Patient Access Solutions Market Analysis

Global Patient Access Solutions Market Overview

The Patient Access Solutions Market Size was valued at USD 1.83 Billion in 2023 and is projected to grow from USD 1.98006 Billion in 2024 to USD 3.45 Billion by 2032, exhibiting a compound annual growth rate (CAGR) of 7.21% during the forecast period (2024 - 2032). The two key market drivers for market expansion are manufacturers' increased focus on brand protection and the booming pharmaceutical and medical device industries. 

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

In September 2023, Health Gorilla, a company specializing in interoperability and privacy-focused health information networks, released the Patient Access solution, which allows healthcare institutions to obtain extensive health data. Consumers can use the Individual Access Services (IAS) purpose of use to send queries to national health information networks. In the past, the ease of accessing comprehensive data from national exchanges has been limited to certain purposes, such as medical care. Insurers and life sciences businesses obtain consumers' medical records through time-consuming and manual methods, in addition to providing healthcare services other than patient treatment. These techniques encompass personally contacting patients through their physicians, asking patients to recall their medical history, or requiring patients to provide their electronic health record (EHR) patient portal credentials.

In February 2023, AGS Health, a firm that uses technology to deliver solutions for managing revenue cycles, stated that it had acquired the patient access outsourcing business section of Availity, a healthcare technology company based in Florida and India.  Over 50% of hospitals in the United States are expecting to have profit margins that are in the negative for the next year. As a result, it is crucial to ensure that payment for services is obtained in a thorough and precise manner. Through this expansion, AGS Health is now able to provide customers with assistance in achieving higher rates of first-pass reimbursement. This is done by enabling the deployment of faster and more adaptable financial clearance solutions on a broader scale. The acquisition allows AGS Health to enhance the capabilities of the AGS AI Platform by integrating innovative technologies that accelerate patient access procedures and enhance precision and scalability. The technical platform has the capability to independently determine, submit, and verify the statuses of prior authorization requests.

Patient Access Solutions Market Trends

• Growing use of telehealth and virtual care is driving the market growth

The growing use of telehealth and virtual care is one major trend in the market for patient access solutions worldwide. Telehealth systems allow for secure communication, remote monitoring, and virtual consultations between healthcare providers and patients, often doing away with the need for in-person visits. Technology advances, better internet access, and the increased acceptance of telehealth by patients and healthcare professionals have all contributed to the acceleration of this trend. Telehealth not only improves patients' access to healthcare services, especially for those who live in distant or underserved areas, but it also boosts patient convenience, improves efficiency, and lowers healthcare costs. Telehealth is therefore anticipated to continue expanding significantly and be essential in determining the future of patient access.

The control of denials is crucial to revenue cycle management. Hospitals have the ability to look into each unpaid claim, identify patterns, and contest a claim's denial. By using this technology, healthcare providers can also streamline their operations and prevent future claim payment problems. Consequently, the demand for a patient access solution is being driven by the denial management's growing significance. For instance, according to a report from the Journal of AHIMA published in April 2022, denial rates for hospitals have increased by more than 20% over the last five years, with average rates of claims denial reaching 10% or more. As a result, the market for patient access solutions is expanding due to the necessity for efficient management of the growing number of denial claims. Healthcare providers are turning to healthcare IT solutions, such as patient access solutions, to properly investigate denial claims.

Insurance companies are increasingly denying claims from and providing coverage for persons who are seeking treatment for chronic or persistent illnesses in an effort to cut expenses and increase profits. Healthcare providers are being given more and more responsibility for managing operating expenses. These capabilities enable healthcare practitioners to thoroughly examine rejected claims using healthcare IT tools like patient access solutions. Governmental directives and regulatory compliances that promote the expansion of the market in the upcoming years are predicted to determine the market's pace. Thus, driving the patient access solutions market revenue.

Patient Access Solutions Market Segment Insights

Patient Access Solutions Service Insights

The market segments of patient access solution, based on service includes Support & Maintenance and Implementation. The support & maintenance segment dominated the market. This category includes the services offered by suppliers or healthcare facilities to guarantee the continued upkeep, support, and maintenance of their patient access software solutions. It is essential for the efficient running and ongoing development of the systems used for scheduling, insurance verification, patient registration, and other access-related tasks.

Figure 1: Patient Access Solutions Market, by Service, 2023 & 2032 (USD Billion) 

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

Patient Access Solutions Software channel Insights

The patient access solutions market segmentation, based on software, includes Eligibility Verification Software and Medical Necessity Management Software. The eligibility verification software category generated the most income. The data submitted by a patient on their medical problems is cross-checked against databases maintained by insurance companies and governmental organizations using eligibility verification software. Making sure that only eligible patients receive benefits from healthcare programs is the major goal of this software. Two parties—the patient and the insurance company or government agency involved in delivering healthcare services, such as Medicare and Medicaid, etc.—are involved in the eligibility verification procedure.

Patient Access Solutions Regional Insights

By region, the study provides the market insights into North America, Europe, Asia-Pacific and Rest of the World. The North American patient access solutions market area will dominate this market. This dominance can be due to the highly developed healthcare infrastructure, the widespread use of healthcare IT solutions, and the supportive government programs promoting the digitalization of healthcare services. The well-established healthcare institutions in the area, such as hospitals, clinics, and diagnostic facilities, were early adopters of patient access solutions, which fueled market expansion. Its dominant position is also aided by the existence of significant market participants in North America.

Further, the major countries studied in the market report are The US, Canada, German, France, the UK, Italy, Spain, China, Japan, India, Australia, South Korea, and Brazil.

Figure 2: PATIENT ACCESS SOLUTIONS MARKET SHARE BY REGION 2023 (USD Billion) 

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

Europe patient access solutions market accounts for the second-largest market share because of variables such as sophisticated healthcare infrastructure and favorable reimbursement regulations, to name a few. These and other factors are expected to boost market growth in Europe over the next several years. Additionally, technological improvements in countries contribute to regional market growth. Further, the German market of patient access solutions held the largest market share, and the UK market of patient access solutions was the fastest growing market in the European region

The Asia-Pacific Patient access solutions Market is expected to grow at the fastest CAGR from 2023 to 2032. The cost of healthcare is rising, the healthcare infrastructure is getting better, digital technologies are becoming more widely used, and people are becoming more aware of the advantages of patient access solutions. Due to their sizable populations and government efforts to improve healthcare services, nations like China, India, Japan, and South Korea are leading this expansion. Growing middle-class populations and higher disposable incomes in the area also contribute to rising healthcare costs. Moreover, China’s market of patient access solutions held the largest market share, and the Indian market of patient access solutions was the fastest growing market in the Asia-Pacific region.

Patient Access Solutions Key Market Players & Competitive Insights

Leading market players are investing heavily in research and development in order to expand their product lines, which will help the patient access solutions market, grow even more. Market participants are also undertaking a variety of strategic activities to expand their footprint, with important market developments including new product launches, contractual agreements, mergers and acquisitions, higher investments, and collaboration with other organizations. To expand and survive in a more competitive and rising market climate, patient access solutions industry must offer cost-effective items.

Manufacturing locally to minimize operational costs is one of the key business tactics used by manufacturers in the patient access solutions industry to benefit clients and increase the market sector. In recent years, the patient access solutions industry has offered some of the most significant advantages to market. Major players in the patient access solutions market attempting to increase market demand by investing in research and development operations include MEDHOST, Cerner Corporation, TransUnion LLC, KYRUUS, UNITED BIOSOURCE LLC, GAFFEY Healthcare, Stericycle Inc, FormFast, Cardinal Health and McKesson.

Healthcare information technology solutions and related services are offered by Cerner Corp (Oracle Cerner), a division of Oracle Corporation. The company provides a wide range of products and services to meet the clinical, financial, and operational requirements of businesses. Its primary offerings are ambulatory, customer relationship management, critical care, acute EHR solutions, women's health, patient engagement, and revenue cycle management. It provides solutions based on the combined Cerner Millennium architecture and the HealtheIntent cloud-based platform.

Distribution of medications, healthcare services, and IT solutions are all offered by McKesson Corp (McKesson). In addition to selling beauty and health goods, the business also distributes drugs and medical supplies. Additionally, it provides pharmacy management software, pharmacy operations, drug purchasing management, pharmacy claims reimbursement, pharmacy group purchasing, pharmacy automation solutions, patient adherence and wellness, audit risk mitigation, alternate site pharmacy solutions, and pharmacy consulting & technology.

Key Companies in the market of patient access solutions include

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  MEDHOST

  
  


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  Cerner Corporation

  
  


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  TransUnion LLC

  
  


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  KYRUUS

  
  


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  UNITED BIOSOURCE LLC

  
  


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  GAFFEY Healthcare

  
  


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  Stericycle Inc

  
  


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  FormFast

  
  


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  Cardinal Health

  
  


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  McKesson

  
  

Patient Access Solutions Industry Developments

July 2022: Denial Prevention and Recovery Accelerator, the most current addition to its Revenue AI vendor-neutral solutions that help providers fast drive revenue cycle optimization to noticeably improve their financial performance, was just released by the Health Cloud company, Innovaccer Inc.

June 2022:Oracle has completed the acquisition of Cerner. Cerner and Oracle have the capacity to transform the way healthcare is provided by arming medical professionals with more knowledge and enabling them to choose better treatments that enhance patient outcomes.

January 2022:The MarinHealth Medical Centre, a 327-bed independent hospital, and UnitedHealth Group joined forces. By signing this contract, Marin County, California would be able to further its revenue cycle operational goals while also enhancing patient satisfaction. Additionally, Optum would offer revenue cycle management services and supporting technologies, and MarinHealth would manage Optum technology to improve patient and supplier experiences and optimize nonclinical administrative procedures.

Patient Access Solutions Market Segmentation

Patient Access Solutions Service Outlook (USD Billion, 2018-2032)

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  Support & Maintenance

  
  


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  Implementation

  
  

Patient Access Solutions Software Outlook (USD Billion, 2018-2032)

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  Eligibility Verification Software

  
  


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  Medical Necessity Management Software

  
  

Patient Access Solutions Regional Outlook (USD Billion, 2018-2032)

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  North America

  
  

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  US

  
  


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  Canada

  
  

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  Europe

  
  

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  Germany

  
  


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  France

  
  


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  UK

  
  


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  Italy

  
  


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  Spain

  
  


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  Rest of Europe

  
  

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  Asia-Pacific

  
  
  
  
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    China

    
    
  
  
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    Japan

    
    
  
  
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    India

    
    
  
  
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    Australia

    
    
  
  
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    South Korea

    
    
  
  
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    Australia

    
    
  
  
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    Rest of Asia-Pacific

    
    
  
  
  
  


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  Rest of the World

  
  
  
  
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    Middle East

    
    
  
  
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    Africa

    
    
  
  
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    Latin America