The report “Healthcare Payer Services Market by Service Type (BPO (Claims, Front end, Provider, Product Development, Care Management, Billing, HR), ITO (Provider Network, Accounts, Analytics, Fraud), & KPO), End User (Public and Private) – Global Forecast to 2027″, is projected to reach USD 118.2 billion by 2027 from USD 69.9 billion in 2022, at a CAGR of 11.1% during the forecast period.
The healthcare payer services market is mainly driven by the increasing health insurance enrolments, rising incidences of healthcare frauds, federal mandates, and rising cases of chronic diseases. However, the risk of data breaches, a loss of managerial control, cultural and language barriers, and high costs associated with outsourcing are expected to restrain the growth of this market to a certain extent.
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“BPO services type segment is expected to account for the largest share of the healthcare payer services market in 2022”
Based on service type, the healthcare payer services market is bifurcated into ITO services, BPO services and KPO services. In 2022, the BPO services segment is expected to hold the largest market share. The large share of this segment is primarily attributed to the fact that BPO services can help payers reduce operational costs by outsourcing administrative and non-core functions such as claims processing, member enrolment, and customer support to specialized BPO service providers. This allows payers to focus on their core business of providing healthcare coverage and managing risk.
“Private payers segment to grow at the highest CAGR in the healthcare payer services market during the forecast period, by end user”
Based on end user, the healthcare payer services market is bifurcated into private payers & public payers. In 2022, the private payers segment is expected to account for the largest market share of the healthcare payer services market. During the forecast period, the private payers’ segment is expected to grow at the highest CAGR. The high growth of this segment is attributed the increasing adoption of private health insurance by individuals and employers, along with advancements in technology and the need for better healthcare services and rising competitiveness among private payers.
“North America is expected to hold the largest share of the healthcare payer services market in 2022”
Based on region, the healthcare payer services market is divided into North America, Europe, Asia Pacific, and the Rest of the World (RoW). Factors such as rise in insurance enrolments due to PPACA, federal healthcare mandates to drive the demand for outsourcing of services, rising healthcare costs, increasing chronic disease prevalence, technological advancements, shifting consumer preferences, and rising need to curb healthcare expenditure are driving the growth in North American market.
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Key Market Players
Prominent players in this market include Accenture (Ireland), Cognizant (US), Tata Consultancy Services (India), XEROX Corporation (US), WNS (Holdings) Limited (India), NTT Data Corporation (Japan), IQVIA Inc. (US), Mphasis (India), Genpact (US), Wipro (India), Infosys BPM (India), Firstsource Solutions (India), IBM Corporation (US), HCL Technologies (India), Solutions (US), Lonza (Switzerland), Omega Healthcare (India), R1 RCM, INC. (US), Invensis Technologies (India), UnitedHealth Group (US), Sykes Enterprises (US), Paraxel Corporation International (US), Access Healthcare (US), and Akurate Management Solutions (US).
In July 2021, Cognizant (US) collaborated with Royal Philips (Netherlands) to create Philips HealthSuite, a cloud-based platform, to deliver and maintain leading-edge digital health solutions, providing advanced connectivity and using big data to create actionable insights.
In April 2021, Xerox Corporation (US) acquired Groupe CT (Canada), an independent document management provider in Eastern Canada, to accelerate a digital transformation roadmap by combining its document management services expertise and leadership with Xerox’s portfolio of workplace solutions to expand its reach in the North American market.
In December 2020, Accenture (Ireland) acquired OpusLine (France) to help clients innovate and deliver digital innovation across their organizations.
In June 2018, WNS (Holdings) Limited (India) entered into a global shared services partnership with Hyperion Insurance Group (UK), which enabled WNS to highlight its position as an industry leader in high-end global insurance BPM.
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