow to USD 423.1 billion in 2026, ultimately reaching USD 756.55 billion by 2034, reflecting a CAGR of 7.5% during the forecast period. In 2025, North America dominated the market with a 49.6% share, underscoring the region's advanced healthcare infrastructure, stringent regulatory environment, and high adoption of outsourcing services.

The growth of healthcare BPO is primarily fueled by the need to manage administrative and operational complexities such as billing, coding, claims management, and compliance with regulations like HIPAA and GDPR. Outsourcing enables healthcare providers, payers, and life sciences companies to focus on patient care while delegating repetitive back-office tasks. Additionally, the digitalization of healthcare, including EHR/EMR adoption, telehealth expansion, and AI integration, has further accelerated demand for specialized BPO services. Life sciences companies increasingly rely on outsourcing for pharmacovigilance, clinical data management, and regulatory submissions to comply with stringent FDA and EMA requirements.

Market Dynamics

Drivers

The rising administrative burden due to evolving coding standards, stricter reimbursement policies, and regulatory compliance is a major growth driver. In 2025, the American Hospital Association reported that claim denials averaged 20.2% for commercial claims and 55.7% for Medicare Advantage claims between 2022-2023, increasing the need for outsourcing solutions. BPO services provide cost-effective, efficient handling of functions such as billing, coding, claims adjudication, and payment integrity, allowing healthcare organizations to focus on clinical care.

Restraints

Data privacy and security concerns pose a significant challenge to market adoption. Handling protected health information (PHI) and sensitive patient data makes BPO providers vulnerable to cyberattacks. Breaches can lead to financial loss, regulatory penalties, reputational damage, and loss of trust. For instance, in August 2025, the HHS Office for Civil Rights reported 58 healthcare breaches affecting over 3.7 million individuals, highlighting the need for robust security measures.

Opportunities

The integration of artificial intelligence (AI) into revenue cycle management, medical coding, and workflow automation presents substantial growth opportunities. AI-powered platforms reduce errors, shorten turnaround times, and enhance operational efficiency. In April 2025, RamSoft Inc. partnered with Maverick Medical AI to integrate the CodePilot platform into radiology practice systems, optimizing billing and revenue cycle processes.

Challenges

High transition and integration costs present obstacles to market growth. Migrating critical processes like RCM and medical coding to BPO vendors involves significant technology upgrades, workflow redesigns, and staff retraining. Mid-sized hospitals and insurers with limited budgets may face delays in adopting outsourcing services due to these operational and financial challenges.

Market Trends

A prominent trend is the shift toward value-based and outcome-driven outsourcing models, where vendors are evaluated on KPIs such as reduction in claim denials, improved coding accuracy, and enhanced patient/member satisfaction. In February 2024, Allina Health transitioned 2,000 IT and RCM employees to Optum, leveraging advanced technologies to streamline billing and revenue operations.

Segmentation Analysis

By Product

The market is classified into healthcare providers and healthcare payers. The healthcare providers segment led with 59.99% share in 2026, adopting BPO services for patient access, care management, and revenue cycle operations. For example, Benefis Health System partnered with Ensemble Health Partners in September 2025 for end-to-end revenue cycle management. The healthcare payers segment is expected to grow at a CAGR of 6.69%.

By Application

Applications include claims management, medical coding, billing & enrollment, fraud & risk management, risk & compliance, audit services, and payment integrity. The claims management segment held the largest share at 19.87% in 2026, driven by rising claim volumes and complex reimbursement rules. The risk & compliance segment is projected to grow at a CAGR of 8.1%.

Regional Outlook

• North America: USD 196.8 billion in 2025, USD 210.26 billion in 2026; U.S. market estimated at USD 197.1 billion in 2026.
• Europe: USD 99.95 billion in 2026; U.K. USD 20.2 billion, Germany USD 23.4 billion, France USD 15.82 billion.
• Asia Pacific: USD 78.28 billion in 2026; Japan USD 23.86 billion, China USD 22.83 billion, India USD 15.32 billion.
• Latin America: USD 19.01 billion in 2026.
• Middle East & Africa (GCC): USD 7.22 billion in 2025.

Competitive Landscape

The healthcare BPO market is fragmented, with NTT DATA, Inc., MDI NetworX LLC., and Invensis Technologies Pvt Ltd. leading due to technology integration, AI adoption, and diverse service offerings. Other key players include Accenture, Optum, Knack RCM, Genpact, Cognizant, and TCS, focusing on R&D, strategic partnerships, and geographic expansion.

Key developments include:

• February 2025: TruBridge partnered with Cibolo Health for financial optimization of rural hospitals.
• October 2024: NTT DATA collaborated with Duke Health to enhance homecare delivery through interactive technology.
• September 2024: EQT AB acquired GeBBS to expand healthcare outsourcing solutions in the U.S.

Conclusion

The global healthcare BPO market is projected to grow from USD 396.8 billion in 2025 to USD 756.55 billion by 2034, driven by rising administrative complexity, digitalization, AI integration, and demand for cost-efficient outsourcing. Despite challenges such as data security concerns and high integration costs, the shift toward value-based, outcome-driven outsourcing models, coupled with advanced technologies, is expected to transform operational efficiency, improve care delivery, and sustain market growth worldwide.

Segmentation By Product, Application, and Region

By Product * Healthcare Payers

• Claims Administration
• Data Management
• Medical Billing
• Others
• Healthcare Providers
  • Patient Access
  • Care Management
  • Revenue Cycle Management (RCM)
  • Others

By Application * Medical Coding & Documentation

• Billing & Enrollment
• Healthcare Network Management
• Fraud & Risk Management
• Claims Management
• Risk & Compliance
• Audit Services
• Payment Integrity
• Others

By Geography * North America (By Product, Application , and Country)

• U.S.
• Canada
• Europe (By Product, Application, and Country/Sub-region)
  • Germany
  • U.K.
  • France
  • Spain
  • Italy
  • Scandinavia
  • Rest of Europe
• Asia Pacific (By Product, Application, and Country/Sub-region)
  • China
  • Japan
  • India
  • Australia
  • Southeast Asia
  • Rest of Asia Pacific
• Latin America (Product, Application, and Country/Sub-region)
  • Brazil
  • Mexico
  • Rest of Latin America
• Middle East & Africa (Product, Application, and Country/Sub-region)
  • GCC
  • South Africa
  • Rest of the Middle East & Africa

Table of Content

1. Introduction

• 1.1. Research Scope
• 1.2. Market Segmentation
• 1.3. Research Methodology
• 1.4. Definitions and Assumptions

2. Executive Summary

3. Market Dynamics

• 3.1. Market Drivers
• 3.2. Market Restraints
• 3.3. Market Opportunities
• 3.4. Market Trends

4. Key Insights

• 4.1. Regulatory Scenarios, By Key Countries/Regions
• 4.2. Technological Advancements in the Market
• 4.3. Overview: Applications of Various Healthcare BPO Services
• 4.4. Key Industry Developments (Mergers, Acquisitions, Partnerships, Launches, etc.)

5. Global Healthcare BPO Market Analysis, Insights and Forecast, 2021-2034

• 5.1. Market Analysis, Insights and Forecast - By Product
  • 5.1.1. Healthcare Payers
    • 5.1.1.1. Claims Administration
    • 5.1.1.2. Data Management
    • 5.1.1.3. Medical Billing
    • 5.1.1.4. Others
  • 5.1.2. Healthcare Providers
    • 5.1.2.1. Patient Access
    • 5.1.2.2. Care Management
    • 5.1.2.3. Revenue Cycle Management (RCM)
    • 5.1.2.4. Others
• 5.2. Market Analysis, Insights and Forecast - By Application
  • 5.2.1. Medical Coding & Documentation
  • 5.2.2. Billing & Enrollment
  • 5.2.3. Healthcare Network Management
  • 5.2.4. Fraud & Risk Management
  • 5.2.5. Claims Management
  • 5.2.6. Risk & Compliance
  • 5.2.7. Audit Services
  • 5.2.8. Payment Integrity
  • 5.2.9. Others
• 5.3. Market Analysis, Insights and Forecast - By Region
  • 5.3.1. North America
  • 5.3.2. Europe
  • 5.3.3. Asia Pacific
  • 5.3.4. Latin America
  • 5.3.5. Middle East & Africa

6. North America Healthcare BPO Market Analysis, Insights and Forecast, 2021-2034

• 6.1. Market Analysis, Insights and Forecast - By Product
  • 6.1.1. Healthcare Payers
    • 6.1.1.1. Claims Administration
    • 6.1.1.2. Data Management
    • 6.1.1.3. Medical Billing
    • 6.1.1.4. Others
  • 6.1.2. Healthcare Providers
    • 6.1.2.1. Patient Access
    • 6.1.2.2. Care Management
    • 6.1.2.3. Revenue Cycle Management (RCM)
    • 6.1.2.4. Others
• 6.2. Market Analysis, Insights and Forecast - By Application
  • 6.2.1. Medical Coding & Documentation
  • 6.2.2. Billing & Enrollment
  • 6.2.3. Healthcare Network Management
  • 6.2.4. Fraud & Risk Management
  • 6.2.5. Claims Management
  • 6.2.6. Risk & Compliance
  • 6.2.7. Audit Services
  • 6.2.8. Payment Integrity
• 6.3. Market Analysis, Insights and Forecast - By Country
  • 6.3.1. U.S.
  • 6.3.2. Canada

7. Europe Healthcare BPO Market Analysis, Insights and Forecast, 2021-2034

• 7.1. Market Analysis, Insights and Forecast - By Product
  • 7.1.1. Healthcare Payers
    • 7.1.1.1. Claims Administration
    • 7.1.1.2. Data Management
    • 7.1.1.3. Medical Billing
    • 7.1.1.4. Others
  • 7.1.2. Healthcare Providers
    • 7.1.2.1. Patient Access
    • 7.1.2.2. Care Management
    • 7.1.2.3. Revenue Cycle Management (RCM)
    • 7.1.2.4. Others
• 7.2. Market Analysis, Insights and Forecast - By Application
  • 7.2.1. Medical Coding & Documentation
  • 7.2.2. Billing & Enrollment
  • 7.2.3. Healthcare Network Management
  • 7.2.4. Fraud & Risk Management
  • 7.2.5. Claims Management
  • 7.2.6. Risk & Compliance
  • 7.2.7. Audit Services
  • 7.2.8. Payment Integrity
• 7.3. Market Analysis, Insights and Forecast - By Country/ Sub-Region
  • 7.3.1. U.K.
  • 7.3.2. Germany
  • 7.3.3. France
  • 7.3.4. Italy
  • 7.3.5. Spain
  • 7.3.6. Scandinavia
  • 7.3.7. Rest of Europe

8. Asia Pacific Healthcare BPO Market Analysis, Insights and Forecast, 2021-2034

• 8.1. Market Analysis, Insights and Forecast - By Product
  • 8.1.1. Healthcare Payers
    • 8.1.1.1. Claims Administration
    • 8.1.1.2. Data Management
    • 8.1.1.3. Medical Billing
    • 8.1.1.4. Others
  • 8.1.2. Healthcare Providers
    • 8.1.2.1. Patient Access
    • 8.1.2.2. Care Management
    • 8.1.2.3. Revenue Cycle Management (RCM)
    • 8.1.2.4. Others
• 8.2. Market Analysis, Insights and Forecast - By Application
  • 8.2.1. Medical Coding & Documentation
  • 8.2.2. Billing & Enrollment
  • 8.2.3. Healthcare Network Management
  • 8.2.4. Fraud & Risk Management
  • 8.2.5. Claims Management
  • 8.2.6. Risk & Compliance
  • 8.2.7. Audit Services
  • 8.2.8. Payment Integrity
• 8.3. Market Analysis, Insights and Forecast - By Country/ Sub-Region
  • 8.3.1. China
  • 8.3.2. Japan
  • 8.3.3. India
  • 8.3.4. Southeast Asia
  • 8.3.5. Australia
  • 8.3.6. Rest of Asia Pacific

9. Latin America Healthcare BPO Market Analysis, Insights and Forecast, 2021-2034

• 9.1. Market Analysis, Insights and Forecast - By Product
  • 9.1.1. Healthcare Payers
    • 9.1.1.1. Claims Administration
    • 9.1.1.2. Data Management
    • 9.1.1.3. Medical Billing
    • 9.1.1.4. Others
  • 9.1.2. Healthcare Providers
    • 9.1.2.1. Patient Access
    • 9.1.2.2. Care Management
    • 9.1.2.3. Revenue Cycle Management (RCM)
    • 9.1.2.4. Others
• 9.2. Market Analysis, Insights and Forecast - By Application
  • 9.2.1. Medical Coding & Documentation
  • 9.2.2. Billing & Enrollment
  • 9.2.3. Healthcare Network Management
  • 9.2.4. Fraud & Risk Management
  • 9.2.5. Claims Management
  • 9.2.6. Risk & Compliance
  • 9.2.7. Audit Services
  • 9.2.8. Payment Integrity
• 9.3. Market Analysis, Insights and Forecast - By Country/ Sub-Region
  • 9.3.1. Brazil
  • 9.3.2. Mexico
  • 9.3.3. Rest of Latin America

10. Middle East & Africa Healthcare BPO Market Analysis, Insights and Forecast, 2021-2034

• 10.1. Market Analysis, Insights and Forecast - By Product
  • 10.1.1. Healthcare Payers
    • 10.1.1.1. Claims Administration
    • 10.1.1.2. Data Management
    • 10.1.1.3. Medical Billing
    • 10.1.1.4. Others
  • 10.1.2. Healthcare Providers
    • 10.1.2.1. Patient Access
    • 10.1.2.2. Care Management
    • 10.1.2.3. Revenue Cycle Management (RCM)
    • 10.1.2.4. Others
• 10.2. Market Analysis, Insights and Forecast - By Application
  • 10.2.1. Medical Coding & Documentation
  • 10.2.2. Billing & Enrollment
  • 10.2.3. Healthcare Network Management
  • 10.2.4. Fraud & Risk Management
  • 10.2.5. Claims Management
  • 10.2.6. Risk & Compliance
  • 10.2.7. Audit Services
  • 10.2.8. Payment Integrity
• 10.3. Market Analysis, Insights and Forecast - By Country/ Sub-Region
  • 10.3.1. GCC
  • 10.3.2. South Africa
  • 10.3.3. Rest of Middle East & Africa

11. Competitive Analysis

• 11.1. Global Market Share Analysis (2025)
• 11.2. Company Profiles (Overview, Products, SWOT Analysis, Recent Developments, Strategies, Financials (Based on Availability))
  • 11.2.1. NTT DATA, Inc.
  • 11.2.2. MDI NetworX LLC.
  • 11.2.3. Invensis Technologies Pvt Ltd
  • 11.2.4. Accenture
  • 11.2.5. Optum, Inc.
  • 11.2.6. Knack RCM
  • 11.2.7. Genpact
  • 11.2.8. Cognizant
  • 11.2.9. TATA Consultancy Services Limited