The healthcare payer services market is estimated to be valued at US$ 76.05 Bn in 2024 and is expected to exhibit a CAGR of 9.4% over the forecast period 2024-2031, as highlighted in a new report published by Coherent Market Insights. Companies covered: Accenture PLC, Institute BCN Esthetics S.L., Hewlett-Packard, Dell, Inc., Zeomega, Verisk Analytics, Inc., UNITEDHEALTH GROUP, NXGN Management, LLC, MCKESSON CORPORATION, IBM Corporation, Epic Systems Corporation, eClinicalWorks, Cerner Corporation, Allscripts Healthcare Solutions, Inc., Aetna, Inc., Cognizant, Accenture, DXC Technology Company, Wipro

Burlingame, Aug. 26, 2024 (GLOBE NEWSWIRE) -- The global Healthcare Payer Services Market is projected to witness steady growth, with sales estimated at USD 76.05 billion in 2024, and anticipated to reach USD 143.06 billion by 2031. This growth reflects a compound annual growth rate (CAGR) of 9.4% during the forecast period, as highlighted in a new report published by Coherent Market Insights. Rapid adoption of advanced technologies such as artificial intelligence and robotic process automation by payers to improve operational efficiency. AI and machine learning help payers streamline claims review, understand trends, and prevent frauds. They also help improve customer service through virtual assistants.

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Market Dynamics:

The healthcare payer services market is primarily driven by the rising healthcare costs globally. Growing geriatric population and increasing incidence of chronic diseases are projected to further fuel the healthcare spending in the coming years. According to the U.S. Centers for Medicare & Medicaid Services, the national health spending is estimated to grow at an average rate of 5.5% annually and reach US$ 6.2 trillion by 2028. In addition, increasing emphasis on lowering the healthcare costs through effective policy management and claims processing is expected to boost the market growth over the forecast period.

Healthcare Payer Services Market Report Coverage

Report Coverage	Details
Market Revenue in 2024	$76.05 billion
Estimated Value by 2031	$143.06 billion
Growth Rate	Poised to grow at a CAGR of 9.4%
Historical Data	2019–2023
Forecast Period	2024–2031
Forecast Units	Value (USD Million/Billion)
Report Coverage	Revenue Forecast, Competitive Landscape, Growth Factors, and Trends
Segments Covered	By Service Type, By Application, By End User
Geographies Covered	North America, Europe, Asia Pacific, and Rest of World
Growth Drivers	• Rising Healthcare Costs • Increasing Adoption of E-Health Services
Restraints & Challenges	• Data privacy and security concerns • Lack of required healthcare infrastructure in developing nations

Market Trends:

Adoption of artificial intelligence and analytics: Major healthcare payers are increasingly adopting artificial intelligence and advanced analytics to optimize processes such as claims management, customer service, and fraud detection. This trend is expected to continue during the forecast period.

Launch of new customized plans: Key players in the market are focusing on developing and launching customized healthcare plans specific to the requirements of employers and customers. This is expected to be a major trend in the healthcare payer services market.

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Market Opportunities:

Claims management services help healthcare payers manage the entire claims lifecycle from receipt to payment. It involves activities like claims processing, validating eligibility and coverage, ensuring accuracy of claims, and reviewing claims forcoding errors or inconsistencies. With rising healthcare costs and complex regulations, there is increasing need for automation and streamlining of claims management. This offers opportunities for payer services providers to offer advanced claims management solutions powered by technologies like artificial intelligence, machine learning and robotic processing automation.

Human resource services help healthcare payers manage employee records, benefits administration, payroll management, talent acquisition and other HR functions. With the rapid growth of the healthcare industry, payers are facing challenges in efficiently managing the HR needs of their large and expanding workforce. This creates an opportunity for payer services providers to offer specialized HR management services tailored to the requirements of the healthcare sector. Consolidating HR functions onto cloud-based platforms allows payers to focus on their core business while ensuring compliance and optimizing HR costs.

Key Market Takeaways:

The global healthcare payer services market is anticipated to witness a CAGR of 9.4% during the forecast period 2024-2031, owing to rising healthcare costs, complex regulations and the need for optimization of payer operations.

On the basis of service, the BPO services segment is expected to hold a dominant position, accounting for over 30% share of the market by 2031, owing to the strong outsourcing trend among healthcare payers to reduce costs and focus on their core competencies.

On the basis of application, the claims management services segment is expected to hold a dominant position over the forecast period, as claims processing remains a major administrative function and a major cost center for healthcare payers.

On the basis of region, North America is expected to hold a dominant position over the forecast period, due to the presence of major payer services providers and the considerable size of the healthcare market in the US.

Key players operating in the healthcare payer services market include Cognizant, EXL, HGS Ltd. (Hinduja Global Solutions Limited), Accenture, and Concentrix. These players are focusing on partnerships, mergers and acquisitions to expand their service offerings and geographic footprint.

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Recent Developments:

In September 2023, Genpact expanded its collaboration with Amazon Web Services (AWS) to enhance financial crime risk operations using generative AI and large language models. This collaboration is expected to offer a competitive edge over competitors.

In April 2023, Cognizant, a provider of IT services, announced extension of long-standing partnership with Microsoft in healthcare. Under this partnership, healthcare payers and providers will have quick access to cutting-edge technological solutions, simplified claims processing, and improved interoperability, all of which are likely to help them improve business processes and provide better patient and member experiences.

Detailed Segmentation:

By Service Type:

• Business Process Outsourcing
• Information Technology Outsourcing
• Knowledge Process Outsourcing
  

By Application:

• 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
• Payment Management Services
• Audit and Analysis Systems
  

By End User:

• Private Payers
• Public Payers

By Region:  

North America:

• U.S.
• Canada

Latin America:

• Brazil
• Argentina
• Mexico
• Rest of Latin America

Europe:

• Germany
• U.K.
• Spain
• France
• Italy
• Russia
• Rest of Europe
  

Asia Pacific:

• China
• India
• Japan
• Australia
• South Korea
• ASEAN
• Rest of Asia Pacific
  

Middle East:

• GCC Countries
• Israel
• Rest of Middle East
  

Africa:

• South Africa
• North Africa
• Central Africa
  

Have a Look at Trending Research Reports on Healthcare IT Domain:

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Author Bio:

Ravina Pandya, PR Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. With an MBA in E-commerce, she has an expertise in SEO-optimized content that resonates with industry professionals.

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Coherent Market Insights is a global market intelligence and consulting organization that provides syndicated research reports, customized research reports, and consulting services. We are known for our actionable insights and authentic reports in various domains including aerospace and defense, agriculture, food and beverages, automotive, chemicals and materials, and virtually all domains and an exhaustive list of sub-domains under the sun. We create value for clients through our highly reliable and accurate reports. We are also committed in playing a leading role in offering insights in various sectors post-COVID-19 and continue to deliver measurable, sustainable results for our clients.

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