Summary

The global Healthcare EDI market is projected to reach USD 7.11 billion by 2029 from USD 4.47 billion in 2024, at a CAGR of 9.7 % from 2024 to 2029. The market's growth is fuelled by the rapid digitization of healthcare records and patient data, regulatory compliance requirements, the growing volume of claims submissions, growing demand from the healthcare insurance industry, and cost reductions associated with EDI implementation. The Workgroup for Electronic Data Interchange (WEDI) estimated that EDI implementation could save USD 1 per claim for health plans and insurers, USD 1.49 for physicians, USD 0.86 for hospitals, and USD 0.83 for other parties in the US. Furthermore, according to the CAQH Index 2023, the estimated volume of claim submissions for the medical industry rose by 8% to 9.5 billion in the US in 2023. However, integration with existing healthcare IT systems, data privacy, and security constraints pose a significant challenge within this market.
“Point-to-point EDI held the largest market share in the healthcare EDI market in 2023.”
The healthcare EDI market is segmented based on transmission type into Value Added Network (VAN) EDI and point-to-point EDI. The point-to-point EDI segment held the largest market share in 2023. Point-to-point EDI, also known as direct EDI, establishes a single line of exchange between the involved partners, requiring them to communicate with each other individually. In the healthcare industry, point-to-point EDI is used by healthcare organizations to connect with clearinghouses or payers directly using an FTP or EDIINT (EDI over the Internet) software, thereby providing users greater control and security over their data. Reduction in intermediary costs, data security, and compliance with regulatory standards are some of the significant factors propelling market growth. However, interoperability issues and setup complexities are some of the factors restraining the market growth.
“By transaction type, the claims payment segment is expected to register the fastest growth over the forecast period.”
By transaction type, the healthcare EDI market is divided into claims submission, claims status, eligibility verification, claims payment, referral certification & authorization, payment remittance, and other EDI transactions. The claims payment segment is projected to be the fastest-growing segment over the forecast year. EDI in claims payment typically involves the automation of payment exchange between payers and providers, wherein the payment is sent directly and electronically from payers to providers through a value-added network (VAN). According to the CAQH Index 2023, fully electronic claim payment could lead to a potential cost savings opportunity of USD 524 million annually for the medical industry. The increasing demand for quick claim adjudication, the rising adoption of electronic claims payment processes by healthcare payers, and the growing complexity of reimbursement models are some of the major factors driving the market growth.
“Asia Pacific is estimated to register the highest CAGR over the forecast period.”
The Healthcare EDI market is segmented segments, namely, North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. The healthcare EDI market in Asia Pacific is projected to register at the highest CAGR rate during the forecast period. The growth of this region is due to growth in healthcare infrastructure, government initiatives to modernize and digitalize the healthcare industry, and growth in the health insurance industry. Countries such as Japan and China are focusing on developing cost-effective solutions emphasizing the importance of real-time public health data sharing, rapid growth in healthcare insurance coverage, growth in cross-border healthcare services, adopting advanced technologies, and regulatory mandates for healthcare data standardization (especially in China and Japan) which bolster the Asia Pacific market growth. For instance, the implementation of the Healthy China 2030 Plan is driving the country’s health insurance system and subsequent HCIT adoption. China expects to achieve health equity by 2030. Moreover, growing medical tourism, rising healthcare expenditure, increased health insurance penetration, and growing government support are other factors augmenting the market growth.
Breakdown of supply-side primary interviews by company type, designation, and region:
• By Company Type: Tier 1 (40%), Tier 2 (35%), and Tier 3 (25%)
• By Designation: Managers (40%), Directors (35%), and Others (25%)
• By Region: North America (40%), Europe (30%), Asia Pacific (20%), Latin America (5%) and Middle East Africa (5%)
List of Companies Profiled in the Report
o McKESSON CORPORATION (US)
o UnitedHealth Group Incorporated (US)
o IBM (US)
o Cognizant (US)
o Boomi (US)
o True Commerce, Inc. (US)
o athenahealth (US)
o Axway (US)
o Experian Information Solutions, Inc. (US)
o Veradigm LLC (US)
o The SSI Group, LLC (US)
o NTT DATA Group Corporation (Japan)
o Comarch SA. (Poland)
o Availity, LLC. (US)
o Quadax, Inc. (US)
o Waystar. (US)
o PLEXIS Healthcare Systems (US)
o Inovalon. (US)
o 123 EDI (US)
o Cirius Group, Inc. (US)
o Epicor Software Corporation (US)
o OSP Labs (US)
o Nalashaa. (US)
o WNS (US)
o PilotFish, Inc. (US)
o Cleo (US)

Research Coverage
This research report categorizes the Healthcare EDI market by component (services [managed services and professional services], and software), transmission type (VAN EDI, and point-to-point EDI), end user (Healthcare providers, healthcare payers, medical device companies, pharmaceutical and biotechnology companies, and pharmacies), and region. The scope of the report covers detailed information regarding the major factors, such as drivers, restraints, challenges, and opportunities, influencing the growth of the healthcare EDI market. A thorough analysis of the key industry players has been done to provide insights into their business overview, offerings, and key strategies such as acquisitions, collaborations, agreements, mergers, product launches & updates, partnerships, expansions, and other recent developments associated with the healthcare EDI market. Competitive analysis of upcoming startups in the healthcare EDI market ecosystem is covered in this report.
Reasons to Buy the Report
The report will help market leaders/new entrants in this market with information on the closest approximations of the revenue numbers for the overall healthcare EDI market and the subsegments. This report will help stakeholders understand the competitive landscape and gain more insights to better position their businesses and plan suitable go-to-market strategies. The report also helps stakeholders understand the market pulse and provides information on key market drivers, restraints, challenges, and opportunities.
The report provides insights on the following pointers:
• Analysis of key drivers (supportive regulations for transaction processes, growing necessity to reduce healthcare costs, reduction in costs and improved operational efficiency with healthcare EDI software, rising demand for streamlined claims management, API integration accelerating claims management), restraints (ensuring data security is a major concern for both patients and EDI Users, elevated costs associated with implementing EDI software), opportunities (rising trend in outsourcing EDI services, adoption of ICD-11 standards, utilizing real-time data exchange, telehealth and remote monitoring expansion), and challenges (integration of diverse healthcare IT solutions across the industry, needs and limitations of end users, interoperability issues in legacy systems, complexities in transactions and healthcare network) influencing the growth of the healthcare EDI market
• Product Development/Innovation: Detailed insights on upcoming technologies, research & development activities, and new product & service launches in the healthcare EDI market
• Market Development: Comprehensive information about lucrative markets – the report analyses the healthcare EDI market across varied regions.
• Market Diversification: Exhaustive information about new products & services, untapped geographies, recent developments, and investments in the healthcare EDI market
• Competitive Assessment: In-depth assessment of market shares, growth strategies, and service offerings of leading players such as McKESSON CORPORATION (US), UnitedHealth Group Incorporated (US), Cognizant (US), IBM (US), Veradigm LLC (US), athenahealth (US), Axway (US), Boomi (US), and True Commerce, Inc. (US), etc. among others in healthcare EDI market.

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Table of Contents

1 INTRODUCTION 33
1.1 STUDY OBJECTIVES 33
1.2 MARKET DEFINITION 33
1.3 MARKET SCOPE 34
1.3.1 MARKETS COVERED 34
1.3.2 INCLUSIONS & EXCLUSIONS 35
1.3.3 YEARS CONSIDERED 36
1.3.4 CURRENCY CONSIDERED 36
1.4 MARKET STAKEHOLDERS 37
1.5 SUMMARY OF CHANGES 37
2 RESEARCH METHODOLOGY 39
2.1 RESEARCH DATA 39
2.1.1 SECONDARY DATA 40
2.1.1.1 Key data from secondary sources 40
2.1.2 PRIMARY DATA 41
2.1.2.1 Primary sources 41
2.1.2.2 Key industry insights 42
2.1.2.3 Breakdown of primary interviews (supply side): by company type, designation, and region 42
2.2 MARKET SIZE ESTIMATION 43
2.3 MARKET BREAKDOWN AND DATA TRIANGULATION 49
2.4 MARKET SHARE ESTIMATION 50
2.5 STUDY ASSUMPTIONS 50
2.6 LIMITATIONS 50
2.6.1 METHODOLOGY-RELATED LIMITATIONS 50
2.6.2 SCOPE-RELATED LIMITATIONS 51
2.7 RISK ASSESSMENT 51
3 EXECUTIVE SUMMARY 52
4 PREMIUM INSIGHTS 56
4.1 HEALTHCARE EDI MARKET OVERVIEW 56
4.2 HEALTHCARE EDI MARKET: REGIONAL MIX 57
4.3 NORTH AMERICA: HEALTHCARE EDI MARKET, BY END USER AND COUNTRY 58
4.4 HEALTHCARE EDI MARKET: GEOGRAPHIC SNAPSHOT 59
 
5 MARKET OVERVIEW 60
5.1 INTRODUCTION 60
5.2 MARKET DYNAMICS 60
5.2.1 DRIVERS 61
5.2.1.1 Supportive regulations for transaction processes 61
5.2.1.2 Growing requirement to curb healthcare costs 62
5.2.1.3 Healthcare EDI software provides low costs and improved operational efficiency 63
5.2.1.4 Increasing demand for streamlined claims management 64
5.2.1.5 Acceleration of claims management with API integration 64
5.2.2 RESTRAINTS 64
5.2.2.1 Concerns associated with data security 64
5.2.2.2 High software implementation costs 67
5.2.3 OPPORTUNITIES 67
5.2.3.1 Rising trend of outsourcing EDI services 67
5.2.3.2 Adoption of ICD-11 guidelines 68
5.2.3.3 Benefits of real-time data exchange 68
5.2.3.4 Expansion of telehealth and remote monitoring capabilities 68
5.2.4 CHALLENGES 69
5.2.4.1 Integration of healthcare IT solutions 69
5.2.4.2 End-user limitations & requirements 69
5.2.4.3 Interoperability issues in legacy systems 70
5.2.4.4 Complexities associated with transactions 70
5.3 TRENDS/DISRUPTIONS IMPACTING CUSTOMERS’ BUSINESSES 71
5.4 HEALTHCARE EDI STANDARDS 71
5.4.1 ANSI X12 71
5.4.2 EDIFACT 71
5.4.3 OTHER STANDARDS 72
5.5 INDUSTRY TRENDS 73
5.5.1 ADOPTION OF INTEROPERABILITY STANDARDS 73
5.5.2 GROWTH OF VALUE-BASED CARE MODELS 73
5.5.3 INCREASING EMPHASIS ON DATA SECURITY & PRIVACY 74
5.5.4 GROWING FOCUS ON INTEGRATION PLATFORM AS A SERVICE (IPAAS) 74
5.5.5 INCREASING USE OF EDI IN SUPPLY CHAIN & DISTRIBUTION INDUSTRY 75
5.6 SUPPLY CHAIN ANALYSIS 75
5.7 ECOSYSTEM ANALYSIS 76
5.8 TECHNOLOGY ANALYSIS 78
5.8.1 KEY TECHNOLOGIES 78
5.8.1.1 REST APIS 78
5.8.1.2 Real-time data exchange 78
5.8.1.3 JSON or XML Conversion 79
5.8.1.4 EDI as a service (EDIAAS) 79
5.8.2 COMPLEMENTARY TECHNOLOGIES 79
5.8.2.1 Health information exchange 79
5.8.2.2 Electronic health records (EHR) 79
5.8.2.3 Healthcare middleware solutions 80
5.8.3 ADJACENT TECHNOLOGIES 80
5.8.3.1 AI and ML 80
5.8.3.2 Blockchain technology 80
5.9 PORTER’S FIVE FORCES ANALYSIS 81
5.9.1 INTENSITY OF COMPETITIVE RIVALRY 82
5.9.2 BARGAINING POWER OF SUPPLIERS 82
5.9.3 BARGAINING POWER OF BUYERS 82
5.9.4 THREAT OF SUBSTITUTES 82
5.9.5 THREAT OF NEW ENTRANTS 82
5.10 KEY STAKEHOLDERS & BUYING CRITERIA 83
5.10.1 KEY STAKEHOLDERS IN BUYING PROCESS 83
5.10.2 BUYING CRITERIA 84
5.11 PRICING ANALYSIS 84
5.11.1 AVERAGE SELLING PRICE TREND, BY REGION 85
5.11.2 INDICATIVE PRICING ANALYSIS, BY SOFTWARE 85
5.12 REGULATORY LANDSCAPE 86
5.12.1 REGULATORY SCENARIO 86
5.12.1.1 North America 86
5.12.1.1.1 US 86
5.12.1.1.2 Canada 87
5.12.1.2 Europe 88
5.12.1.3 Asia Pacific 88
5.12.1.3.1 China 88
5.12.1.3.2 Japan 88
5.12.1.3.3 India 89
5.12.1.4 Middle East & Africa 89
5.12.1.5 Latin America 89
5.12.2 REGULATORY BODIES, GOVERNMENT AGENCIES, AND OTHER ORGANIZATIONS 90
5.13 KEY CONFERENCES AND EVENTS 93
5.14 CASE STUDY ANALYSIS 94
5.14.1 TRANSFORMING CLAIMS MANAGEMENT WITH OPTUM CLAIMS MANAGER 94
5.14.1.1 Use case 1: Optum claims manager enhances revenue management & compliance for North Carolina 94
5.14.2 VIBRA HEALTHCARE'S SUCCESS WITH WAYSTAR 94
5.14.2.1 Use case 2: Streamlining billing and enhancing cost reduction with Waystar 94
 
5.14.3 ENHANCING PHARMACY CLAIMS EFFICIENCY WITH RELAYRX 95
5.14.3.1 Use case 3: Streamlining pharmacy reimbursements and improving patient outcomes 95
5.15 PATENT ANALYSIS 95
5.15.1 PATENT PUBLICATION TRENDS FOR HEALTHCARE EDI 95
5.15.2 INSIGHTS: JURISDICTION AND TOP APPLICANT ANALYSIS 96
5.16 END-USER ANALYSIS 99
5.16.1 UNMET NEEDS FOR END USERS IN HEALTHCARE EDI MARKET 99
5.16.2 END-USER EXPECTATIONS 100
5.17 INVESTMENT & FUNDING SCENARIO 100
5.18 HEALTHCARE EDI BUSINESS MODEL ANALYSIS 101
5.18.1 TOP USE CASES & MARKET POTENTIAL 102
5.18.1.1 Key use cases 103
5.18.2 CASE STUDIES OF AI/GENERATIVE AI IMPLEMENTATION 103
5.18.2.1 Case study 1: Simplification of prior authorization with Availity AuthAI 103
5.18.2.2 Case study 2: Automating claims management with implementation of AI 104
5.18.2.3 Case study 3: Enhancement of supply chain with AI-powered solution 104
5.18.3 IMPACT OF AI/GEN AI ON INTERCONNECTED & ADJACENT ECOSYSTEMS 105
5.18.3.1 Electronic health records market 105
5.18.3.2 Medical billing market 105
5.18.3.3 Healthcare revenue cycle management market 106
5.18.3.4 Health information exchange market 106
5.18.4 USER READINESS AND IMPACT ASSESSMENT 106
5.18.4.1 User readiness 106
5.18.4.1.1 Healthcare providers 106
5.18.4.1.2 Healthcare payers 106
5.18.4.2 Impact assessment 107
5.18.4.2.1 User A: Healthcare providers 107
5.18.4.2.1.1 Implementation 107
5.18.4.2.1.2 Impact 107
5.18.4.2.2 User B: Academic research institutes 107
5.18.4.2.2.1 Implementation 107
5.18.4.2.2.2 Impact 107
 
6 HEALTHCARE EDI MARKET, BY COMPONENT 108
6.1 INTRODUCTION 109
6.2 SERVICES 109
6.2.1 MANAGED SERVICES 111
6.2.1.1 Claims management services 112
6.2.1.1.1 Rising complexities associated with healthcare billing and regulatory requirements to boost demand 112
6.2.1.2 Supply management services 113
6.2.1.2.1 Growing focus on automation and real-time data integration to drive market 113
6.2.2 PROFESSIONAL SERVICES 114
6.2.2.1 Implementation services 116
6.2.2.1.1 Increasing demand for interoperability & integration of cloud systems to fuel market 116
6.2.2.2 Maintenance & support services 117
6.2.2.2.1 Requirement of software updates and real-time support to boost demand 117
6.2.2.3 Other services 118
6.3 SOFTWARE 119
6.3.1 SOFTWARE, BY DEPLOYMENT MODEL 120
6.3.1.1 On-premise EDI model 121
6.3.1.1.1 Enhanced control over data security to support market growth 121
6.3.1.2 Web/Cloud-based EDI model 122
6.3.1.2.1 High uptake of SaaS models to propel market 122
6.3.2 SOFTWARE, BY TRANSACTION TYPE 123
6.3.2.1 Claims management software 124
6.3.2.1.1 Claims submission 125
6.3.2.1.1.1 Growing need for improved claims accuracy and low administration costs to drive market 125
6.3.2.1.2 Claims status 126
6.3.2.1.2.1 Growing demand for claims checks with minimal manual intervention to fuel uptake 126
6.3.2.1.3 Eligibility verification 127
6.3.2.1.3.1 Growing focus on real-time patient insurance validation to boost market 127
6.3.2.1.4 Claims payment 128
6.3.2.1.4.1 Need for streamlined reimbursement processes to fuel uptake 128
6.3.2.1.5 Referral certification & authorization 129
6.3.2.1.5.1 Growing requirement for healthcare investments to drive market 129
6.3.2.1.6 Payment remittance 130
6.3.2.1.6.1 Growing focus on streamlining payment facilities to drive market 130
6.3.2.1.7 Other EDI claims transactions 131
6.3.2.2 Supply management software 132
6.3.2.2.1 Procurement management 134
6.3.2.2.1.1 Rising demand for supply chain efficiencies to fuel uptake 134
6.3.2.2.2 Inventory management 135
6.3.2.2.2.1 Growing requirement for real-time inventory tracking to drive market 135
6.3.2.2.3 Order management 136
6.3.2.2.3.1 Rising volume of medical supplies & pharmaceuticals to support market growth 136
7 HEALTHCARE EDI MARKET, BY TRANSMISSION TYPE 137
7.1 INTRODUCTION 138
7.2 VALUE-ADDED NETWORK (VAN) EDI 138
7.2.1 INCREASING DEMAND FOR CLEARINGHOUSE SERVICES TO DRIVE MARKET 138
7.3 POINT-TO-POINT EDI 140
7.3.1 UTILIZATION BY LARGE ORGANIZATIONS FOR VOLUME TRANSACTIONS TO BOOST DEMAND 140
7.4 MULTI-CHANNEL EDI 141
7.4.1 GRADUAL SHIFT TOWARDS API-BASED EXCHANGE FOR ENHANCED INTEROPERABILITY TO PROPEL MARKET 141
8 HEALTHCARE EDI MARKET, BY END USER 143
8.1 INTRODUCTION 144
8.2 HEALTHCARE PROVIDERS 144
8.2.1 HOSPITALS & CLINICS 146
8.2.1.1 Mitigation of denial claims loss to boost demand 146
8.2.2 AMBULATORY SURGERY CENTERS 147
8.2.2.1 Rising trend toward outpatient care facilities to drive market 147
8.2.3 OTHER HEALTHCARE PROVIDERS 148
8.3 HEALTHCARE PAYERS 149
8.3.1 PRIVATE PAYERS 151
8.3.1.1 Fraud prevention and improvements in traceability to fuel uptake 151
8.3.2 PUBLIC PAYERS 152
8.3.2.1 Mandatory EDI compliance for healthcare data processing to propel market 152
8.4 MEDICAL DEVICE COMPANIES 153
8.4.1 TECHNOLOGICAL INNOVATION AND SEAMLESS DEVICE PROCUREMENT REQUIREMENTS TO DRIVE MARKET 153
8.5 PHARMACEUTICAL & BIOTECHNOLOGY COMPANIES 154
8.5.1 AUTOMATION OF SUPPLY CHAIN PROCESSES TO BOOST DEMAND 154
8.6 PHARMACIES 155
8.6.1 RETAIL PHARMACY EXPANSION TO SUPPORT MARKET GROWTH 155
9 HEALTHCARE EDI MARKET, BY REGION 157
9.1 INTRODUCTION 158
9.2 NORTH AMERICA 158
9.2.1 MACROECONOMIC OUTLOOK FOR NORTH AMERICA 164
9.2.2 US 164
9.2.2.1 Increasing investments in rural healthcare to encourage growth 164
9.2.3 CANADA 169
9.2.3.1 Rising investments in preventive and social care to facilitate growth 169
9.3 EUROPE 173
9.3.1 MACROECONOMIC OUTLOOK FOR EUROPE 178
9.3.2 GERMANY 178
9.3.2.1 Favorable government initiatives to promote growth 178
9.3.3 UK 183
9.3.3.1 Growing digitization of healthcare infrastructure to drive market 183
9.3.4 FRANCE 187
9.3.4.1 Growing modernization efforts in healthcare to boost market 187
9.3.5 ITALY 192
9.3.5.1 Increasing focus on optimizing healthcare resources to accelerate growth 192
9.3.6 SPAIN 196
9.3.6.1 Universal public healthcare system to sustain growth 196
9.3.7 REST OF EUROPE 200
9.4 ASIA PACIFIC 205
9.4.1 MACROECONOMIC OUTLOOK FOR ASIA PACIFIC 211
9.4.2 JAPAN 211
9.4.2.1 Innovations in digital health solutions to propel market 211
9.4.3 CHINA 216
9.4.3.1 High uptake of digitization and policy-driven expansion of health services to drive market 216
9.4.4 INDIA 220
9.4.4.1 Growing adoption of EHR solutions to fuel uptake 220
9.4.5 REST OF ASIA PACIFIC 224
9.5 LATIN AMERICA 229
9.5.1 MACROECONOMIC OUTLOOK FOR LATIN AMERICA 234
9.5.2 BRAZIL 234
9.5.2.1 Improvements in hospital management systems to drive market 234
9.5.3 MEXICO 239
9.5.3.1 Budgetary cuts and shortage of healthcare professionals to restrain market 239
9.5.4 REST OF LATIN AMERICA 243
 
9.6 MIDDLE EAST & AFRICA 248
9.6.1 MACROECONOMIC OUTLOOK FOR MIDDLE EAST & AFRICA 253
9.6.2 GCC COUNTRIES 253
9.6.2.1 Rising healthcare investments for supply management to fuel uptake 253
9.6.3 REST OF MIDDLE EAST & AFRICA 258
10 COMPETITIVE LANDSCAPE 263
10.1 INTRODUCTION 263
10.2 KEY PLAYER STRATEGY/RIGHT TO WIN 263
10.2.1 OVERVIEW OF STRATEGIES ADOPTED BY PLAYERS IN HEALTHCARE EDI MARKET 263
10.3 REVENUE ANALYSIS 265
10.4 MARKET SHARE ANALYSIS 266
10.4.1 SOFTWARE PROVIDERS 266
10.4.1.1 Ranking of key market players 267
10.4.2 SERVICE PROVIDERS 268
10.4.2.1 Ranking of key market players 269
10.5 COMPANY EVALUATION MATRIX: KEY PLAYERS, 2023 270
10.5.1 STARS 270
10.5.2 EMERGING LEADERS 270
10.5.3 PERVASIVE PLAYERS 271
10.5.4 PARTICIPANTS 271
10.5.5 COMPANY FOOTPRINT: KEY PLAYERS, 2023 272
10.5.5.1 Company footprint 272
10.5.5.2 Component footprint 273
10.5.5.3 Transmission type footprint 274
10.5.5.4 End-user footprint 275
10.5.5.5 Region footprint 276
10.6 COMPANY EVALUATION MATRIX: STARTUPS/SMES, 2023 277
10.6.1 PROGRESSIVE COMPANIES 277
10.6.2 RESPONSIVE COMPANIES 277
10.6.3 DYNAMIC COMPANIES 277
10.6.4 STARTING BLOCKS 277
10.6.5 COMPETITIVE BENCHMARKING: STARTUPS/SMES, 2023 279
10.7 COMPANY VALUATION & FINANCIAL METRICS 280
10.7.1 FINANCIAL METRICS 280
10.8 BRAND/PRODUCT COMPARISON 281
10.9 COMPETITIVE SCENARIO 282
10.9.1 PRODUCT/SERVICE LAUNCHES & ENHANCEMENTS 282
10.9.2 DEALS 283
10.9.3 OTHER DEVELOPMENTS 284
 
11 COMPANY PROFILES 285
11.1 KEY PLAYERS 285
11.1.1 MCKESSON CORPORATION 285
11.1.1.1 Business overview 285
11.1.1.2 Products/Services offered 286
11.1.1.2.1 Deals 287
11.1.1.2.2 Other developments 287
11.1.1.3 MnM view 288
11.1.1.3.1 Key strengths 288
11.1.1.3.2 Strategic choices 288
11.1.1.3.3 Weaknesses & competitive threats 288
11.1.2 UNITEDHEALTH GROUP 289
11.1.2.1 Business overview 289
11.1.2.2 Products/Services offered 290
11.1.2.3 Recent developments 291
11.1.2.3.1 Deals 291
11.1.2.4 MnM view 291
11.1.2.4.1 Key strengths 291
11.1.2.4.2 Strategic choices 291
11.1.2.4.3 Weaknesses & competitive threats 291
11.1.3 COGNIZANT 292
11.1.3.1 Business overview 292
11.1.3.2 Products/Services offered 294
11.1.3.3 Recent developments 294
11.1.3.3.1 Deals 294
11.1.3.4 MnM view 295
11.1.3.4.1 Key strengths 295
11.1.3.4.2 Strategic choices 295
11.1.3.4.3 Weaknesses & competitive threats 295
11.1.4 IBM 296
11.1.4.1 Business overview 296
11.1.4.2 Products/Services offered 298
11.1.4.3 Recent developments 298
11.1.4.3.1 Deals 298
11.1.4.4 MnM view 299
11.1.4.4.1 Key strengths 299
11.1.4.4.2 Strategic choices 299
11.1.4.4.3 Weaknesses & competitive threats 299
11.1.5 VERADIGM LLC 300
11.1.5.1 Business overview 300
11.1.5.2 Products/Services offered 301
 
11.1.6 ATHENAHEALTH, INC. 302
11.1.6.1 Business overview 302
11.1.6.2 Products/Services offered 302
11.1.7 BOOMI, LP 303
11.1.7.1 Business overview 303
11.1.7.2 Products/Services offered 303
11.1.7.3 Recent developments 304
11.1.7.3.1 Product enhancements 304
11.1.8 EXPERIAN INFORMATION SOLUTIONS, INC. 305
11.1.8.1 Business overview 305
11.1.8.2 Products/Services offered 306
11.1.8.3 Recent developments 307
11.1.8.3.1 Product launches 307
11.1.9 SSI GROUP LLC 308
11.1.9.1 Business overview 308
11.1.9.2 Products/Services offered 309
11.1.10 QUADAX, INC. 310
11.1.10.1 Business overview 310
11.1.10.2 Products/Services offered 311
11.1.10.3 Recent developments 311
11.1.10.3.1 Deals 311
11.1.11 WAYSTAR 312
11.1.11.1 Business overview 312
11.1.11.2 Products/Services offered 313
11.1.12 AVAILITY, LLC 314
11.1.12.1 Business overview 314
11.1.12.2 Products/Services offered 314
11.1.12.3 Recent developments 316
11.1.12.3.1 Product launches 316
11.1.12.3.2 Deals 316
11.1.13 COMARCH SA 318
11.1.13.1 Business overview 318
11.1.13.2 Products/Services offered 319
11.1.14 AXWAY 320
11.1.14.1 Business overview 320
11.1.14.2 Products/Services offered 321
11.1.14.3 Recent developments 322
11.1.14.3.1 Deals 322
11.1.15 PLEXIS HEALTHCARE SYSTEMS 323
11.1.15.1 Business overview 323
11.1.15.2 Products/Services offered 323
 
11.1.16 TRUE COMMERCE, INC. 324
11.1.16.1 Business overview 324
11.1.16.2 Products/Services offered 324
11.1.16.3 Recent developments 325
11.1.16.3.1 Deals 325
11.1.17 INOVALON 326
11.1.17.1 Business overview 326
11.1.17.2 Products/Services offered 326
11.1.17.3 Recent developments 327
11.1.17.3.1 Product enhancements 327
11.1.17.3.2 Deals 328
11.1.18 123 EDI 329
11.1.18.1 Business overview 329
11.1.18.2 Products/Services offered 329
11.1.19 NTT DATA GROUP CORPORATION 330
11.1.19.1 Business overview 330
11.1.19.2 Products/Services offered 331
11.1.19.3 Recent developments 332
11.1.19.3.1 Deals 332
11.1.20 CIRIUS GROUP, INC. 333
11.1.20.1 Business overview 333
11.1.20.2 Products/Services offered 333
11.1.21 EPICOR SOFTWARE CORPORATION 334
11.1.21.1 Business overview 334
11.1.21.2 Products/Services offered 334
11.1.21.3 Recent developments 336
11.1.21.3.1 Deals 336
11.2 OTHER PLAYERS 337
11.2.1 OSP LABS 337
11.2.2 NALASHAA 338
11.2.3 WNS 339
11.2.4 PILOTFISH, INC. 340
11.2.5 CLEO 341
12 APPENDIX 342
12.1 DISCUSSION GUIDE 342
12.2 KNOWLEDGESTORE: MARKETSANDMARKETS’ SUBSCRIPTION PORTAL 349
12.3 CUSTOMIZATION OPTIONS 351
12.4 RELATED REPORTS 352
12.5 AUTHOR DETAILS 353