Healthcare Payer Service Market Research Report Information by Service Type (Business Process Outsourcing Services, IT Outsourcing Services, and Knowledge Process Outsourcing Services) by Application (Claims Management, Integrated Front Office and Back Office Operations, Member Management, Provider Management, Billing and Accounts Management, Analytics and Fraud Management, Human Resource, Clinical Decision-Making, Patient Engagement, and Others), by End User (Private Payers and Public Payers), by Region (North America, Europe, Asia-Pacific

Healthcare Payer Service Market Overview

Healthcare Payer Service Market size was valued at USD 69.32 billion in 2022. The Healthcare Payer Service Market industry is projected to grow from USD 73.01 Billion in 2023 to USD 156.04 billion by 2032, exhibiting a compound annual growth rate (CAGR) of 8.81% during the forecast period (2023 - 2032).

Source: Secondary Research, Primary Research, MRFR Database, and Analyst Review

Healthcare Payer Service Market Trends

The increasing number of healthcare insurance enrollments boosts market growth.

Healthcare insurance enrollments are increasing owing to several factors, such as the growing aging population in developing regions, the rising cost of healthcare, and changes in employer-sponsored health insurance. As per the Assistant Secretary for Planning and Evaluation, there were approximately 31 million people enrolled in late 2020 and early 2021 in America. Furthermore, there were more than 40.2 million American people who enrolled in Marketplace and Medicaid expansion coverage in 2022 and early 2023.

Furthermore, according to secondary research, there is a high increment in health insurance enrolment in low- and middle-income countries due to increasing awareness of the benefits of health insurance adoption, reducing the cost of health insurance products, and the government offering individuals opportunities to try health insurance at a subsidized rate. Hence, increasing awareness of health insurance and rising health insurance enrollment are fueling the growth of the healthcare payer services market.

Healthcare Payer Service Market Segment Insights

Healthcare Payer Service Service Type Insights

The Healthcare Payer Service Market segmentation, based on service type, includes business process outsourcing services, IT outsourcing services, and knowledge process outsourcing services. The business process outsourcing services segment held the majority share in 2022 in the Healthcare Payer Service Market revenue. This is due to the globalization of BPO services and growing outsourcing in the biopharma and pharma industries. Moreover, companies are forming strategic alliances, including acquisitions, to fulfill the increasing demand for services such as medical coding, billing, claim processing, and patient data management. For instance, Aspirion (US) acquired FIRM Revenue Cycle Management Services, Inc. (US) to enhance and bolter Aspirion’s services in order to fulfill its client demand. Furthermore, this acquisition assisted Aspirion’s in bringing greater value to the revenue cycle market through leveraging advanced technologies.

HEALTHCARE PAYER SERVICE MARKET SIZE, BY SERVICE TYPE, 2022 & 2032 (USD Billion)

Source: Secondary Research, Primary Research, MRFR Database, and Analyst Review

Healthcare Payer Service Application Insights

The Healthcare Payer Service Market segmentation is based on application that include claims management, integrated front office and back-office operations, member management, provider management, billing and accounts management, analytics and fraud management, human resource, clinical decision-making, patient engagement, and others. The claims management segment has dominated the market in 2022 and analytics and fraud management is projected to be the fastest-growing segment during the forecast period, 2023-2032. This is attributed to the increasingly adoption of cloud-based solutions, blockchain technologies and cognitive automation.

July 2021: Cognizant (US) collaborated with Royal Philips (Netherlands) to create Philips HealthSuite, a cloud-based platform to deliver end-to-end digital health solutions that will help organizations to improve patient care and accelerate clinical trials.

Healthcare Payer Service End User Insights

The Healthcare Payer Service Market segmentation is based on end user that includes private payers and public payers. The private payers segment has dominated the market in 2022 and the public payers segment is projected to be the fastest-growing segment during the forecast period, 2023-2032. This is due to the rising healthcare costs, increasing incidences of chronic diseases, and growing geriatric population.

July 2021: Cognizant (US) collaborated with Royal Philips (Netherlands) to create Philips HealthSuite, a cloud-based platform to deliver end-to-end digital health solutions that will help organizations to improve patient care and accelerate clinical trials.

Healthcare Payer Service Regional Insights

By Region, the study segments the market into North America, Europe, Asia-Pacific, and the Rest of the World. The North America healthcare payer service market accounted for the largest market share in 2022. This is due to the advanced healthcare system in this area, the growing adoption of healthcare policies, and the established presence of major market players. Companies such as Oracle Corporation (US), IQVIA Holding, Inc (US), HCL Technologies limited (India), an Accenture (Ireland) are actively working on improving healthcare payer service and fulfilling the demands of customers. Oracle Corporation is engaged in developing, designing, and installing healthcare information technology. It caters to managed care organizations, hospitals, medical centers, reference laboratories, home health agencies, blood banks, imaging centers, pharmacies, pharmaceutical manufacturers, employers, governments, and public health organizations.

Further, the major countries studied are the U.S., Canada, Germany, France, the UK, Italy, Spain, China, Japan, India, Australia, South Korea, and Brazil.

Figure 3: HEALTHCARE PAYER SERVICE MARKET SIZE, BY REGION 2022 & 2032 (USD Billion)

Source: Secondary Research, Primary Research, MRFR Database, and Analyst Review

Europe healthcare payer service market accounts for the second-largest market share due to growing demand for healthcare IT services, rising government initiatives across the region. further, Germany healthcare payer service market was attributed to hold the largest market share, and the Italy healthcare payer service market is expected to fastest-growing market in the European region.

The Asia-Pacific healthcare payer service market is expected to grow at a significant share from 2023 to 2032. This is due to the rising investments and reforms to modernize China’s healthcare infrastructure, implementation of new ICT guidelines in Japan and the increasing patient population suffering from chronic diseases such as cancer, orthopedic, and cardiovascular diseases in the Asia-Pacific region. Moreover, China healthcare payer service market is expected to hold the largest market share, and India healthcare payer service market is expected fastest-growing market in the Asia-Pacific region. For instance, one of Asia's leading private alternative investment companies, Baring Private Equity Asia (BPEA), entered official agreements with Hinduja Global Solutions in August 2021 to purchase its Healthcare Services division to funds associated with Due to expansion. Thus, these acquisitions will also boost market growth for the healthcare payer service Market.

The Rest of the World is segmented into the Middle East, Africa, and Latin America. The healthcare payer service market in the above-mentioned regions is likely to witness growth due to technological advancement, and growing investment in healthcare infrastructure in the region. Moreover, Moreover, the Middle East & Africa has a huge opportunity for market growth due to the rise in prevalence of chronic diseases.

Healthcare Payer Service Key Market Players & Competitive Insights

The Healthcare Payer Service Market is characterized by the presence of many global, regional, and local vendors. Developments in the healthcare industry and growing research and development make the healthcare payer service market lucrative. To expand their reach and optimize their operational costs, the major players focus on obtaining regulatory authorizations from government agencies for their products and emphasize acquisitions and product launches to gain a substantial market share. The market comprises tier-1, tier-2, and local players. The tier-1 and tier-2 players have reach across the globe with diverse product portfolios. Companies such as Oracle Corporation (US), IQVIA Holding, Inc (US), HCL Technologies limited (India), Accenture (Ireland), and Cognizant (US) dominate the Healthcare Payer Service Market due to service differentiation, financial stability, strategic developments, and diversified regional presence. The players are focused on investing in research and development. Furthermore, they adopt strategic growth initiatives, such as expansion, product launches, joint ventures, and partnerships, to strengthen their market position and capture a large customer base.

One of the primary business strategies adopted by companies in the global healthcare payer service industry to benefit clients and expand the healthcare payer service market sector is to provide services locally to reduce operating costs.

Accenture (Ireland) provides a wide range of services and solutions in the domains of strategy, consulting, digital, technology, and operations. The industries the company serves include agribusiness, automotive, banking, capital markets, retail, travel, health, chemicals, media and technology, and communications. It also offers services exclusive to the sector, including banking, insurance, health care, platform security, and trust. The company has operations in Latin America, the Americas, Europe, Africa, the Middle East, and Asia-Pacific. For instance, in September 2023, Accenture (Ireland) has acquired Nautilus Consulting that specializes in Electronic Patient Record (EPR) solutions in the UK. The acquisition will help to enhance Accenture’s digital transformation, implementation, and optimization capabilities across the UK and global healthcare space.

Also, Cognizant (US) provides information technology (IT), consulting, and business process outsourcing (BPO) services. The company offers the following products and services: internet of things, enterprise services, cloud enablement, intelligent process automation, application services, infrastructure, security, and enterprise application services; core modernization; digital engineering; digital experience; digital strategy; industry and platform solutions; and quality engineering and assurance. Among the sectors for which CTS provides services are banking and finance, consumer goods, healthcare, education, energy and utilities, and communications. It also provides services to the life sciences, retail, manufacturing, media and entertainment, insurance, information services, transportation and logistics, and travel and hospitality industries. The company operates in the Asia-Pacific region, the Americas, Europe, and the Middle East.

Key Companies in the Healthcare Payer Service Market include

• Oracle Corporation (US)


• IQVIA Holding, Inc (US)


• HCL Technologies limited (India)


• Accenture (Ireland)


• Cognizant (US)


• Dell Inc (US)


• Genpact (US)


• Omega Healthcare Management Services (India)


• Infosys Limited (India)


• NTT DATA, Inc (Japan)

Healthcare Payer Service Industry Developments

July 2021: Cognizant (US) collaborated with Royal Philips (Netherlands) to create Philips HealthSuite, a cloud-based platform to deliver end-to-end digital health solutions that will help organizations to improve patient care and accelerate clinical trials.

Healthcare Payer Service Market Segmentation:

Healthcare Payer Service Service Type Outlook

• Business Process Outsourcing Services


• IT Outsourcing Services


• Knowledge Process Outsourcing Services

Healthcare Payer Service Application Outlook

• Claims Management


• Integrated Front Office and Back Office Operations


• Member Management


• Provider Management


• Billing and Accounts Management


• Analytics and Fraud Management


• Human Resource


• Clinical Decision-Making


• Patient Engagement


• Others

Healthcare Payer Service End User Outlook

• Private Payers


• Public Payers

Healthcare Payer Service Regional Outlook

• North America
  
  
  
  • US
  
  
  • Canada
  
  
  
  


• Europe
  
  
  
  • Germany
  
  
  • France
  
  
  • UK
  
  
  • Italy
  
  
  • Spain
  
  
  • Rest of Europe
  
  
  
  


• Asia-Pacific
  
  
  
  • China
  
  
  • Japan
  
  
  • India
  
  
  • Australia
  
  
  • South Korea
  
  
  • Rest of Asia-Pacific
  
  
  
  


• Rest of the World
  
  
  
  • Middle East
  
  
  • Africa
  
  
  • Latin America