Healthcare Claims Management Market
Healthcare Claims Management Market Size, Share & Trends Analysis Report by Component (Software and Services), by Type (Integrated Solutions and Standalone Solutions), by Delivery mode (On-premise and Cloud-based), and End User (Healthcare Payers and Healthcare Providers) Forecast Period (2023-2030) Update Available - Forecast 2024-2030
Healthcare Claims Management market is anticipated to grow at a CAGR of 5.2% during the forecast period (2023-2030). Healthcare claims management is the process of submitting and processing healthcare claims to payers, such as health insurance companies and government programs. Healthcare claims management solutions can help providers to streamline the claims process and improve their efficiency. These solutions are essential tools for providers who want to streamline their claims process and improve their efficiency.
In September 2023, IQVIA health insurance management platform is a state-of-the-art platform that provides the ability to govern claims information exchange within regulatory requirements. The comprehensive health insurance platform addresses regulatory requirements and standards by controlling data and utilizing appropriate format specifications. Running end-to-end insurance transaction cycles between providers and payers has never been more efficient.
Segmental Outlook
The global Healthcare Claims Management market is segmented on the component, type, delivery mode, and end user. Based on the Component, the market is sub-segmented into Software and Services. Based on the type, the market is sub-segmented into Integrated Solutions and Standalone Solutions. Based on delivery mode, the market is sub-segmented into On-premise and Cloud-based. And based on the End user, the market is sub-segmented into Healthcare Payers and Healthcare Providers. Among the delivery mode, the cloud based sub-segment is anticipated to hold a considerable share of the market, owing to the development of cloud-based healthcare claims management solutions is making it more affordable and accessible for providers to implement.
The Software Sub-Segment is Anticipated to Hold a Considerable Share of the Global Healthcare Claims Management Market
Among the application, the automotive sub-segment is expected to hold a considerable share of the global Healthcare Claims Management market. This segmental growth is attributed to factor includes, Growing importance of denials management. Healthcare denials are becoming increasingly common, as payers are becoming more scrutiny of claims. Hence, companies are working on development of better software and adopting various strategic initiatives such as partnership, product launch and acquisition to stay competitive in the market. For instance, In February 2023, Inovalon, a provider of cloud-based software solutions, announced the addition of its EASE All-Payer claims management solution to the PointClickCare Marketplace. Building on a five-year partnership, Inovalon’s newest listing on the Marketplace offers healthcare providers sophisticated revenue cycle management (RCM) tools that are seamlessly integrated into PointClickCare’s Electronic Health Record (EHR). The Inovalon EASE All-Payer claims management software, powered by the Inovalon ONE Platform, helps providers achieve a 99% first-pass acceptance rate among commercial and Medicare payers. The solution leverages an advanced payer rules engine that validates claims based on the latest requirements from the Centers for Medicare & Medicaid Services and Commercial insurers.
Regional Outlook
The global Healthcare Claims Management market is further segmented based on geography including North America (the US, and Canada), Europe (UK, Italy, Spain, Germany, France, and the Rest of Europe), Asia-Pacific (India, China, Japan, South Korea, and Rest of Asia), and the Rest of the World (the Middle East & Africa, and Latin America). Among these, Asia pacific is anticipated to hold a prominent share of the market across the globe, owing to increasing patient volumes due to rising number of generic population in the region.
Global Healthcare Claims Management Market Growth, by Region 2023-2030
The European Region is Expected to Grow at a Significant CAGR in the Global Healthcare Claims Management Market
Among all regions, the European regions is anticipated to grow at a considerable CAGR over the forecast period. Regional growth is attributed to healthcare denials are becoming increasingly common, as payers are becoming more scrutiny of claims. This is driving the demand for healthcare claims management solutions that can help providers to reduce denials and improve their revenue cycle management. Hence, the market players are focusing on strategic initiatives such as partnership, merger, and product launch to capture the market. For instance, In February 2023, FORVIS has launched a Denials Monitoring Management tool to assist hospitals with preventable insurance claim denials. The software integrates into an organization’s existing data feeds to analyze trends in insurance denials and help identify strategies to decrease preventable denials. Reimbursement is among the most complex and costly areas of the US healthcare system. Determining the root cause for denied claims can be very time-intensive for hospital employees, just as revenue cycle departments are experiencing high turnover and staffing shortages. Staff time and write-offs associated with denied claims frequently cost organizations 3% or more of annual net revenue.
Market Players Outlook
The major companies serving the Healthcare Claims Management market include Accenture plc., CareCloud, Cerner Corp, Cognizant Technology Solutions Corp, Conifer Health Solutions, eClinicalWorks, Genpact Limited, IBM Corp, McKesson Corp, Optum, Inc, Oracle Corp, and others. The market players are considerably contributing to the market growth by the adoption of various strategies including mergers and acquisitions, partnerships, collaborations, funding, and new product launches, to stay competitive in the market. For instance, In February 2023, Experian Health, announces the launch of AI Advantage to mitigate the increasingly high volume of healthcare insurance claims denials. As the most seamless and comprehensive system for claims management in the healthcare industry today, the products leverage artificial intelligence (AI). Coupled with Experian’s expertise in big data solutions and insights, these all-new solutions will help healthcare providers prioritize their claims reimbursement process and decrease claim denials overall, saving time and money across the entire healthcare value chain and ultimately improving care and service for patient consumers.
The Report Covers
- Market value data analysis of 2022 and forecast to 2030.
- Annualized market revenues ($ million) for each market segment.
- Country-wise analysis of major geographical regions.
- Key companies operating in the global healthcare claims management market. Based on the availability of data, information related to new product launches, and relevant news is also available in the report.
- Analysis of business strategies by identifying the key market segments positioned for strong growth in the future.
- Analysis of market-entry and market expansion strategies.
- Competitive strategies by identifying ‘who-stands-where’ in the market.
1. Report Summary
• Current Industry Analysis and Growth Potential Outlook
1.1. Research Methods and Tools
1.2. Market Breakdown
1.2.1. By Segments
1.2.2. By Region
2. Market Overview and Insights
2.1. Scope of the Report
2.2. Analyst Insight & Current Market Trends
2.2.1. Key Findings
2.2.2. Recommendations
2.2.3. Conclusion
3. Competitive Landscape
3.1. Key Company Analysis
3.2. Cerner Corp
3.2.1. Overview
3.2.2. Financial Analysis
3.2.3. SWOT Analysis
3.2.4. Recent Developments
3.3. IBM Corp
3.3.1. Overview
3.3.2. Financial Analysis
3.3.3. SWOT Analysis
3.3.4. Recent Developments
3.4. Microsoft Corp.
3.4.1. Overview
3.4.2. Financial Analysis
3.4.3. SWOT Analysis
3.4.4. Recent Developments
3.5. Key Strategy Analysis
4. Market Segmentation
4.1. Global Healthcare Claims Management Market by Component
4.1.1. Software
4.1.2. Services
4.2. Global Healthcare Claims Management Market by Type
4.2.1. Integrated Solutions
4.2.2. Standalone Solutions
4.3. Global Healthcare Claims Management Market by Delivery Mode
4.3.1. On-premise
4.3.2. Cloud-based
4.4. Global Healthcare Claims Management Market by End user
4.4.1. Healthcare Payers
4.4.2. Healthcare Providers
5. Regional Analysis
5.1. North America
5.1.1. United States
5.1.2. Canada
5.2. Europe
5.2.1. UK
5.2.2. Germany
5.2.3. Italy
5.2.4. Spain
5.2.5. France
5.2.6. Rest of Europe
5.3. Asia-Pacific
5.3.1. China
5.3.2. India
5.3.3. Japan
5.3.4. South Korea
5.3.5. Rest of Asia-Pacific
5.4. Rest of the World
6. Company Profiles
6.1. Accenture plc.
6.2. CareCloud
6.3. Cognizant Technology Solutions Corp
6.4. Conifer Health Solutions
6.5. eClinicalWorks
6.6. Genpact Limited
6.7. Kareo
6.8. McKesson Corp
6.9. Optum, Inc
6.10. Oracle Corp
6.11. Quest Diagnostics
6.12. The SSI Group, Inc.
1. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COMPONENT, 2022-2030 ($ MILLION)
2. GLOBAL HEALTHCARE CLAIMS MANAGEMENT SOFTWARE MARKET RESEARCH AND ANALYSIS BY REGION,2022-2030 ($ MILLION)
3. GLOBAL HEALTHCARE CLAIMS MANAGEMENT SERVICES MARKET RESEARCH AND ANALYSIS BY REGION, 2022-2030 ($ MILLION)
4. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY TYPE, 2022-2030 ($ MILLION)
5. GLOBAL INTEGRATED SOLUTIONS IN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY REGION,2022-2030 ($ MILLION)
6. GLOBAL STANDALONE SOLUTIONS IN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY REGION,2022-2030 ($ MILLION)
7. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY DELIVERY MODE, 2022-2030 ($ MILLION)
8. GLOBAL ON-PREMISE HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY REGION, 2022-2030 ($ MILLION)
9. GLOBAL CLOUD-BASED HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY REGION, 2022-2030 ($ MILLION)
10. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY END USER, 2022-2030 ($ MILLION)
11. GLOBAL HEALTHCARE CLAIMS MANAGEMENT FOR HEALTHCARE PAYERS MARKET RESEARCH AND ANALYSIS BY REGION, 2022-2030 ($ MILLION)
12. GLOBAL HEALTHCARE CLAIMS MANAGEMENT FOR HEALTHCARE PROVIDERS MARKET RESEARCH AND ANALYSIS BY REGION, 2022-2030 ($ MILLION)
13. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY REGION, 2022-2030 ($ MILLION)
14. NORTH AMERICAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COUNTRY, 2022-2030 ($ MILLION)
15. NORTH AMERICAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COMPONENT, 2022-2030 ($ MILLION)
16. NORTH AMERICAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY TYPE, 2022-2030 ($ MILLION)
17. NORTH AMERICAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY DELIVERY MODE, 2022-2030 ($ MILLION)
18. NORTH AMERICAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY END USER, 2022-2030 ($ MILLION)
19. EUROPEAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COUNTRY, 2022-2030 ($ MILLION)
20. EUROPEAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COMPONENT, 2022-2030 ($ MILLION)
21. EUROPEAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY TYPE, 2022-2030 ($ MILLION)
22. EUROPEAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY DELIVERY MODE, 2022-2030 ($ MILLION)
23. EUROPEAN HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY END USER, 2022-2030 ($ MILLION)
24. ASIA- PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COUNTRY, 2022-2030 ($ MILLION)
25. ASIA- PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COMPONENT, 2022-2030 ($ MILLION)
26. ASIA- PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY TYPE, 2022-2030 ($ MILLION)
27. ASIA- PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY DELIVERY MODE, 2022-2030 ($ MILLION)
28. ASIA- PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY END USER, 2022-2030 ($ MILLION)
29. REST OF THE WORLD HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COUNTRY, 2022-2030 ($ MILLION)
30. REST OF THE WORLD HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY COMPONENT, 2022-2030 ($ MILLION)
31. REST OF THE WORLD HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY TYPE, 2022-2030 ($ MILLION)
32. REST OF THE WORLD HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY DELIVERY MODE, 2022-2030 ($ MILLION)
33. REST OF THE WORLD HEALTHCARE CLAIMS MANAGEMENT MARKET RESEARCH AND ANALYSIS BY END USER, 2022-2030 ($ MILLION)
1. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY COMPONENT, 2022 VS 2030 (%)
2. GLOBAL HEALTHCARE CLAIMS MANAGEMENT SOFTWARE MARKET SHARE BY REGION, 2022 VS 2030 (%)
3. GLOBAL HEALTHCARE CLAIMS MANAGEMENT SERVICES MARKET SHARE BY REGION, 2022 VS 2030 (%)
4. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY TYPE, 2022 VS 2030 (%)
5. GLOBAL INTEGRATED SOLUTIONS IN HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY REGION, 2022 VS 2030 (%)
6. GLOBAL STANDALONE SOLUTIONS IN HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY REGION, 2022 VS 2030 (%)
7. GLOBAL DROWSINESS MONITORING IN HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY REGION, 2022 VS 2030 (%)
8. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY DELIVERY MODE, 2022 VS 2030 (%)
9. GLOBAL ON-PREMISE HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY REGION, 2022 VS 2030 (%)
10. GLOBAL CLOUD-BASED HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY REGION, 2022 VS 2030 (%)
11. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY END USER, 2022 VS 2030 (%)
12. GLOBAL HEALTHCARE CLAIMS MANAGEMENT FOR HEALTHCARE PAYERS MARKET SHARE BY REGION, 2022 VS 2030 (%)
13. GLOBAL HEALTHCARE CLAIMS MANAGEMENT FOR HEALTHCARE PROVIDERS MARKET SHARE BY REGION, 2022 VS 2030 (%)
14. GLOBAL HEALTHCARE CLAIMS MANAGEMENT MARKET SHARE BY REGION, 2022 VS 2030 (%)
15. US HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
16. CANADA HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
17. UK HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
18. FRANCE HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
19. GERMANY HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
20. ITALY HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
21. SPAIN HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
22. REST OF EUROPE HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
23. INDIA HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
24. CHINA HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
25. JAPAN HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
26. SOUTH KOREA HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
27. REST OF ASIA-PACIFIC HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
28. REST OF THE WORLD HEALTHCARE CLAIMS MANAGEMENT MARKET SIZE, 2022-2030 ($ MILLION)
