의료보험자 서비스 시장 : 서비스 유형, 용도, 최종 사용자, 지역별 예측(-2032년)

Global Healthcare Payer Service Market Research Report Information by Service Type (Business Process Outsourcing Services, IT Outsourcing Services, and Knowledge Process Outsourcing Services) by Application (Claims Management, Integrated Front Office and Back Office Operations, Member Management, Provider Management, Billing and Accounts Management, Analytics and Fraud Management, Human Resource, Clinical Decision-Making, Patient Engagement, and Others), by End User (Private Payers and Public Payers), by Region Forecast to 2032

Market Overview

The Healthcare Payer Service Market was valued at USD 69.32 billion in 2022. The Healthcare Payer Service Market is expected to increase from USD 73.01 billion in 2023 to USD 156.04 billion by 2032, with a compound yearly growth rate (CAGR) of 8.81% over the forecast period (2023-2032).

Healthcare insurance enrollments are increasing due to a variety of factors, including an aging population in emerging countries, rising healthcare costs, and changes in employer-sponsored health insurance. According to the Assistant Secretary for Planning and Evaluation, there were around 31 million persons enrolled in late 2020 and early 2021 in America. Furthermore, more than 40.2 million Americans signed up for Marketplace and Medicaid expansion coverage in 2022 and early 2023.

Furthermore, according to secondary research, there has been a significant increase in health insurance enrollment in low- and middle-income countries as a result of increased awareness of the benefits of health insurance adoption, lower costs of health insurance products, and the government providing individuals with opportunities to try health insurance at a reduced cost. As a result, increased health insurance knowledge and enrollment are driving the growth of the healthcare payer services market.

Market Segment insights

The Healthcare Payer Service Market is segmented by service type, which includes business process outsourcing, IT outsourcing, and knowledge process outsourcing services.

The Healthcare Payer Service Market is segmented by applications such as claims management, integrated front and back-office operations, member management, provider management, billing and accounts management, analytics and fraud management, human resources, clinical decision-making, patient engagement, and others.

The Healthcare Payer Service Market is segmented based on end users, which comprise both private and public payers.

Regional insights

The study divides the market into four regions: North America, Europe, Asia-Pacific, and the rest of the world. The North American healthcare payer service market held the biggest market share in 2022. This is due to the advanced healthcare system in this region, the increasing adoption of healthcare policies, and the established presence of significant market participants.

The Asia-Pacific healthcare payer service market is predicted to increase significantly between 2023 and 2032. This is due to increased investments and reforms to modernize China's healthcare infrastructure, the implementation of new ICT guidelines in Japan, and the Asia-Pacific region's growing patient population suffering from chronic diseases such as cancer, orthopedics, and cardiovascular disease.

The rest of the world is divided into three regions: the Middle East, Africa, and Latin America. The healthcare payer service market in the regions is expected to expand because to technology advancements and increased investment in healthcare infrastructure in the region.

Major Players

Oracle Corporation (US), IQVIA Holdings, Inc (US), HCL Technologies Limited (India), Accenture (Ireland), Cognizant (US), Dell Inc (US), Genpact (US), Omega Healthcare Management Services (India), Infosys Limited (India), and NTT DATA, Inc (Japan) are among the key players in the Healthcare Payer Service Market.

TABLE OF CONTENTS

1 EXECUTIVE SUMMARY

2 MARKET INTRODUCTION

• 2.1 DEFINITION
• 2.2 SCOPE OF THE STUDY
• 2.3 RESEARCH OBJECTIVE
• 2.4 MARKET STRUCTURE

3 RESEARCH METHODOLOGY

• 3.1 OVERVIEW
• 3.2 DATA FLOW
  • 3.2.1 DATA MINING PROCESS
• 3.3 PURCHASED DATABASE:
• 3.4 SECONDARY SOURCES:
  • 3.4.1 SECONDARY RESEARCH DATA FLOW:
• 3.5 PRIMARY RESEARCH:
  • 3.5.1 PRIMARY RESEARCH DATA FLOW:
  • 3.5.2 PRIMARY RESEARCH: NUMBER OF INTERVIEWS CONDUCTED
  • 3.5.3 PRIMARY RESEARCH: REGIONAL COVERAGE
• 3.6 APPROACHES FOR MARKET SIZE ESTIMATION:
  • 3.6.1 REVENUE ANALYSIS APPROACH
• 3.7 DATA FORECASTING
  • 3.7.1 DATA FORECASTING TECHNIQUE
• 3.8 DATA FORMULATIONLING
  • 3.8.1 MICROECONOMIC FACTOR ANALYSIS:
  • 3.8.2 DATA FORMULATIONLING:
• 3.9 TEAMS AND ANALYST CONTRIBUTION

4 MARKET DYNAMICS

• 4.1 INTRODUCTION
• 4.2 DRIVERS
  • 4.2.1 INCREASING NUMBER OF HEALTHCARE INSURANCE ENROLLMENTS
  • 4.2.2 RISING CASES OF HEALTHCARE FRAUD
• 4.3 RESTRAINTS
  • 4.3.1 HIGH RISK OF DATA BREACHES AND LOSS OF CONFIDENTIALITY
• 4.4 OPPORTUNITY
  • 4.4.1 INCREASING ADOPTION OF ADVANCED DATA ANALYTICS

5 MARKET FACTOR ANALYSIS

• 5.1 VALUE CHAIN ANALYSIS
  • 5.1.1 CUSTOMER ACQUISITION (PREPURCHASE QUERY)
  • 5.1.2 SERVICE CUSTOMIZATION
  • 5.1.3 CUSTOMER PURCHASE SUPPORT
  • 5.1.4 CUSTOMER FULFILMENT & POST-PURCHASE SUPPORT
• 5.2 PORTER'S FIVE FORCES MODEL
  • 5.2.1 THREAT OF NEW ENTRANTS
  • 5.2.2 BARGAINING POWER OF SUPPLIERS
  • 5.2.3 THREAT OF SUBSTITUTES
  • 5.2.4 BARGAINING POWER OF BUYERS
  • 5.2.5 INTENSITY OF RIVALRY
• 5.3 COVID-19 IMPACT ANALYSIS
  • 5.3.1 DEMAND-SUPPLY ANALYSIS
  • 5.3.2 PRICING ANALYSIS
  • 5.3.3 IMPACT ON KEY PLAYERS
• 5.4 QUALITATIVE OVERVIEW ON "EVALUATING WORKFLOW GAPS IN HEALTHCARE TRANSACTIONAL PROCESSES BETWEEN MEDICAL INSURANCE PAYERS AND LABORATORIES OR PHARMACIES

6 GLOBAL HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE

• 6.1 OVERVIEW
• 6.2 BUSINESS PROCESS OUTSOURCING SERVICES
• 6.3 IT OUTSOURCING SERVICES
• 6.4 KNOWLEDGE PROCESS OUTSOURCING SERVICES

7 GLOBAL HEALTHCARE PAYER SERVICES MARKET, BY APPLICATION

• 7.1 OVERVIEW
• 7.2 CLAIMS MANAGEMENT
• 7.3 INTEGRATED FRONT OFFICE AND BACK OFFICE OPERATIONS
• 7.4 MEMBER MANAGEMENT
• 7.5 PROVIDER MANAGEMENT
• 7.6 BILLING AND ACCOUNTS MANAGEMENT
• 7.7 ANALYTICS AND FRAUD MANAGEMENT
• 7.8 HUMAN RESOURCE
• 7.9 CLINICAL DECISION-MAKING
• 7.10 PATIENT ENGAGEMENT
• 7.11 OTHERS

8 GLOBAL HEALTHCARE PAYER SERVICES MARKET, BY END USER

• 8.1 OVERVIEW
• 8.2 PRIVATE PAYERS
• 8.3 PUBLIC PAYERS

9 GLOBAL HEALTHCARE PAYER SERVICES MARKET, BY REGION

• 9.1 OVERVIEW
• 9.2 NORTH AMERICA
  • 9.2.1 US
  • 9.2.2 CANADA
• 9.3 EUROPE
  • 9.3.1 GERMANY
  • 9.3.2 FRANCE
  • 9.3.3 UK
  • 9.3.4 ITALY
  • 9.3.5 SPAIN
  • 9.3.6 REST OF EUROPE
• 9.4 ASIA-PACIFIC
  • 9.4.1 CHINA
  • 9.4.2 INDIA
  • 9.4.3 JAPAN
  • 9.4.4 SOUTH KOREA
  • 9.4.5 AUSTRALIA
  • 9.4.6 REST OF ASIA-PACIFIC
• 9.5 REST OF THE WORLD
  • 9.5.1 MIDDLE EAST & AFRICA
  • 9.5.2 SOUTH AMERICA

10 COMPETITIVE LANDSCAPE

• 10.1 INTRODUCTION
• 10.2 MARKET SHARE ANALYSIS, 2022
• 10.3 COMPETITOR DASHBOARD
• 10.4 PUBLIC PLAYERS STOCK SUMMARY
• 10.5 COMPARATIVE ANALYSIS: KEY PLAYERS FINANICAL
• 10.6 KEY DEVELOPMENTS & GROWTH STRATEGIES
  • 10.6.1 ACQUISITION
  • 10.6.2 COLLABORATION

11 COMPANY PROFILES

• 11.1 ORACLE CORPORATION
  • 11.1.1 COMPANY OVERVIEW
  • 11.1.2 FINANCIAL OVERVIEW
  • 11.1.3 SERVICES OFFERED
  • 11.1.4 KEY DEVELOPMENTS
  • 11.1.5 SWOT ANALYSIS
  • 11.1.6 KEY STRATEGIES
• 11.2 IQVIA HOLDING, INC.
  • 11.2.1 COMPANY OVERVIEW
  • 11.2.2 FINANCIAL OVERVIEW
  • 11.2.3 SERVICES OFFERED
  • 11.2.4 KEY DEVELOPMENTS
  • 11.2.5 SWOT ANALYSIS
  • 11.2.6 KEY STRATEGIES
• 11.3 HCL TECHNOLOGIES LIMITED
  • 11.3.1 COMPANY OVERVIEW
  • 11.3.2 FINANCIAL OVERVIEW
  • 11.3.3 SERVICES/SOLUTIONS OFFERED
  • 11.3.4 KEY DEVELOPMENTS
  • 11.3.5 SWOT ANALYSIS
  • 11.3.6 KEY STRATEGIES
• 11.4 ACCENTURE
  • 11.4.1 COMPANY OVERVIEW
  • 11.4.2 FINANCIAL OVERVIEW
  • 11.4.3 PRODUCTS OFFERED
  • 11.4.4 KEY DEVELOPMENTS
  • 11.4.5 KEY STRATEGIES
• 11.5 COGNIZANT
  • 11.5.1 COMPANY OVERVIEW
  • 11.5.2 FINANCIAL OVERVIEW
  • 11.5.3 PRODUCTS OFFERED
  • 11.5.4 KEY DEVELOPMENTS
  • 11.5.5 SWOT ANALYSIS
  • 11.5.6 KEY STRATEGIES
• 11.6 DELL INC.
  • 11.6.1 COMPANY OVERVIEW
  • 11.6.2 FINANCIAL OVERVIEW
  • 11.6.3 PRODUCTS OFFERED
  • 11.6.4 KEY DEVELOPMENTS
  • 11.6.5 KEY STRATEGIES
• 11.7 GENPACT
  • 11.7.1 COMPANY OVERVIEW
  • 11.7.2 FINANCIAL OVERVIEW
  • 11.7.3 PRODUCTS OFFERED
  • 11.7.4 KEY DEVELOPMENTS
  • 11.7.5 KEY STRATEGIES
• 11.8 OMEGA HEALTHCARE MANAGEMENT SERVICES
  • 11.8.1 COMPANY OVERVIEW
  • 11.8.2 FINANCIAL OVERVIEW
  • 11.8.3 SERVICES OFFERED
  • 11.8.4 KEY DEVELOPMENTS
  • 11.8.5 KEY STRATEGIES
• 11.9 INFOSYS LIMITED
  • 11.9.1 COMPANY OVERVIEW
  • 11.9.2 FINANCIAL OVERVIEW
  • 11.9.3 SERVICES OFFERED
  • 11.9.4 KEY DEVELOPMENTS
  • 11.9.5 SWOT ANALYSIS
  • 11.9.6 KEY STRATEGIES
• 11.10 NTT DATA, INC
  • 11.10.1 COMPANY OVERVIEW
  • 11.10.2 FINANCIAL OVERVIEW
  • 11.10.3 SERVICES OFFERED
  • 11.10.4 KEY DEVELOPMENTS
  • 11.10.5 KEY STRATEGIES