Summary

Healthcare Payer Services Market Growth & Trends

The global healthcare payer services market is expected to reach USD 111.9 billion by 2030, registering a CAGR of 7.6% from 2023 to 2030, according to a new report by Grand View Research, Inc. The industry is anticipated to witness substantial demand for IT operations so as to allow companies to focus on their core tasks and reduce operational costs. The growing vigilance regarding data security and customer-centricity in projects, especially in the aerospace & defense and BFSI sectors, are fueling the demand for information technology services outsourcing.

The market is progressing owing to the ever-increasing demand for consultancy-related projects. The growing need for proficiency in formulating and streamlining IT strategy, enterprise architecture advisory, portfolio consulting, and ensuring effective and smooth digital transformation further boosts the industry growth. Rapid innovations, offering various benefits to different industries globally, will also support market growth. Delegation of time-consuming and tedious tasks to service providers empowers businesses to concentrate on their central functionalities and reduces the load on their internal resources. It also offers optimization of capacity, resources, and flexibility to meet the demands of the changing commercial environment, and better access to innovation and intellectual property.

Service providers are coming up with different operational and pricing models to gain a competitive edge over others. The advent of cloud computing has fueled market growth as it enables firms to automate and ease their business applications and processes. Hence, enterprises, especially Small & Medium Businesses (SMBs), are largely deploying the Software as a Service (SaaS) model and the Infrastructure as a Service (IaaS) model, which has compelled the service providers to capitalize on the cloud-based offerings.

The COVID-19 pandemic has impacted the healthcare payer services market significantly. The market is doing well financially as compared to other sectors due to a rise in demand for medical care. However, the coming years for the economics of the market are full of threats. However, the payers are doing their part in this pandemic by providing support to providers, helping in the management and delivery of COVID-19 related supplies to multiple care providers, and also creating web portals that provide relevant and rapid information related to COVID-19.

Healthcare Payer Services Market Report Highlights

• ITO services segment dominated the market with the largest revenue share in 2022. The rising demand for advanced and innovative technologies, increased investment in Artificial Intelligence (AI) technology, and growing engagement in healthcare decisions are the key factors driving the market growth of this segment.

• The claims management services segment dominated the market with the largest revenue share in 2022. The presence of ACA and increasing overall healthcare expenditure are crucial factors driving the number of members enrolled in the Centers for Medicare and Medicaid Services.

• The public payers segment is expected to emerge as the fastest growing, with a CAGR of 9.0% during the forecast period.

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Table of Contents

Table of Contents

Chapter 1. Methodology and Scope
1.1. Market Segmentation & Scope
1.1.1. Service
1.1.2. Application
1.1.3. End Use
1.1.4. Regional scope
1.1.5. Estimates and forecast timeline
1.2. Research Methodology
1.3. Information Procurement
1.3.1. Purchased database
1.3.2. GVR’s internal database
1.3.3. Secondary sources
1.3.4. Primary research
1.3.5. Details of primary research
1.4. Information or Data Analysis
1.5. Market Formulation & Validation
1.6. Model Details
1.7. List of Secondary Sources
1.8. List of Primary Sources
1.9. Objectives
Chapter 2. Executive Summary
2.1. Market Outlook
2.2. Segment Outlook
2.2.1. Service outlook
2.2.2. Application outlook
2.2.3. End Use outlook
2.2.4. Regional outlook
2.3. Competitive Insights
Chapter 3. Healthcare Payer Services Market Variables, Trends & Scope
3.1. Market Lineage Outlook
3.1.1. Parent market outlook
3.1.2. Related/ancillary market outlook
3.2. Penetration & Growth Prospect Mapping
3.3. Market Dynamics
3.3.1. Market driver analysis
3.3.2. Market restraint analysis
3.4. Healthcare Payer Services Market Analysis Tools
3.4.1. Industry Analysis - Porter’s
3.4.1.1. Supplier power
3.4.1.2. Buyer power
3.4.1.3. Substitution threat
3.4.1.4. Threat of new entrant
3.4.1.5. Competitive rivalry
3.4.2. PESTEL Analysis
3.4.2.1. Political landscape
3.4.2.2. Technological landscape
3.4.2.3. Economic landscape
Chapter 4. Healthcare Payer Services: Service Estimates & Trend Analysis
4.1. Healthcare Payer Services Market: Key Takeaways
4.2. Healthcare Payer Services Market: Movement & Market Share Analysis, 2022 & 2030
4.3. BPO Services
4.3.1. BPO services market estimates and forecasts, 2018 to 2030 (USD Billion)
4.4. ITO Services
4.4.1. ITO services market estimates and forecasts, 2018 to 2030 (USD Billion)
4.5. KPO Services
4.5.1. KPO services market estimates and forecasts, 2018 to 2030 (USD Billion)
Chapter 5. Healthcare Payer Services: Application Estimates & Trend Analysis
5.1. Healthcare Payer Services Market: Key Takeaways
5.2. Healthcare Payer Services Market: Movement & Market Share Analysis, 2022 & 2030
5.3. Claims Management Services
5.3.1. Claims management services market estimates and forecasts, 2018 to 2030 (USD Billion)
5.4. Integrated Front Office Service and Back Office Operations
5.4.1. Integrated front office service and back office operations market estimates and forecasts, 2018 to 2030 (USD Billion)
5.5. Member Management Services
5.5.1. Member management services market estimates and forecasts, 2018 to 2030 (USD Billion)
5.6. Provider Management Services
5.6.1. Provider management services market estimates and forecasts, 2018 to 2030 (USD Billion)
5.7. Billing and Accounts Management Services
5.7.1. Billing and accounts management services market estimates and forecasts, 2018 to 2030 (USD Billion)
5.8. Analytics and Fraud Management Services
5.8.1. Analytics and fraud management services market estimates and forecasts, 2018 to 2030 (USD Billion)
5.9. HR Services
5.9.1. HR services market estimates and forecasts, 2018 to 2030 (USD Billion)
Chapter 6. Healthcare Payer Services: End Use Estimates & Trend Analysis
6.1. Healthcare Payer Services Market: Key Takeaways
6.2. Healthcare Payer Services Market: Movement & Market Share Analysis, 2022 & 2030
6.3. Private Payers
6.3.1. Private payers market estimates and forecasts, 2018 to 2030 (USD Billion)
6.4. Public Payers
6.4.1. Public payers market estimates and forecasts, 2018 to 2030 (USD Billion)
Chapter 7. Healthcare Payer Services Market: Regional Estimates & Trend Analysis
7.1. Regional Outlook
7.2. Healthcare Payer Services Market by Region: Key Takeaways
7.3. North America
7.3.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.3.2. U.S.
7.3.2.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.3.3. Canada
7.3.3.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4. Europe
7.4.1. UK
7.4.1.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.2. Germany
7.4.2.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.3. France
7.4.3.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.4. Italy
7.4.4.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.5. Spain
7.4.5.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.6. Sweden
7.4.6.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.7. Norway
7.4.7.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.4.8. Denmark
7.4.8.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.5. Asia Pacific
7.5.1. Japan
7.5.1.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.5.2. China
7.5.2.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.5.3. India
7.5.3.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.5.4. Australia
7.5.4.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.5.5. Thailand
7.5.5.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.5.6. South Korea
7.5.6.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.6. Latin America
7.6.1. Brazil
7.6.1.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.6.2. Mexico
7.6.2.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.6.3. Argentina
7.6.3.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.7. MEA
7.7.1. Saudi Arabia
7.7.1.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.7.2. South Africa
7.7.2.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.7.3. UAE
7.7.3.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
7.7.4. Kuwait
7.7.4.1. Market estimates and forecasts, 2018 - 2030 (Revenue, USD Billion)
Chapter 8. Competitive Landscape
8.1. Recent Developments & Impact Analysis, By Key Market Participants
8.2. Market Participant Categorization
8.2.1. Cognizant
8.2.1.1. Company overview
8.2.1.2. Financial performance
8.2.1.3. Product benchmarking
8.2.1.4. Strategic initiatives
8.2.2. EXL
8.2.2.1. Company overview
8.2.2.2. Financial performance
8.2.2.3. Product benchmarking
8.2.2.4. Strategic initiatives
8.2.3. HGS Limited (Hinduja Global Solutions Limited)
8.2.3.1. Company overview
8.2.3.2. Financial performance
8.2.3.3. Product benchmarking
8.2.3.4. Strategic initiatives
8.2.4. Accenture
8.2.4.1. Company overview
8.2.4.2. Financial performance
8.2.4.3. Product benchmarking
8.2.4.4. Strategic initiatives
8.2.5. Xerox Corporation
8.2.5.1. Company overview
8.2.5.2. Financial performance
8.2.5.3. Product benchmarking
8.2.5.4. Strategic initiatives
8.2.6. Concentrix Corporation
8.2.6.1. Company overview
8.2.6.2. Financial performance
8.2.6.3. Product benchmarking
8.2.6.4. Strategic initiatives
8.2.7. Genpact
8.2.7.1. Company overview
8.2.7.2. Financial performance
8.2.7.3. Product benchmarking
8.2.7.4. Strategic initiatives
8.2.8. Wipro Limited
8.2.8.1. Company overview
8.2.8.2. Financial performance
8.2.8.3. Product benchmarking
8.2.8.4. Strategic initiatives
8.2.9. HCL Technologies Limited
8.2.9.1. Company overview
8.2.9.2. Financial performance
8.2.9.3. Product benchmarking
8.2.9.4. Strategic initiatives