의료 지불자 서비스 시장 규모, 점유율, 성장 분석 : 서비스별, 용도별, 최종 용도별, 지역별 - 산업별 예측(2024-2031년)

Global Healthcare Payer Services Market size was valued at USD 65.4 billion in 2022 and is poised to grow from USD 70.83 billion in 2023 to USD 134.04 billion by 2031, growing at a CAGR of 8.3% during the forecast period (2024-2031).

The global healthcare payer services market is poised for substantial growth as the costs associated with healthcare supply chain business process outsourcing (BPO) decline. This trend is coupled with an increasing demand for outsourcing in inventory control and overall healthcare delivery efficiency. Factors like the implementation of ICD-10 codes, patent expirations in pharmaceuticals, and the decreasing costs of healthcare delivery significantly contribute to this growth. Furthermore, the integration of advanced technologies like AI, analytics, and cloud-based services intensifies market competition, with players like Accenture providing solutions that enhance service accessibility and reduce logistics costs. Despite challenges posed by the COVID-19 pandemic, healthcare payers have adapted positively, forming strategic alliances and launching initiatives aimed at addressing systemic health disparities, further bolstering market expansion potential.

Top-down and bottom-up approaches were used to estimate and validate the size of the Global Healthcare Payer Services market and to estimate the size of various other dependent submarkets. The research methodology used to estimate the market size includes the following details: The key players in the market were identified through secondary research, and their market shares in the respective regions were determined through primary and secondary research. This entire procedure includes the study of the annual and financial reports of the top market players and extensive interviews for key insights from industry leaders such as CEOs, VPs, directors, and marketing executives. All percentage shares split, and breakdowns were determined using secondary sources and verified through Primary sources. All possible parameters that affect the markets covered in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data.

Global Healthcare Payer Services Market Segmental Analysis

Global Healthcare Payer Services Market is segmented by services, application, end use and region. Based on services, the market is segmented into BPO services, ITO services and KPO services. Based on application, the market is segmented into claims management services, integrated front office service and back office operations, member management services, provider management services, billing and accounts management services, analytics and fraud management services and hr services. Based on end use, the market is segmented into private payers and public payers. Based on region, the market is segmented into North America, Europe, Asia Pacific, Latin America and Middle East & Africa.

Driver of the Global Healthcare Payer Services Market

The Global Healthcare Payer Services market is significantly driven by the increasing complexity of payer operations, which encompass various challenges such as claims processing, member enrollment, billing, and customer service. As these organizations navigate intricate operational hurdles, they turn to specialized payer service providers for assistance. These providers deliver tailored expertise, advanced technology solutions, and operational support designed to streamline processes and improve overall efficiency. By effectively managing these complexities, payer services help organizations optimize their operations, ultimately contributing to the heightened demand for such services in the healthcare payer market.

Restraints in the Global Healthcare Payer Services Market

In the Global Healthcare Payer Services market, various restraints hinder growth, particularly regarding cost constraints and pricing pressures. Payer organizations grapple with escalating healthcare costs while attempting to keep premiums manageable for their members. This dynamic challenges payer service providers to not only showcase significant cost savings but also to develop competitive pricing models that ensure their sustainability in an increasingly competitive landscape. As the demand for affordable healthcare solutions rises, these organizations must navigate financial pressures effectively to maintain viability and meet the evolving needs of their customers.

Market Trends of the Global Healthcare Payer Services Market

The Global Healthcare Payer Services market is experiencing a significant shift towards value-based care models, driven by the increasing emphasis on improving patient outcomes and achieving cost-efficiency in healthcare delivery. Payer service providers are adapting their strategies and offerings to support these value-based payment frameworks, which prioritize quality over quantity of care. This trend encompasses enhanced care coordination, robust population health management initiatives, and the integration of advanced analytics to monitor and improve patient outcomes. Additionally, as healthcare systems worldwide seek to optimize resources and ensure sustainable care, there is a growing demand for innovative payer solutions that facilitate seamless transitions to value-based care.

Table of Contents

Introduction

• Objectives of the Study
• Scope of the Report
• Definitions

Research Methodology

• Information Procurement
• Secondary & Primary Data Methods
• Market Size Estimation
• Market Assumptions & Limitations

Executive Summary

• Global Market Outlook
• Supply & Demand Trend Analysis
• Segmental Opportunity Analysis

Market Dynamics & Outlook

• Market Overview
• Market Size
• Market Dynamics
  • Drivers & Opportunities
  • Restraints & Challenges
• Porters Analysis
  • Competitive rivalry
  • Threat of substitute
  • Bargaining power of buyers
  • Threat of new entrants
  • Bargaining power of suppliers

Key Market Insights

• Key Success Factors
• Degree of Competition
• Top Investment Pockets
• Market Ecosystem
• Market Attractiveness Index, 2023
• PESTEL Analysis
• Macro-Economic Indicators
• Value Chain Analysis
• Pricing Analysis

Global Healthcare Payer Services Market Size by Services & CAGR (2024-2031)

• Market Overview
• BPO Services
• ITO Services
• KPO Services

Global Healthcare Payer Services Market Size by Application & CAGR (2024-2031)

• Market Overview
• Claims Management Services
• Integrated Front Office Service and Back Office Operations
• Member Management Services
• Provider Management Services
• Billing and Accounts Management Services
• Analytics and Fraud Management Services
• HR Services

Global Healthcare Payer Services Market Size by End Use & CAGR (2024-2031)

• Market Overview
• Private Payers
• Public Payers

Global Healthcare Payer Services Market Size & CAGR (2024-2031)

• North America (Services, Application, End Use)
  • USA
  • Canada
• Europe (Services, Application, End Use)
  • Germany
  • Spain
  • France
  • UK
  • Italy
  • Rest of Europe
• Asia Pacific (Services, Application, End Use)
  • China
  • India
  • Japan
  • South Korea
  • Rest of Asia-Pacific
• Latin America (Services, Application, End Use)
  • Brazil
  • Rest of Latin America
• Middle East & Africa (Services, Application, End Use)
  • GCC Countries
  • South Africa
  • Rest of Middle East & Africa

Competitive Intelligence

• Top 5 Player Comparison
• Market Positioning of Key Players, 2023
• Strategies Adopted by Key Market Players
• Recent Developments in the Market
• Company Market Share Analysis, 2023
• Company Profiles of All Key Players
  • Company Details
  • Product Portfolio Analysis
  • Company's Segmental Share Analysis
  • Revenue Y-O-Y Comparison (2021-2023)

Key Company Profiles

• UnitedHealth Group (UNH) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• CVS Health (CVS) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• McKesson Corporation (MCK) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Cigna (CI) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Elevance Health (ELV) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Centene Corporation (CNC) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Humana Inc. (HUM) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Anthem, Inc. (ANTM) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Cognizant Technology Solutions (CTSH) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Accenture plc (ACN) (Ireland)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Wipro Limited (WIT) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Tata Consultancy Services (TCS) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Infosys Limited (INFY) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• HCL Technologies (HCL) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• DXC Technology Company (DXC) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• IBM Corporation (IBM) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Oracle Corporation (ORCL) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Microsoft Corporation (MSFT) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Amazon.com, Inc. (AMZN) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Google LLC (Alphabet Inc.) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments

Conclusion & Recommendations