North America Healthcare Payer Services Market Size, Share & Trends Analysis Report By Services (BPO Services, ITO Services, KPO Services), By Application, By End-use (Private Payers, Public Payers), And Segment Forecasts, 2023 - 2030

February 2023 | 103 pages | ID: N03F750B06E4EN
Grand View Research, Inc.

Abstracts

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North America Healthcare Payer Services Market Growth & Trends

The North America healthcare payer services market is expected to reach USD 83.0 billion by 2030, expanding at a CAGR of 7.3%, from 2023 to 2030, according to a new report by Grand View Research, Inc. The main drivers of this market are the rising demand for healthcare IT, changes in regulatory research, the presence of several healthcare policies, the growing disease burden, and the increasing adoption of health insurance policies.

The market for healthcare payer services in North America has been severely impacted by the COVID-19 outbreak. To overcome this, healthcare payer services have accelerated the adoption of telehealth, telemedicine hubs, and virtual care in North America. It has created opportunities for healthcare payers to offer new services and reach more patients, particularly in rural areas or among those with mobility issues. Telehealth allows for remote consultations and remote monitoring of patients, which can help reduce the burden on healthcare providers and improve the overall accessibility of healthcare.

The use of artificial intelligence (AI) and machine learning (ML) technologies can also help healthcare payers identify at-risk populations & develop targeted interventions. By analyzing large amounts of data, these technologies can help payers to identify patterns and predict patient outcomes, which can lead to improved patient outcomes, reduced costs, and increased efficiency in healthcare delivery. In addition, AI can be used to improve the accuracy of diagnoses, reduce misdiagnosis, and improve the overall quality of care.

North America Healthcare Payer Services Market Report Highlights

• U.S. accounted for the largest market share of 79.6% in 2022 and is also anticipated to register the fastest growth of 7.5% during the forecast period.
• ITO Services dominated the service segment with a market share of 51.3 % in 2022. The major growth factors are increasing demand for innovative and advanced technologies, a rise in investment in AI technology, and a rise in involvement in healthcare decisions.
• Provider management services is anticipated to register the fastest growth of 8.6% over the forecast period.
• In September 2022, Accenture announced the acquisition of The Beacon Group, a consulting firm. This would help its growth across the aerospace, technology, healthcare, industrial, and life sciences verticals.

Contents

CHAPTER 1 REPORT SCOPE

1.1 Segment Scope
1.2 Service Scope
1.3 Application Scope
1.4 End-use Scope
1.5 Country Scope
1.6 Estimates and Forecast Timeline

CHAPTER 2 RESEARCH METHODOLOGY

2.1 Information procurement
2.2 Purchased database:
2.3 GVR’s Internal Database
2.4 Secondary sources:
2.5 Primary Research:
2.6 List of Primary Sources
2.7 Information Or Data analysis
2.8 Market Formulation & Validation
2.9 Country - wise Market Calculation
  2.9.1 Country - Wise Market: Base Estimates
  2.9.2 North America Market: CAGR Calculation
  2.9.3 Country Based Segment Share Calculation
2.10 Model Details
  2.10.1 Company share analysis (Model 1)
2.11 List of Abbreviations
2.12 Objectives
  2.12.1 Objective - 1:
  2.12.2 Objective - 2:
  2.12.3 Objective - 3:
  2.12.4 Objective - 4:

CHAPTER 3 EXECUTIVE SUMMARY

3.1 Market Snapshot
3.2 Segment Snapshot
3.3 Segment Snapshot
3.4 Competitive Landscape Snapshot

CHAPTER 4 NORTH AMERICA HEALTHCARE PAYER SERVICES MARKET VARIABLES, TRENDS & SCOPE

4.1 Market Lineage Outlook
  4.1.1 Parent market outlook
    4.1.1.1 Global Healthcare Payer Services Market:
  4.1.2 Related/ancillary market outlook
    4.1.2.1 Healthcare Payer BPO market:
    4.1.2.2 Life Sciences Analytics market:
    4.1.2.3 Life sciences BPO Market:
4.2 Market Variable Analysis
  4.2.1 Market driver analysis
    4.2.1.1 Presence of Various Healthcare Policies
    4.2.1.2 Growing Disease Burden
    4.2.1.3 Increasing Adoption of Health Insurance Policies
  4.2.2 Market restraint analysis
    4.2.2.1 Increasing Legal & Regulatory Constraints for Offshore Outsourcing
4.3 Business Environment Analysis tools
  4.3.1 PESTEL Analysis
  4.3.2 Porter’s five forces analysis
4.4 Key Opportunities in the North America Healthcare Payer Services Market
  4.4.1 Telehealth and Virtual Care
  4.4.2 Data Analytics
  4.4.3 Artificial Intelligence (AI) and Machine Learning
  4.4.4 Digital Health Platforms
4.5 Digital Technology Landscape
4.6 COVID-19 Impact and Recovery Analysis

CHAPTER 5 NORTH AMERICA HEALTHCARE PAYER SERVICES MARKET: SERVICE SEGMENT ANALYSIS

5.1 Definitions & Scope
5.2 North America Healthcare Payer Services: Market Share Analysis, 2022 & 2030
5.3 Bpo Services
  5.3.1 Bpo Services Market, 2018 - 2030 (USD Million)
5.4 Ito Services
  5.4.1 Ito Services Market, 2018 - 2030 (USD Million)
5.5 Kpo Services
  5.5.1 Kpo Services Market, 2018 - 2030 (USD Million)

CHAPTER 6 NORTH AMERICA HEALTHCARE PAYER SERVICES MARKET: APPLICATION SEGMENT ANALYSIS

6.1 Definitions & Scope
6.2 North America Healthcare Payer Services: Market Share Analysis, 2022 & 2030
6.3 Claims Management Services
  6.3.1 Claims Management Services Market, 2018 - 2030 (USD Million)
6.4 Integrated Front Office Service And Back Office Operations
  6.4.1 Integrated Front Office Service And Back Office Operations Market, 2018 - 2030 (USD Million)
6.5 Member Management Services
  6.5.1 Member Management Services Market, 2018 - 2030 (USD Million)
6.6 Provider Management Services
  6.6.1 Provider Management Services Market, 2018 - 2030 (USD Million)
6.7 Billing And Accounts Management Services
  6.7.1 Billing & Accounts Management Services Market, 2018 - 2030 (USD Million)
6.8 Analytics And Fraud Management Services
  6.8.1 Analytics & Management Services Market, 2018 - 2030 (USD Million)
6.9 Hr Services
  6.9.1 Hr Services Market, 2018 - 2030 (USD Million)

CHAPTER 7 NORTH AMERICA HEALTHCARE PAYER SERVICES MARKET: END-USE SEGMENT ANALYSIS

7.1 Definitions & Scope
7.2 North America Healthcare Payer Services: Market Share Analysis, 2022 & 2030
7.3 Private Payers
  7.3.1 Private Payers Market, 2018 - 2030 (USD Million)
7.4 Public Payers
  7.4.1 Public Payers Market, 2018 - 2030 (USD Million)

CHAPTER 8 NORTH AMERICA HEALTHCARE PAYER SERVICES MARKET: COUNTRY LEVEL ESTIMATES AND TREND ANALYSIS, BY SERVICE, APPLICATION, & END-USE

8.1 North America
8.2 Swot Analysis:
  8.2.1 North America Healthcare Payer Services Market Estimates And Forecasts, 2018 - 2030 (USD Million)
8.3 U.S.
  8.3.1 Key Country Dynamics
  8.3.2 Competitive Scenario
  8.3.3 Regulatory Framework
  8.3.4 U.S. Healthcare Payer Services Market Estimates And Forecasts, 2018 - 2030 (USD Million)
8.4 Canada
  8.4.1 Key Country Dynamics
  8.4.2 Competitive Scenario
  8.4.3 Regulatory Framework
  8.4.4 Canada Healthcare Payer Services Market Estimates And Forecasts, 2018 - 2030 (USD Million)

CHAPTER 9 COMPETITIVE ANALYSIS

9.1 Participant’s Overview
9.2 Financial Performance
9.3 Participant Categorization
  9.3.1 Market Leaders
    9.3.1.1 North America Healthcare Payer Services Market Share Analysis, 2022
9.4 Company Profile
  9.4.1 Cognizant
    9.4.1.1 Company Overview
    9.4.1.2 Financial Performance
    9.4.1.3 Service Benchmarking
    9.4.1.4 Strategic Initiatives
  9.4.2 Flatworld Solutions
    9.4.2.1 Company Overview
    9.4.2.2 Financial Performance
    9.4.2.3 Service Benchmarking
    9.4.2.4 Strategic Initiatives
  9.4.3 Accenture
    9.4.3.1 Company Overview
    9.4.3.2 Financial Performance
    9.4.3.3 Service Benchmarking
    9.4.3.4 Strategic Initiatives
  9.4.4 Xerox Corporation
    9.4.4.1 Company Overview
    9.4.4.2 Financial Performance
    9.4.4.3 Service Benchmarking
    9.4.4.4 Strategic Initiatives
  9.4.5 Wipro Ltd.
    9.4.5.1 Company Overview
    9.4.5.2 Financial Performance
    9.4.5.3 Service Benchmarking
    9.4.5.4 Strategic Initiatives
  9.4.6 Infosys
    9.4.6.1 Company Overview
    9.4.6.2 Financial Performance
    9.4.6.3 Service Benchmarking
    9.4.6.4 Strategic Initiatives
  9.4.7 Iqvia
    9.4.7.1 Company Overview
    9.4.7.2 Financial Performance
    9.4.7.3 Service Benchmarking
    9.4.7.4 Strategic Initiatives
  9.4.8 Orion Healthcorp
    9.4.8.1 Company Overview
    9.4.8.2 Financial Performance
    9.4.8.3 Service Benchmarking
    9.4.8.4 Strategic Initiatives
  9.4.9 Promantra
    9.4.9.1 Company Overview
    9.4.9.2 Financial Performance
    9.4.9.3 Service Benchmarking
    9.4.9.4 Strategic Initiatives
  9.4.10 Medisys Data Solutions, Inc.
    9.4.10.1 Company Overview
    9.4.10.2 Financial Performance
    9.4.10.3 Service Benchmarking
    9.4.10.4 Strategic Initiatives

List Of Tables

LIST OF TABLES

Table 1 List of secondary sources:
Table 2 List of Abbreviations
Table 1 Key Companies undergoing Expansions
Table 2 Key Companies undertaking Acquisitions
Table 3 Key Companies undergoing Collaborations
Table 4 Key Companies Launching New Products/Services
Table 5 Key Companies undergoing Partnerships
Table 6 Key Companies undergoing Other Strategies

List Of Figures

LIST OF FIGURES

Fig. 1 Market research process
Fig. 2 Information Procurement
Fig. 3 Primary research pattern
Fig. 4 Market research approaches
Fig. 5 QFD modeling for market share assessment
Fig. 6 Market formulation & validation
Fig. 11 Parent market outlook
Fig. 12 Related/ancillary market outlook (2022)
Fig. 13 Market driver relevance analysis (Current & future impact)
Fig. 14 Survey response on chronic health conditions diagnosed in the general public and older millennials in the U.S.
Fig. 15 Percentage of uninsured people in the U.S. between the ages of 18 years and 64 years
Fig. 16 Market restraint relevance analysis (Current & future impact)
Fig. 17 Political & legal, economic and technological
Fig. 18 Porter’s five forces analysis
Fig. 19 Share of visits with a mental health and substance use disorder primary diagnosis, 2019 - 2021
Fig. 20 North America healthcare payer services market service outlook: Segment dashboard
Fig. 21 North America healthcare payer services market: service movement analysis
Fig. 22 BPO Services market, 2018 - 2030 (USD Million)
Fig. 23 ITO Services market, 2018 - 2030 (USD Million)
Fig. 24 KPO Services market, 2018 - 2030 (USD Million)
Fig. 25 North America healthcare payer services market application outlook: Segment dashboard
Fig. 26 North America healthcare payer services market: application movement analysis
Fig. 27 Claims Management Services market, 2018 - 2030 (USD Million)
Fig. 28 Integrated front office service & back office operations market, 2018 - 2030 (USD Million)
Fig. 29 Member Management Services market, 2018 - 2030 (USD Million)
Fig. 30 Provider Management Services market, 2018 - 2030 (USD Million)
Fig. 31 Billing & Accounts Management Services market, 2018 - 2030 (USD Million)
Fig. 32 Analytics & Fraud Management Services market, 2018 - 2030 (USD Million)
Fig. 33 HR Services market, 2018 - 2030 (USD Million)
Fig. 34 North America healthcare payer services market end - use outlook: Segment dashboard
Fig. 35 North America healthcare payer services market: end - use movement analysis
Fig. 36 Private payers market, 2018 - 2030 (USD Million)
Fig. 37 Public payers market, 2018 - 2030 (USD Million)
Fig. 38 Regional marketplace: Key takeaways
Fig. 39 Regional marketplace: Key takeaways
Fig. 40 North America: SWOT analysis
Fig. 41 North America Healthcare payer services market estimates and forecasts, 2018 - 2030 (USD Million)
Fig. 42 Key country dynamics
Fig. 43 U.S. healthcare payer services market estimates and forecasts, 2018 - 2030 (USD Million)
Fig. 44 Key country dynamics
Fig. 45 Canada healthcare payer services market estimates and forecasts, 2018 - 2030 (USD Million)
Fig. 46 Heat map analysis
Fig. 47 North America healthcare payer services market share analysis, 2022
Fig. 48 Strategic framework