Spurring Demand for Claims Management Services to Bolster the Market Growth Globally

Published: Nov 2023

The global healthcare payer services market is anticipated to grow at a considerable CAGR of 7.8% during the forecast period (2023-2030). Claim management services is one of the major types of healthcare payer services, which has witnessed a significant increase in demand. These kind of services are in demand owing to the presence of associate chartered accountants (ACA) coupled with the increasing overall healthcare expenditure. These are some of the crucial factors that are driving the number of members enrolled in the Centers for Medicare and Medicaid Services (CMMS). According to the CMMS, an estimated 60 million individuals (18.2% of the US population) were enrolled in Medicare in 2021. The program accounted for $901 billion (22.3% of overall health consumption expenditures); this share is about 11.0% points higher than Medicare’s percentage of health consumption expenditures in 1970. In 2021, most of the spending was for hospital care and physician and professional services. 

Browse the full report description of “Healthcare Payer Services Market Size, Share & Trends Analysis Report by Services (Business Process Outsourcing (BPO) Services, Knowledge Process Outsourcing (KPO) Services, and Information Technology Outsourcing (ITO) Services), and by End-Use (Private Payers and Public Payers), Forecast Period (2023-2030)” at https://www.omrglobal.com/industry-reports/healthcare-payer-services-market

Most of the payer workload is composed of claims processing services, which are the most data-intensive operations. The claims that providers submit are examined for qualifying requirements, veracity, and the precise amount that must be paid back. Due to the introduction of the digital era, the method has been streamlined and processing times have decreased significantly. For instance, in October 2021, blue shield of California, google cloud collaborated to transform medical billing by bringing real time reimbursement information to providers. Blue Shield and Google Cloud launched a new approach to paying providers that processed members’ claims in real time. By developing a scalable cloud platform that integrated solutions from Blue Shield’s other technology partners, the companies digitized health care claims using automated processing, artificial intelligence, and machine learning technologies to greatly improve the accuracy and timeliness of billing information and claims payment. 

Furthermore, according to the study published in the Journal of Medical Internet Research, titled 'Combating Health Care Fraud and Abuse: Conceptualization and Prototyping Study of a Blockchain Antifraud Framework' in September 2020, an estimated $2.6 billion loss is attributed to health care fraud and abuse. With traditional health care claims verification and reimbursement, the health care provider submitted a claim after rendering services to a patient, which is then verified and reimbursed by the payer. Such incidences will lead to increased adoption of claim management services, driving the market growth over the forecast period. 

Market Coverage

The market number available for – 2022-2030

Base year- 2022

Forecast period- 2023-2030

Segment Covered- 

o By Services

o By End-Use

Regions Covered-

o North America

o Europe

o Asia-Pacific

o Rest of the World

Competitive Landscape- includes Accenture plc, Dell Inc., Oracle Corp., Xerox Holdings Corp., HCL Technologies Ltd., Hewlett-Packard, IBM Corp., and others.

Key questions addressed by the report

What is the market growth rate?

Which segment and region dominate the market in the base year?

Which segment and region will project the fastest growth in the market?

Who is the leader in the market?

How players are addressing challenges to sustain growth?

Where is the investment opportunity?

Global Healthcare Payer Services Market Report Segment

By Services

  • Business Process Outsourcing (BPO) Services
  • Knowledge Process Outsourcing (KPO) Services
  • Information Technology Outsourcing (ITO) Services

By End-Use

  • Private Payers
  • Public Payers

Global Healthcare Payer Services Market Report Segment by Region

North America

United States

Canada

Europe

UK

Germany

Italy

Spain

France

Rest of Europe 

Asia-Pacific

China

India

Japan

South Korea

Rest of Asia-Pacific 

Rest of the World

Latin America 

Middle East & Africa


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