미국의 헬스케어 지불자용 테크놀러지 솔루션 시장 : 솔루션 유형, 지불자 유형, 애플리케이션별 - 세계 예측(2024-2032년)

Technology Solutions in U.S. Healthcare Payer Market size is set to record 7.2% CAGR from 2024 to 2032 due to increasing launches of AI and ML applications.

Lately, companies are developing and implementing AI-driven analytics to enhance claims processing and fraud detection. They are also rolling out ML models to personalize patient care and optimize resource allocation. Strong demand for technologies offering more sophisticated predictive insights and automated administrative tasks to improve decision-making, reduce costs, and enhance patient outcomes will also favor the industry growth. For instance, in July 2024, CitiusTech launched its industry-first Gen AI Quality & Trust solution for helping healthcare organizations to ensure reliability, quality, and trust in Generative AI applications.

The technology solutions in U.S. healthcare payer industry is segmented into solution type, payer type, and application.

The market size from the standalone solutions type segment will record a decent growth rate between 2024 and 2032, due to the rising need for streamlining administrative processes and improving patient care management. Standalone solutions are largely implemented to automate claims processing to enhance data analytics and improve patient engagement. Healthcare payers are also leveraging advanced technologies to reduce operational costs and increase efficiency. Moreover, the shift towards innovative technological solutions is redefining the landscape of healthcare administration and patient care.

Based on payer type, the government segment in the technology solutions in U.S. healthcare payer market is expected to record significant growth from 2024 to 2032. Government payers integrate advanced technology solutions to enhance healthcare delivery and management. Lately, innovations such as electronic health records (EHRs) and advanced data analytics are improving patient care and operational efficiency. Rising government programs for adopting these technologies to streamline processes and reduce costs will add to the segment growth.

In terms of application, the technology solutions in U.S. healthcare payer market from the government segment is anticipated to witness significant CAGR from 2024-2032, owing to increasing adoption of solutions to enhance efficiency and improve patient care. These solutions are streamlining claims processing for reducing administrative costs and enhancing data security. By adopting EHRs and advanced data analytics, governments are also transforming how healthcare payments are managed to predict patient needs and optimize resource allocation. Moreover, governments are improving interoperability between different healthcare systems for ensuring that patient information is seamlessly shared and utilized.

Table of Contents

Chapter 1 Methodology & Scope

• 1.1 Market scope & definitions
• 1.2 Research design
  • 1.2.1 Research approach
  • 1.2.2 Data collection methods
• 1.3 Base estimates & calculations
  • 1.3.1 Base year calculation
  • 1.3.2 Key trends for market estimation
• 1.4 Forecast model
• 1.5 Primary research and validation
  • 1.5.1 Primary sources
  • 1.5.2 Data mining sources

Chapter 2 Executive Summary

• 2.1 Industry 360° synopsis

Chapter 3 Industry Insights

• 3.1 Industry ecosystem analysis
• 3.2 Industry impact forces
  • 3.2.1 Growth drivers
    • 3.2.1.1 Increasing demand for streamlining operational workflow and reducing administrative expenses
    • 3.2.1.2 Shift towards value-based care approaches
    • 3.2.1.3 Modernization of billing and claim settlement approaches
    • 3.2.1.4 Growing adoption of telehealth services among payers and providers
  • 3.2.2 Industry pitfalls & challenges
    • 3.2.2.1 Stringent regulatory requirements related to data security and privacy
    • 3.2.2.2 Overreliance on traditional business models and practices
• 3.3 Growth potential analysis
• 3.4 Regulatory landscape
• 3.5 Porter's analysis
• 3.6 PESTEL analysis

Chapter 4 Competitive Landscape, 2023

• 4.1 Introduction
• 4.2 Company market share analysis
• 4.3 Company matrix analysis
• 4.4 Competitive positioning matrix
• 4.5 Strategy dashboard

Chapter 5 Market Estimates and Forecast, By Solution Type, 2021 - 2032 ($ Mn)

• 5.1 Key trends
• 5.2 Integrated
• 5.3 Standalone

Chapter 6 Market Estimates and Forecast, By Payer Type, 2021 - 2032 ($ Mn)

• 6.1 Key trends
• 6.2 Commercial
• 6.3 Government

Chapter 7 Market Estimates and Forecast, By Application, 2021 - 2032 ($ Mn)

• 7.1 Key trends
• 7.2 Claims management
• 7.3 Enrollment and member management
• 7.4 Provider management
• 7.5 Revenue management and billing
• 7.6 Analytics
• 7.7 Data management and authorization
• 7.8 Personalized/CRM
• 7.9 Value based payments
• 7.10 Clinical decision support
• 7.11 Other applications

Chapter 8 Company Profiles

• 8.1 Cognizant Technology Solutions Corporation
• 8.2 HCL Technologies Limited
• 8.3 HealthEdge Software, Inc.
• 8.4 Hyland Software, Inc.
• 8.5 KMS Healthcare
• 8.6 Medecision
• 8.7 MedHOK, Inc.
• 8.8 Open Text Corporation
• 8.9 Oracle Corporation
• 8.10 OSP
• 8.11 Pegasystems Inc.
• 8.12 System Soft Technologies LLC
• 8.13 Virtusa Corp.
• 8.14 ZeOmega, Inc.
• 8.15 Zyter, Inc.