ヘルスケアペイヤーサービスの市場：サービスタイプ（BPO（クレーム、フロントエンド、プロバイダー、商品開発、ケアマネジメント、ビリング、HR）、ITO（プロバイダーネットワーク、アカウント、分析、不正）、＆KPO）、エンドユーザー（公共、民間）-2027年までの世界予測

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

ヘルスケアペイヤーサービス市場は、2022年の699億米ドルから2027年には1182億米ドルに達すると予測され、予測期間中の年平均成長率は11.1%に達するとされています。アウトソーシングの利用拡大、連邦政府の義務... もっと見る

出版社	出版年月	電子版価格	ページ数	図表数	言語
MarketsandMarkets マーケッツアンドマーケッツ	2023年2月22日	US$4,950 シングルユーザライセンスライセンス・価格情報注文方法はこちら	237	169	英語

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サマリー

ヘルスケアペイヤーサービス市場は、2022年の699億米ドルから2027年には1182億米ドルに達すると予測され、予測期間中の年平均成長率は11.1%に達するとされています。アウトソーシングの利用拡大、連邦政府の義務化、医療詐欺の増加、健康保険加入率の上昇、慢性疾患患者の増加などが業界成長の主な要因となっています。しかし、データ漏洩の可能性、管理統制の喪失、言語・文化的なハードル、アウトソーシングの高コストなどの要因により、この市場の拡大がある程度制限される可能性があると予想されています。
2021年、ヘルスケアペイヤーサービス市場で最大のシェアを占めるのはBPOサービスタイプセグメント"
サービスタイプ別に、ヘルスケアペイヤーサービス市場は、ITOサービス、BPOサービス、KPOサービスに二分される。2021年には、BPOサービス分野が最大の市場シェアを占めています。ITOサービス分野は、医療とITの統合の進展、EHRとEMRの利用の増加、業務効率向上のための技術投資の増加、より良い意思決定のためのデータ分析の活用、安全で苦情に強いITシステムの必要性などの要因により、予測期間中に最も高いCAGRで成長すると予測されます。

"2021年のヘルスケアペイヤーサービス市場では、民間支払者セグメントが最大のシェアを占めた"
エンドユーザーに基づいて、ヘルスケアペイヤーサービス市場は、民間ペイヤー＆公共ペイヤーに二分されます。民間支払者セグメントは、2021年に最大の市場シェアを占め、予測期間中に最も高いCAGRを記録すると予想されています。このセグメントの高成長は、患者中心の医療提供に重点を置くようになり、医療業界への民間企業の参入を奨励する政府の取り組みが増加していること、民間支払者間の競争力が高まっていることに起因しています。
"2021年、アジア太平洋地域が最も急成長する地域市場に"

地域別に見ると、ヘルスケアペイヤーサービス市場は、北米、欧州、アジア太平洋地域、およびその他の地域（RoW）に二分されます。2021年には、北米がヘルスケアペイヤーサービス市場を支配し、アジア太平洋がそれに続きました。この市場の大きなシェアは、PPACAによる保険加入の増加、サービスのアウトソーシング需要を促進する連邦政府の医療義務化、医療費抑制のニーズの高まりに起因しています。しかし、アジア太平洋地域は、先進技術の導入が進んでいること、および主要企業がアジア太平洋地域の新興国でのプレゼンス拡大に注力していることから、予測期間中に最も高いCAGRで成長すると予想されます。
本レポートのために実施した一次インタビューは、以下のように分類されます：

- 企業タイプ別Tier1（35％）、Tier2（45％）、Tier3（20％）。
- 指名別：Cレベル（35％）、Dレベル（25％）、その他（40％）。
- 地域別北米（45％）、欧州（30％）、アジア太平洋（20％）、中南米（2％）、中東・アフリカ（3％）。

この市場の著名なプレーヤーには、Accenture（アイルランド）、Cognizant（米国）、Tata Consultancy Services（インド）、XEROX Corporation（米国）、WNS (Holdings) Limited（インド）、株式会社NTT Data（日本）、IQVIA Inc.(米国）、Mphasis（インド）、Genpact（米国）、Wipro（インド）、Infosys BPM（インド）、Firstsource Solutions（インド）、IBM Corporation（米国）、HCL Technologies（インド）、ソリューションズ（米国）、Lonza（スイス）、Omega Healthcare（インド）、R1 RCM（米国）、UnitedHealth Group（米国）、パラクセル社（米国）、
研究対象です：
本レポートでは、ヘルスケアペイヤーサービス市場の全体像を把握することができます。サービスタイプやエンドユーザーなどの異なるセグメントにおける市場規模や今後の成長可能性を推定することを目的としています。また、主要な市場プレイヤーの会社概要、最近の動向、主要な市場戦略とともに、詳細な競合分析も行っています。

レポート購入の主なメリット
本レポートは、ヘルスケアペイヤーサービス市場全体とそのサブセグメントにおける収益数の最も近い近似値を提供することで、市場リーダー/新規参入者の助けとなります。また、本レポートは、関係者が競争環境をよりよく理解し、より多くの洞察を得ることで、自社のビジネスをよりよく位置づけ、適切な市場参入戦略を立てるのに役立ちます。また、関係者が市場の鼓動を理解し、主要な市場促進要因、阻害要因、課題、および機会に関する情報を提供することができます。

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1 INTRODUCTION 26
1.1 STUDY OBJECTIVES 26
1.2 MARKET DEFINITION 26
1.2.1 INCLUSIONS AND EXCLUSIONS 26
1.3 MARKET SCOPE 27
1.4 YEARS CONSIDERED 27
1.5 CURRENCY CONSIDERED 28
TABLE 1 EXCHANGE RATES UTILIZED FOR CONVERSION TO USD 28
1.6 STAKEHOLDERS 28
1.7 SUMMARY OF CHANGES 28
1.8 LIMITATIONS 29
2 RESEARCH METHODOLOGY 30
2.1 RESEARCH APPROACH 30
2.2 RESEARCH METHODOLOGY DESIGN 30
FIGURE 1 HEALTHCARE PAYER SERVICES MARKET: RESEARCH DESIGN 30
2.2.1 SECONDARY RESEARCH 31
2.2.1.1 Key data from secondary sources 32
2.2.2 PRIMARY DATA 32
FIGURE 2 PRIMARY SOURCES 32
2.2.2.1 Key data from primary sources 33
2.2.2.2 Insights from primary experts 34
FIGURE 3 BREAKDOWN OF PRIMARY INTERVIEWS: BY COMPANY TYPE, DESIGNATION, AND REGION 34
2.3 MARKET SIZE ESTIMATION 35
FIGURE 4 SUPPLY-SIDE MARKET SIZE ESTIMATION: REVENUE SHARE ANALYSIS 35
FIGURE 5 TOP-DOWN APPROACH 36
FIGURE 6 CAGR PROJECTION FROM ANALYSIS OF DRIVERS, RESTRAINTS, OPPORTUNITIES, AND CHALLENGES (2022–2027) 38
FIGURE 7 CAGR PROJECTION: SUPPLY-SIDE ANALYSIS 39
2.4 MARKET BREAKDOWN AND DATA TRIANGULATION 40
FIGURE 8 DATA TRIANGULATION METHODOLOGY 40
2.5 MARKET SHARE ESTIMATION 40
2.6 STUDY ASSUMPTIONS 41
2.7 LIMITATIONS 41
2.7.1 METHODOLOGY-RELATED LIMITATIONS 41
2.7.2 SCOPE-RELATED LIMITATIONS 41
2.8 RISK ASSESSMENT 42
TABLE 2 HEALTHCARE PAYER SERVICES MARKET: RISK ANALYSIS 42
2.9 RECESSION IMPACT 42
3 EXECUTIVE SUMMARY 44
FIGURE 9 HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2022 VS. 2027 (USD MILLION) 44
FIGURE 10 HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2022 VS. 2027 (USD MILLION) 45
FIGURE 11 HEALTHCARE PAYER SERVICES MARKET: GEOGRAPHICAL SNAPSHOT 46
4 PREMIUM INSIGHTS 47
4.1 HEALTHCARE PAYER SERVICES MARKET OVERVIEW 47
FIGURE 12 RISING NEED TO CURB HEALTHCARE COSTS TO DRIVE MARKET 47
4.2 HEALTHCARE PAYER SERVICES MARKET: GEOGRAPHIC GROWTH OPPORTUNITIES 48
FIGURE 13 JAPAN TO WITNESS HIGHEST GROWTH RATE DURING FORECAST PERIOD 48
4.3 NORTH AMERICA: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE AND COUNTRY (2021) 49
FIGURE 14 BPO SEGMENT IN THE US ACCOUNTED FOR LARGEST MARKET SHARE IN 2021 49
4.4 HEALTHCARE PAYER SERVICES MARKET: REGIONAL MIX 49
FIGURE 15 ASIA PACIFIC TO REGISTER HIGHEST GROWTH RATE DURING FORECAST PERIOD 49
5 MARKET OVERVIEW 50
5.1 INTRODUCTION 50
5.2 MARKET DYNAMICS 50
FIGURE 16 HEALTHCARE PAYER SERVICES MARKET: DRIVERS, RESTRAINTS, OPPORTUNITIES, AND CHALLENGES 50
5.2.1 DRIVERS 51
5.2.1.1 Rising number of healthcare insurance enrollments 51
5.2.1.2 Outsourcing of services to reduce healthcare costs 51
5.2.1.3 Stringent federal mandates to increase payer workloads 52
5.2.1.4 Increasing cases of healthcare fraud 52
5.2.1.5 Rising incidence of chronic diseases 53
5.2.2 RESTRAINTS 54
5.2.2.1 Data breaches and loss of confidentiality 54
5.2.2.2 High costs associated with outsourcing healthcare payer services 55
5.2.2.3 Loss of managerial control 55
5.2.3 OPPORTUNITIES 56
5.2.3.1 Adoption of advanced data analytics 56
5.2.3.2 Gradual shift to ICD-11 standards 56
5.2.3.3 Service portfolio expansion for vendors 57
5.2.3.4 Rising need for cost-effective solutions 57

5.2.4 CHALLENGES 57
5.2.4.1 Migration from legacy systems 57
5.2.4.2 Concerns regarding data security 58
5.2.4.3 Cultural differences and language barriers 58
5.3 PRICING ANALYSIS 59
5.3.1 HEALTHCARE PAYER SERVICES MARKET: BPO PRICING ANALYSIS 59
TABLE 3 HEALTHCARE PAYER SERVICES MARKET: AVERAGE SELLING PRICE FOR BPO SERVICES 59
5.3.2 HEALTHCARE PAYER SERVICES MARKET: IT OUTSOURCING PRICING ANALYSIS 59
TABLE 4 HEALTHCARE IT INTEGRATION SOLUTIONS: PRICING MODEL 60
5.4 REGULATORY ANALYSIS 61
5.4.1 NORTH AMERICA 61
5.4.2 EUROPE 62
5.4.3 ASIA PACIFIC 62
5.4.4 MIDDLE EAST AND AFRICA 63
5.4.5 LATIN AMERICA 63
5.5 VALUE CHAIN ANALYSIS 63
FIGURE 17 HEALTHCARE PAYER SERVICES MARKET: VALUE-CHAIN ANALYSIS 64
5.6 PORTER’S FIVE FORCES ANALYSIS 64
FIGURE 18 HIGH INTENSITY OF COMPETITIVENESS AMONG PLAYERS 64
TABLE 5 HEALTHCARE PAYER SERVICES MARKET: PORTER’S FIVE FORCES ANALYSIS 65
5.7 ECOSYSTEM ANALYSIS 66
FIGURE 19 HEALTHCARE PAYER SERVICES MARKET: ECOSYSTEM ANALYSIS MAP 66
5.8 TECHNOLOGY ANALYSIS 66
5.8.1 MACHINE LEARNING 66
5.8.2 ARTIFICIAL INTELLIGENCE 66
5.8.3 INTERNET OF THINGS 67
5.8.4 BLOCKCHAIN 67
5.8.5 AUGMENTED REALITY 67
5.9 HEALTHCARE PAYER SERVICES MARKET: APPROACHES TO BPO SERVICES 67
5.9.1 BUNDLED SERVICES 67
5.9.2 FEE-FOR-SERVICE 67
5.9.3 FLEXIBLE CONTRACTS 68
5.9.4 BEST-SHORE 68
5.10 HEALTHCARE PAYER SERVICES MARKET: APPROACHES TO BPO MODELS 68
5.10.1 MULTI-SOURCING 68
5.10.2 CAPTIVE CENTER 69
5.10.3 HYBRID DELIVERY MODEL 70
5.10.4 PREFERRED PROVIDERS 70
5.10.5 STRATEGIC PARTNERSHIPS 70
5.10.6 GLOBAL DELIVERY MODEL 71
5.11 KEY STAKEHOLDERS AND BUYING CRITERIA 71
5.11.1 KEY STAKEHOLDERS IN BUYING PROCESS 71
FIGURE 20 INFLUENCE OF STAKEHOLDERS ON BUYING PROCESS 71
TABLE 6 INFLUENCE OF STAKEHOLDERS ON END USERS FOR BUYING PROCESS (%) 72
5.11.2 BUYING CRITERIA 72
FIGURE 21 KEY BUYING CRITERIA FOR HEALTHCARE PAYER COMPONENTS 72
TABLE 7 KEY BUYING CRITERIA FOR HCIT COMPONENTS 72
5.12 RECESSION IMPACT ON HEALTHCARE PAYER SERVICES MARKET 73
5.12.1 MACRO INDICATORS OF RECESSION 73
FIGURE 22 GLOBAL GDP: 2011─2021 (USD TRILLION) 74
6 HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE 75
6.1 INTRODUCTION 76
TABLE 8 HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 77
6.2 BUSINESS PROCESS OUTSOURCING (BPO) SERVICES 77
TABLE 9 HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 79
TABLE 10 HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY REGION, 2020–2027 (USD MILLION) 80
6.2.1 CLAIMS MANAGEMENT SERVICES 80
6.2.1.1 Voluntary agreements between healthcare providers & payers to fuel uptake 80
TABLE 11 COMMERCIALLY AVAILABLE CLAIMS MANAGEMENT SOLUTIONS 81
TABLE 12 HEALTHCARE PAYER SERVICES MARKET FOR BPO CLAIMS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 81
6.2.2 INTEGRATED FRONT-END SERVICES AND BACK-OFFICE OPERATIONS 81
6.2.2.1 Reduced overhead expenses and improved efficiency offered by outsourcing companies to support market growth 81
TABLE 13 HEALTHCARE PAYER SERVICES MARKET FOR BPO INTEGRATED FRONT-END SERVICES AND BACK-OFFICE OPERATIONS, BY REGION, 2020–2027 (USD MILLION) 82
6.2.3 MEMBER MANAGEMENT SERVICES 83
6.2.3.1 Ability to manage member-related eligibility data strategically across enterprises to drive market 83
TABLE 14 COMMERCIALLY AVAILABLE MEMBER MANAGEMENT SOLUTIONS 84
TABLE 15 HEALTHCARE PAYER SERVICES MARKET FOR BPO MEMBER MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 84
6.2.4 PROVIDER MANAGEMENT SERVICES 84
6.2.4.1 Outsourcing provider management services to third-party vendors for operational efficiency to drive market 84
TABLE 16 HEALTHCARE PAYER SERVICES MARKET FOR BPO PROVIDER MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 85
6.2.5 PRODUCT DEVELOPMENT AND BUSINESS ACQUISITION SERVICES (PDBA) 86
6.2.5.1 Rising focus on customer engagement and retention to drive market 86
TABLE 17 HEALTHCARE PAYERS MARKET FOR BPO PRODUCT DEVELOPMENT AND BUSINESS ACQUISITION SERVICES, BY REGION, 2020–2027 (USD MILLION) 86
6.2.6 CARE MANAGEMENT SERVICES 87
6.2.6.1 Ability to execute appropriate clinical coverage decisions to support market growth 87
TABLE 18 HEALTHCARE PAYER SERVICES MARKET FOR BPO CARE MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 87
6.2.7 BILLING AND ACCOUNTS MANAGEMENT SERVICES 87
6.2.7.1 Reduced process time and minimal burden on payer staff to drive market 87
TABLE 19 HEALTHCARE PAYER SERVICES MARKET FOR BPO BILLING AND ACCOUNTS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 88
6.2.8 HR SERVICES 88
6.2.8.1 Outsourcing of human resource services for improved employee experiences to support market growth 88
TABLE 20 HEALTHCARE PAYER SERVICES MARKET FOR BPO HR SERVICES, BY REGION, 2020–2027 (USD MILLION) 89
6.3 INFORMATION TECHNOLOGY OUTSOURCING (ITO) SERVICES 90
TABLE 21 HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 91
TABLE 22 HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY REGION, 2020–2027 (USD MILLION) 91
6.3.1 CLAIMS MANAGEMENT SERVICES 92
6.3.1.1 Rapid turnaround time with low errors & costs to drive outsourcing of operations 92
TABLE 23 HEALTHCARE PAYER SERVICES MARKET FOR ITO CLAIMS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 92
6.3.2 PROVIDER NETWORK MANAGEMENT SERVICES 92
6.3.2.1 Rising focus on core functions to support market growth 92
TABLE 24 HEALTHCARE PAYER SERVICES MARKET FOR ITO PROVIDER NETWORK MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 93
6.3.3 BILLING AND ACCOUNTS MANAGEMENT SERVICES 94
6.3.3.1 Rising cash flow and low space requirements to drive market 94
TABLE 25 HEALTHCARE PAYER SERVICES MARKET FOR ITO BILLING AND ACCOUNTS MANAGEMENT SERVICES, BY REGION, 2020–2027 (USD MILLION) 94
6.3.4 FRAUD ANALYTICS SERVICES 95
6.3.4.1 Rising volume of fraudulent claims to drive adoption of analytics 95
TABLE 26 HEALTHCARE PAYER SERVICES MARKET FOR ITO FRAUD ANALYTICS SERVICES, BY REGION, 2020–2027 (USD MILLION) 95
6.3.5 OTHER ITO SERVICES 96
TABLE 27 HEALTHCARE PAYER SERVICES MARKET FOR OTHER ITO SERVICES, BY REGION, 2020–2027 (USD MILLION) 96
6.4 KNOWLEDGE PROCESS OUTSOURCING SERVICES 96
6.4.1 RISING NUMBER OF FRAUD CLAIMS TO DRIVE KPO SERVICES 96
TABLE 28 HEALTHCARE PAYER SERVICES MARKET FOR KPO SERVICES, BY REGION, 2020–2027 (USD MILLION) 97
7 HEALTHCARE PAYER SERVICES MARKET, BY END USER 98
7.1 INTRODUCTION 99
TABLE 29 HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 99
7.2 PRIVATE PAYERS 99
7.2.1 PROVISION OF CONSUMER-FOCUSED HEALTHCARE PLANS TO FUEL UPTAKE OF SOLUTIONS 99
TABLE 30 HEALTHCARE PAYER SERVICES MARKET FOR PRIVATE PAYERS, BY REGION, 2020–2027 (USD MILLION) 100
7.3 PUBLIC PAYERS 101
7.3.1 RISING NEED FOR DIVERSE HEALTHCARE IT SOLUTIONS TO DRIVE MARKET 101
TABLE 31 HEALTHCARE PAYER SERVICES MARKET FOR PUBLIC PAYERS, BY REGION, 2020–2027 (USD MILLION) 101
8 HEALTHCARE PAYER SERVICES MARKET, BY REGION 102
8.1 INTRODUCTION 103
TABLE 32 HEALTHCARE PAYER SERVICES MARKET, BY REGION, 2020–2027 (USD MILLION) 103
8.2 NORTH AMERICA 104
TABLE 33 NORTH AMERICA: HEALTHCARE PAYER SERVICES MARKET, BY COUNTRY, 2020–2027 (USD MILLION) 104
FIGURE 23 NORTH AMERICA: MARKET SNAPSHOT 105
8.2.1 NORTH AMERICA: RECESSION IMPACT ANALYSIS 105
TABLE 34 NORTH AMERICA: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 106
TABLE 35 NORTH AMERICA: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 107
TABLE 36 NORTH AMERICA: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 108
TABLE 37 NORTH AMERICA: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 108
8.2.2 US 109
8.2.2.1 Increasing insurance enrolments and rising need to curb healthcare expenditure to drive market 109
TABLE 38 US: MACROECONOMIC INDICATORS FOR HEALTHCARE 109
TABLE 39 US: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 110
TABLE 40 US: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 111
TABLE 41 US: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 112
TABLE 42 US: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 112
8.2.3 CANADA 113
8.2.3.1 Rising focus on delivering improved services to drive market uptake 113
TABLE 43 CANADA: MACROECONOMIC INDICATORS FOR HEALTHCARE 113
TABLE 44 CANADA: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 113
TABLE 45 CANADA: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 114
TABLE 46 CANADA: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 115
TABLE 47 CANADA: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 115
8.3 EUROPE 116
8.3.1 EUROPE: RECESSION IMPACT ANALYSIS 116
TABLE 48 EUROPE: HEALTHCARE PAYER SERVICES MARKET, BY REGION, 2020–2027 (USD MILLION) 117
TABLE 49 EUROPE: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 117
TABLE 50 EUROPE: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 118
TABLE 51 EUROPE: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 119
TABLE 52 EUROPE: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 119
8.3.2 GERMANY 120
8.3.2.1 High adoption of EHR systems among primary care physicians to drive market 120
TABLE 53 GERMANY: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 120
TABLE 54 GERMANY: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 121
TABLE 55 GERMANY: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 122
TABLE 56 GERMANY: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 122
8.3.3 UK 123
8.3.3.1 Rising government support for healthcare digitalization to drive market 123
TABLE 57 UK: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 123
TABLE 58 UK: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICE, BY TYPE, 2020–2027 (USD MILLION) 124
TABLE 59 UK: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 125
TABLE 60 UK: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 125
8.3.4 FRANCE 126
8.3.4.1 Shortage of skilled personnel to drive demand 126
TABLE 61 FRANCE: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 126
TABLE 62 FRANCE: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 127
TABLE 63 FRANCE: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 128
TABLE 64 FRANCE: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 128
8.3.5 ITALY 129
8.3.5.1 Rising need to improve patient care to drive adoption of healthcare payer solutions 129
TABLE 65 ITALY: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 129
TABLE 66 ITALY: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 130
TABLE 67 ITALY: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 131
TABLE 68 ITALY: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 131
8.3.6 SPAIN 132
8.3.6.1 High level of mobile phone penetration to fuel uptake of risk management compliance services 132
TABLE 69 SPAIN: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 132
TABLE 70 SPAIN: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 133
TABLE 71 SPAIN: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 134
TABLE 72 SPAIN: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 134
8.3.7 REST OF EUROPE 135
TABLE 73 REST OF EUROPE: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 135
TABLE 74 REST OF EUROPE: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 136
TABLE 75 REST OF EUROPE: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 137
TABLE 76 REST OF EUROPE: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 137
8.4 ASIA PACIFIC 138
TABLE 77 ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY COUNTRY, 2020–2027 (USD MILLION) 138
FIGURE 24 ASIA PACIFIC: MARKET SNAPSHOT 139
8.4.1 ASIA PACIFIC: RECESSION IMPACT ANALYSIS 139
TABLE 78 ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 140
TABLE 79 ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 140
TABLE 80 ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 141
TABLE 81 ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 141
8.4.2 INDIA 142
8.4.2.1 Availability of highly skilled personnel at low cost to support market growth 142
TABLE 82 INDIA: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 142
TABLE 83 INDIA: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 143
TABLE 84 INDIA: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 144
TABLE 85 INDIA: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 144
8.4.3 JAPAN 145
8.4.3.1 Rising geriatric population to drive adoption of payer solutions for EHRs 145
TABLE 86 JAPAN: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 145
TABLE 87 JAPAN: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 146
TABLE 88 JAPAN: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 147
TABLE 89 JAPAN: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 147
8.4.4 CHINA 148
8.4.4.1 Strong government support for HCIT to drive market 148
TABLE 90 CHINA: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 148
TABLE 91 CHINA: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 149
TABLE 92 CHINA: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 150
TABLE 93 CHINA: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 150
8.4.5 REST OF ASIA PACIFIC 151
TABLE 94 REST OF ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 151
TABLE 95 REST OF ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD THOUSAND) 152
TABLE 96 REST OF ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 153
TABLE 97 REST OF ASIA PACIFIC: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 153
8.5 REST OF THE WORLD 154
8.5.1 REST OF THE WORLD: RECESSION IMPACT ANALYSIS 154
TABLE 98 REST OF THE WORLD: HEALTHCARE PAYER SERVICES MARKET, BY SERVICE TYPE, 2020–2027 (USD MILLION) 154
TABLE 99 REST OF THE WORLD: HEALTHCARE PAYER SERVICES MARKET FOR BPO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 155
TABLE 100 REST OF THE WORLD: HEALTHCARE PAYER SERVICES MARKET FOR ITO SERVICES, BY TYPE, 2020–2027 (USD MILLION) 156
TABLE 101 REST OF THE WORLD: HEALTHCARE PAYER SERVICES MARKET, BY END USER, 2020–2027 (USD MILLION) 156
9 COMPETITIVE LANDSCAPE 157
9.1 OVERVIEW 157
9.2 STRATEGIES ADOPTED BY KEY PLAYERS 157
TABLE 102 HEALTHCARE PAYER SERVICES MARKET: OVERVIEW OF STRATEGIES ADOPTED BY KEY PLAYERS 157
FIGURE 25 HEALTHCARE PAYERS SERVICES MARKET: KEY DEVELOPMENTS (2019–2022) 159
FIGURE 26 HEALTHCARE PAYER SERVICES MARKET: REVENUE ANALYSIS OF KEY PLAYERS 160
9.3 GEOGRAPHIC REVENUE ASSESSMENT OF KEY PLAYERS 160
FIGURE 27 HEALTHCARE PAYER SERVICES MARKET: GEOGRAPHIC REVENUE MIX 160
9.4 MARKET RANKING 161
FIGURE 28 HEALTHCARE PAYER SERVICES MARKET: MARKET RANKING OF LEADING COMPANIES (2022) 161
9.5 MARKET SHARE ANALYSIS 162
TABLE 103 HEALTHCARE PAYER SERVICES MARKET: INTENSITY OF COMPETITIVE RIVALRY 162
FIGURE 29 HEALTHCARE PAYER SERVICES MARKET: MARKET SHARE ANALYSIS 163
9.6 COMPANY EVALUATION QUADRANT 164
9.6.1 STARS 164
9.6.2 EMERGING LEADERS 164
9.6.3 PARTICIPANTS 164
9.6.4 PERVASIVE PLAYERS 164
FIGURE 30 HEALTHCARE PAYER SERVICES MARKET: COMPANY EVALUATION QUADRANT (2021) 165
9.7 COMPANY EVALUATION QUADRANT FOR STARTUPS 166
9.7.1 PROGRESSIVE COMPANIES 166
9.7.2 RESPONSIVE COMPANIES 166
9.7.3 STARTING BLOCKS 166
9.7.4 DYNAMIC COMPANIES 166
FIGURE 31 HEALTHCARE PAYER SERVICES MARKET: COMPANY EVALUATION QUADRANT FOR STARTUPS (2021) 167
9.8 COMPETITIVE BENCHMARKING 168
9.8.1 COMPANY PRODUCT FOOTPRINT 168
TABLE 104 COMPANY PRODUCT FOOTPRINT 168
9.8.2 COMPANY REGION FOOTPRINT 168
TABLE 105 COMPANY REGION FOOTPRINT 168
9.9 COMPETITIVE SCENARIO 169
9.9.1 SERVICE LAUNCHES & APPROVALS 169
TABLE 106 HEALTHCARE PAYER SERVICES MARKET: KEY SERVICE LAUNCHES & APPROVALS 169
9.9.2 DEALS 170
TABLE 107 HEALTHCARE PAYER SERVICES MARKET: KEY DEALS 170
9.9.3 OTHER DEVELOPMENTS 176
TABLE 108 HEALTHCARE PAYER SERVICES MARKET: OTHER KEY DEVELOPMENTS 176
10 COMPANY PROFILES 178
10.1 KEY PLAYERS 178
(Business Overview, Products/Services/Solutions Offered, MnM View, Key Strengths and Right to Win, Strategic Choices Made, Weaknesses and Competitive Threats, Recent Developments)*
10.1.1 ACCENTURE 178
TABLE 109 ACCENTURE: BUSINESS OVERVIEW 178
FIGURE 32 ACCENTURE: COMPANY SNAPSHOT (2022) 179
10.1.2 COGNIZANT 181
TABLE 110 COGNIZANT: BUSINESS OVERVIEW 181
FIGURE 33 COGNIZANT: COMPANY SNAPSHOT (2021) 182
10.1.3 TATA CONSULTANCY SERVICES 187
TABLE 111 TATA CONSULTANCY SERVICES: BUSINESS OVERVIEW 187
FIGURE 34 TATA CONSULTANCY SERVICES: COMPANY SNAPSHOT (2021) 188
10.1.4 XEROX CORPORATION 190
TABLE 112 XEROX CORPORATION: BUSINESS OVERVIEW 190
FIGURE 35 XEROX CORPORATION: COMPANY SNAPSHOT (2021) 190
10.1.5 WNS (HOLDINGS) LTD. 193
TABLE 113 WNS (HOLDINGS) LTD.: BUSINESS OVERVIEW 193
FIGURE 36 WNS (HOLDINGS) LTD.: COMPANY SNAPSHOT (2021) 194
10.1.6 NTT DATA CORPORATION 196
TABLE 114 NTT DATA CORPORATION: BUSINESS OVERVIEW 196
FIGURE 37 NTT DATA CORPORATION: COMPANY SNAPSHOT (2021) 196
10.1.7 MPHASIS 199
TABLE 115 MPHASIS: BUSINESS OVERVIEW 199
FIGURE 38 MPHASIS: COMPANY SNAPSHOT (2021) 200
10.1.8 GENPACT LIMITED 202
TABLE 116 GENPACT: BUSINESS OVERVIEW 202
FIGURE 39 GENPACT: COMPANY SNAPSHOT (2020) 203
10.1.9 WIPRO LIMITED 205
TABLE 117 WIPRO LIMITED: BUSINESS OVERVIEW 205
FIGURE 40 WIPRO LIMITED: COMPANY SNAPSHOT (2022) 206
10.1.10 INFOSYS BPM 209
TABLE 118 INFOSYS BPM: BUSINESS OVERVIEW 209
FIGURE 41 INFOSYS BPM: COMPANY SNAPSHOT (2022) 209
10.1.11 FIRSTSOURCE SOLUTIONS 211
TABLE 119 FIRSTSOURCE SOLUTIONS: BUSINESS OVERVIEW 211
FIGURE 42 FIRSTSOURCE SOLUTIONS: COMPANY SNAPSHOT (2021) 212
10.1.12 DELL INC. 214
TABLE 120 DELL INC.: BUSINESS OVERVIEW 214
FIGURE 43 DELL INC.: COMPANY SNAPSHOT (2021) 215
10.1.13 ORACLE CORPORATION 217
TABLE 121 ORACLE CORPORATION: BUSINESS OVERVIEW 217
FIGURE 44 ORACLE CORPORATION: COMPANY SNAPSHOT (2021) 218
10.1.14 IBM 220
TABLE 122 IBM: BUSINESS OVERVIEW 220
FIGURE 45 IBM: COMPANY SNAPSHOT (2021) 221
10.1.15 IQVIA INC. 224
TABLE 123 IQVIA INC.: BUSINESS OVERVIEW 224
FIGURE 46 IQVIA INC.: COMPANY SNAPSHOT (2021) 225
*Business Overview, Products/Services/Solutions Offered, MnM View, Key Strengths and Right to Win, Strategic Choices Made, Weaknesses and Competitive Threats, Recent Developments might not be captured in case of unlisted companies.
10.2 OTHER PLAYERS 227
10.2.1 CONDUENT, INC. 227
10.2.2 CONIFER HEALTH SOLUTIONS, LLC 228
10.2.3 OMEGA HEALTHCARE 229
10.2.4 INOVALON 230
10.2.5 SAS INSTITUTE, INC. 230
10.2.6 UNITEDHEALTH GROUP 231
10.2.7 HCL TECHNOLOGIES LIMITED 232
10.2.8 PAREXEL INTERNATIONAL CORPORATION 233
10.2.9 R1RCM, INC. 234
10.2.10 ALLSCRIPTS HEALTHCARE, LLC. 235
11 APPENDIX 236
11.1 DISCUSSION GUIDE 236
11.2 KNOWLEDGESTORE: MARKETSANDMARKETS’ SUBSCRIPTION PORTAL 239
11.3 CUSTOMIZATION OPTIONS 241
11.4 RELATED REPORTS 241
11.5 AUTHOR DETAILS 242

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Table of Contents

Summary

The healthcare payer services market 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 increased usage of outsourcing, federal mandates, rising instances of healthcare fraud, rising enrolment in health insurance, and rising chronic disease cases are the key drivers of industry growth. However, it is anticipated that some factors, such as the possibility of data breaches, the loss of administrative control, linguistic and cultural hurdles, and the high costs of outsourcing, may limit this market's expansion to some extent.
BPO service type segment holds the largest share of the healthcare payer services market in 2021”
On the basis of service type, the healthcare payer services market is bifurcated into ITO services, BPO services and KPO services. In 2021, the BPO services segment accounted for the largest market share. ITO services segment is projected to grow at the highest CAGR during the forecast period due to factors such as rising integration of healthcare and information technology, increasing use of EHRs and EMRs, increasing investment in technology to improve operational efficiency, leveraging data analytics for better decision making, and need for secure and complaint IT systems.

“Private payers segment accounted for the largest share of the healthcare payer services market in 2021.”
On the basis of end user, the healthcare payer services market is bifurcated into private payers & public payers. The private payers segment accounted for the largest market share in 2021 and is expected to register the highest CAGR during the forecast period. The high growth of this segment is attributed to the growing focus on patient centric healthcare delivery and the increasing government initiatives to encourage private sector participation in the healthcare industry and rising competitiveness among private payers.
“Asia Pacific to be the fastest-growing regional market in 2021.”

On the basis of region, the healthcare payer services market is bifurcated into North America, Europe, Asia Pacific, and the Rest of the World (RoW). In 2021, North America dominated the healthcare payer services market, followed by Asia Pacific. The large share of this market is attributed to the rise in insurance enrolments due to PPACA, federal healthcare mandates to drive the demand for outsourcing of services, rising need to curb healthcare expenditure. However, Asia Pacific is expected to grow at the highest CAGR during the forecast period owing to the increasing adoption of advanced technologies and the growing focus of major players on expanding their presence in emerging Asia Pacific countries.
The primary interviews conducted for this report can be categorized as follows:

• By Company Type: Tier 1 (35%), Tier 2 (45%), and Tier 3 (20%)
• By Designation: C-level (35%), D-level (25%), and Others (40%)
• By Region: North America (45%), Europe (30%), Asia Pacific (20%), Latin America (2%), and Middle East & Africa (3%)

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 (US), UnitedHealth Group (US), Paraxel Corporation International (US),
Research Coverage:
This report provides a picture of the healthcare payer services market. It aims at estimating the size and future growth potential of the market across different segments, such as service type, and end user. The report also includes an in-depth competitive analysis of the key market players, along with their company profiles, recent developments, and key market strategies.

Key Benefits of Buying the Report:
The report will help market leaders/new entrants by providing them with the closest approximations of the revenue numbers for the overall healthcare payer services market and its subsegments. This report will also help stakeholders better understand the competitive landscape and gain more insights to better position their business and make suitable go-to-market strategies. It will also enable stakeholders to understand the pulse of the market and provide them with information on the key market drivers, restraints, challenges, and opportunities.

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ご注文は、お電話またはWEBから承ります。お見積もりの作成もお気軽にご相談ください。

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