의료비 환급 시장 규모, 점유율 및 동향 분석 보고서 : 청구별, 지불자별, 서비스 제공업체별, 지역별 부문 예측(2025-2030년)

Healthcare Reimbursement Market Growth & Trends:

The global healthcare reimbursement market size is expected to reach USD 13,315.0 billion by 2030, according to a new report by Grand View Research, Inc., exhibiting a CAGR of 5.4% from 2025 to 2030. Supportive government initiatives along with rising cost of prescription medicines are likely to work in favor of the market.

The U.S. Affordable Care Act focuses on controlling and minimizing costs of healthcare. The law supports innovative methods to deliver medical care to reduce healthcare costs and makes affordable health insurance available to more people. Since the Obamacare came into effect in 2014, the number of uninsured children under the age of 18 in the U.S. reduced to 5.0% in 2015 as compared to 9% in 2008.

In addition, the Centre for Medicare & Medicaid Services is working towards delivery of reliable high-quality care, endorsement of efficient results in healthcare system, and making health insurance affordable for millions of Americans who are seeking and getting coverage. The Medicaid spending in the U.S. grew by 3.9% in 2016 or 17.0% of the total National Health Expenditure. And Medicare spending grew by 3.6% in 2016 or 20.0% of the total National Health Expenditure.

The underpaid segment is anticipated to dominate the market through 2026 owing to growing cases of frauds against government healthcare programs and increasing use of healthcare services that are not medically required. There have been several cases where businesses and individuals have defrauded federal and state government healthcare programs by submitting false claims for healthcare services, treatment, pharmaceutical, and medical devices that were never rendered.

Also, the rivalry among healthcare providers and rising pressure from commercial and public payers to reduce costs as well as to improve care are shifting their focus towards value-based care models from volume-based healthcare models.

Healthcare Reimbursement Market Report Highlights:

• The underpaid segment dominated the market with a revenue share of 81.2% in 2024. Underpaid claims often result from billing and filing errors, contract discrepancies, insurance processing or calculating errors, and more.
• The public payers dominated the global market for healthcare reimbursements in 2024. This is attributed to rooted trust regarding full payments by public payers in multiple countries, especially in nations with mid or low-income levels, history of full payments, government's involvement in multiple public insurance businesses and more.
• The physician office segment held the largest revenue share of 47.4% in 2024. This is attributed to increased hospital admissions due to the growing prevalence of chronic diseases, enhanced hospital infrastructures in multiple countries with growing economies, a rising number of specialty hospitals, and more.
• North America dominated the global market of healthcare reimbursement and accounted for a revenue share of 45.7% in 2024.

Table of Contents

Chapter 1. Methodology and Scope

• 1.1. Market Segmentation & Scope
• 1.2. Segment Definitions
  • 1.2.1. Claim
  • 1.2.2. Payer
  • 1.2.3. Service Provider
• 1.3. Estimates and Forecast Timeline
• 1.4. Research Methodology
• 1.5. Information Procurement
  • 1.5.1. Purchased Database
  • 1.5.2. GVR's Internal Database
  • 1.5.3. Secondary Sources
  • 1.5.4. Primary Research
• 1.6. Information Analysis
  • 1.6.1. Data Analysis Models
• 1.7. Market Formulation & Data Visualization
• 1.8. Model Details
  • 1.8.1. Commodity Flow Analysis
• 1.9. List of Secondary Sources
• 1.10. Objectives

Chapter 2. Executive Summary

• 2.1. Market Snapshot
• 2.2. Segment Snapshot
• 2.3. Competitive Landscape Snapshot

Chapter 3. Healthcare Reimbursement Market Variables, Trends, & Scope

• 3.1. Market Lineage Outlook
• 3.2. Market Dynamics
  • 3.2.1. Market Driver Analysis
  • 3.2.2. Market Restraint Analysis
• 3.3. Business Environment Analysis
  • 3.3.1. Industry Analysis - Porter's Five Forces Analysis
    • 3.3.1.1. Supplier Power
    • 3.3.1.2. Buyer Power
    • 3.3.1.3. Substitution Threat
    • 3.3.1.4. Threat of New Entrants
    • 3.3.1.5. Competitive Rivalry
  • 3.3.2. PESTLE Analysis

Chapter 4. Healthcare Reimbursement Market: Claim Business Analysis

• 4.1. Claim Market Share, 2024 & 2030
• 4.2. Claim Segment Dashboard
• 4.3. Market Size & Forecasts and Trend Analysis, by Claim, 2018 to 2030 (USD Million)
• 4.4. Underpaid
  • 4.4.1. Underpaid Market, 2018 - 2030 (USD Million)
• 4.5. Full Paid
  • 4.5.1. Full Paid Market, 2018 - 2030 (USD Million)

Chapter 5. Healthcare Reimbursement Market: Payer Business Analysis

• 5.1. Payer Market Share, 2024 & 2030
• 5.2. Payer Segment Dashboard
• 5.3. Market Size & Forecasts and Trend Analysis, by Payer, 2018 to 2030 (USD Million)
• 5.4. Private Payers
  • 5.4.1. Private Payers Market, 2018 - 2030 (USD Million)
• 5.5. Public Payers
  • 5.5.1. Public Payers Market, 2018 - 2030 (USD Million)

Chapter 6. Healthcare Reimbursement Market: Service Provider Business Analysis

• 6.1. Service Provider Market Share, 2024 & 2030
• 6.2. Service Provider Segment Dashboard
• 6.3. Market Size & Forecasts and Trend Analysis, by Service Provider, 2018 to 2030 (USD Million)
• 6.4. Hospitals
  • 6.4.1. Hospitals Market, 2018 - 2030 (USD Million)
• 6.5. Physician Office
  • 6.5.1. Physician Office Market, 2018 - 2030 (USD Million)
• 6.6. Diagnostic Laboratories
  • 6.6.1. Diagnostic Laboratories Market, 2018 - 2030 (USD Million)
• 6.7. Other Service Providers
  • 6.7.1. Other Service Providers Market, 2018 - 2030 (USD Million)

Chapter 7. Healthcare Reimbursement Market: Regional Estimates & Trend Analysis

• 7.1. Regional Market Share Analysis, 2024 & 2030
• 7.2. Regional Market Dashboard
• 7.3. Market Size, & Forecasts Trend Analysis, 2018 to 2030
• 7.4. North America
  • 7.4.1. North America Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
  • 7.4.2. U.S.
    • 7.4.2.1. Key Country Dynamics
    • 7.4.2.2. Regulatory Framework
    • 7.4.2.3. Competitive Insights
    • 7.4.2.4. U.S. Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.4.3. Canada
    • 7.4.3.1. Key Country Dynamics
    • 7.4.3.2. Regulatory Framework
    • 7.4.3.3. Competitive Insights
    • 7.4.3.4. Canada Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.4.4. Mexico
    • 7.4.4.1. Key Country Dynamics
    • 7.4.4.2. Regulatory Framework
    • 7.4.4.3. Competitive Insights
    • 7.4.4.4. Mexico Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
• 7.5. Europe
  • 7.5.1. Europe Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
  • 7.5.2. UK
    • 7.5.2.1. Key Country Dynamics
    • 7.5.2.2. Regulatory Framework
    • 7.5.2.3. Competitive Insights
    • 7.5.2.4. UK Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.3. Germany
    • 7.5.3.1. Key Country Dynamics
    • 7.5.3.2. Regulatory Framework
    • 7.5.3.3. Competitive Insights
    • 7.5.3.4. Germany Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.4. France
    • 7.5.4.1. Key Country Dynamics
    • 7.5.4.2. Regulatory Framework
    • 7.5.4.3. Competitive Insights
    • 7.5.4.4. France Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.5. Italy
    • 7.5.5.1. Key Country Dynamics
    • 7.5.5.2. Regulatory Framework
    • 7.5.5.3. Competitive Insights
    • 7.5.5.4. Italy Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.6. Spain
    • 7.5.6.1. Key Country Dynamics
    • 7.5.6.2. Regulatory Framework
    • 7.5.6.3. Competitive Insights
    • 7.5.6.4. Spain Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.7. Norway
    • 7.5.7.1. Key Country Dynamics
    • 7.5.7.2. Regulatory Framework
    • 7.5.7.3. Competitive Insights
    • 7.5.7.4. Norway Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.8. Denmark
    • 7.5.8.1. Key Country Dynamics
    • 7.5.8.2. Regulatory Framework
    • 7.5.8.3. Competitive Insights
    • 7.5.8.4. Denmark Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.5.9. Sweden
    • 7.5.9.1. Key Country Dynamics
    • 7.5.9.2. Regulatory Framework
    • 7.5.9.3. Competitive Insights
    • 7.5.9.4. Sweden Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
• 7.6. Asia Pacific
  • 7.6.1. Asia Pacific Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
  • 7.6.2. Japan
    • 7.6.2.1. Key Country Dynamics
    • 7.6.2.2. Regulatory Framework
    • 7.6.2.3. Competitive Insights
    • 7.6.2.4. Japan Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.6.3. China
    • 7.6.3.1. Key Country Dynamics
    • 7.6.3.2. Regulatory Framework
    • 7.6.3.3. Competitive Insights
    • 7.6.3.4. China Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.6.4. India
    • 7.6.4.1. Key Country Dynamics
    • 7.6.4.2. Regulatory Framework
    • 7.6.4.3. Competitive Insights
    • 7.6.4.4. India Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.6.5. South Korea
    • 7.6.5.1. Key Country Dynamics
    • 7.6.5.2. Regulatory Framework
    • 7.6.5.3. Competitive Insights
    • 7.6.5.4. South Korea Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.6.6. Australia
    • 7.6.6.1. Key Country Dynamics
    • 7.6.6.2. Regulatory Framework
    • 7.6.6.3. Competitive Insights
    • 7.6.6.4. Australia Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.6.7. Thailand
    • 7.6.7.1. Key Country Dynamics
    • 7.6.7.2. Regulatory Framework
    • 7.6.7.3. Competitive Insights
    • 7.6.7.4. Thailand Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
• 7.7. Latin America
  • 7.7.1. Latin America Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
  • 7.7.2. Brazil
    • 7.7.2.1. Key Country Dynamics
    • 7.7.2.2. Regulatory Framework
    • 7.7.2.3. Competitive Insights
    • 7.7.2.4. Brazil Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.7.3. Argentina
    • 7.7.3.1. Key Country Dynamics
    • 7.7.3.2. Regulatory Framework
    • 7.7.3.3. Competitive Insights
    • 7.7.3.4. Argentina Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
• 7.8. MEA
  • 7.8.1. MEA Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
  • 7.8.2. South Africa
    • 7.8.2.1. Key Country Dynamics
    • 7.8.2.2. Regulatory Framework
    • 7.8.2.3. Competitive Insights
    • 7.8.2.4. South Africa Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.8.3. Saudi Arabia
    • 7.8.3.1. Key Country Dynamics
    • 7.8.3.2. Regulatory Framework
    • 7.8.3.3. Competitive Insights
    • 7.8.3.4. Saudi Arabia Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.8.4. UAE
    • 7.8.4.1. Key Country Dynamics
    • 7.8.4.2. Regulatory Framework
    • 7.8.4.3. Competitive Insights
    • 7.8.4.4. UAE Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 7.8.5. Kuwait
    • 7.8.5.1. Key Country Dynamics
    • 7.8.5.2. Regulatory Framework
    • 7.8.5.3. Competitive Insights
    • 7.8.5.4. Kuwait Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)

Chapter 8. Competitive Landscape

• 8.1. Participant Overview
• 8.2. Company Market Position Analysis
• 8.3. Company Categorization
• 8.4. Strategy Mapping
• 8.5. Company Profiles/Listing
  • 8.5.1. United HealthCare Services, Inc.
    • 8.5.1.1. Overview
    • 8.5.1.2. Financial Performance
    • 8.5.1.3. Product Benchmarking
    • 8.5.1.4. Strategic Initiatives
  • 8.5.2. Allianz Care
    • 8.5.2.1. Overview
    • 8.5.2.2. Financial Performance
    • 8.5.2.3. Product Benchmarking
    • 8.5.2.4. Strategic Initiatives
  • 8.5.3. CVS Health
    • 8.5.3.1. Overview
    • 8.5.3.2. Financial Performance
    • 8.5.3.3. Product Benchmarking
    • 8.5.3.4. Strategic Initiatives
  • 8.5.4. Reliance Nippon Life Insurance Company Limited
    • 8.5.4.1. Overview
    • 8.5.4.2. Financial Performance
    • 8.5.4.3. Product Benchmarking
    • 8.5.4.4. Strategic Initiatives
  • 8.5.5. Cigna Healthcare
    • 8.5.5.1. Overview
    • 8.5.5.2. Financial Performance
    • 8.5.5.3. Product Benchmarking
    • 8.5.5.4. Strategic Initiatives
  • 8.5.6. Aviva
    • 8.5.6.1. Overview
    • 8.5.6.2. Financial Performance
    • 8.5.6.3. Product Benchmarking
    • 8.5.6.4. Strategic Initiatives
  • 8.5.7. BNPP Paribas Cardif
    • 8.5.7.1. Overview
    • 8.5.7.2. Financial Performance
    • 8.5.7.3. Product Benchmarking
    • 8.5.7.4. Strategic Initiatives
  • 8.5.8. Wellcare Health Plans, Inc.
    • 8.5.8.1. Overview
    • 8.5.8.2. Financial Performance
    • 8.5.8.3. Product Benchmarking
    • 8.5.8.4. Strategic Initiatives
  • 8.5.9. Agile Health
    • 8.5.9.1. Overview
    • 8.5.9.2. Financial Performance
    • 8.5.9.3. Product Benchmarking
    • 8.5.9.4. Strategic Initiatives
  • 8.5.10. Violet Cross Blue Cover Association
    • 8.5.10.1. Overview
    • 8.5.10.2. Financial Performance
    • 8.5.10.3. Product Benchmarking
    • 8.5.10.4. Strategic Initiatives