Healthcare Payer Services Market Trends

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Overview and Scope

Payer services help the payers to streamline their business processes and deliver better services to their customers. Organizations that determine service prices, collect payments, handle claims, and pay provider claims are known as payers in the healthcare sector. Examples of payers include Medicare, Medicaid, and health plan providers.

Sizing and Forecast

The payer services market size has grown rapidly in recent years. It will grow from $134.92 billion in 2023 to $156.72 billion in 2024 at a compound annual growth rate (CAGR) of 16.2%. The growth in the historic period can be attributed to growing demand for cost containment, healthcare complexity, rising need for data analytics, rising demand for member engagement, aging population, increased chronic conditions.

The payer services market size is expected to see rapid growth in the next few years. It will grow to $277.68 billion in 2028 at a compound annual growth rate (CAGR) of 15.4%. The growth in the forecast period can be attributed to population health management, value-based care models, expansion of telehealth, demand for personalized healthcare. Major trends in the forecast period include data analytics and ai, telehealth integration, consumer-centric approaches, health equity and inclusivity, remote monitoring and wearables.

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Segmentation & Regional Insights

The payer services market covered in this report is segmented –

1)By Outsourcing Services: Business Process Outsourcing Services, Knowledge Process Outsourcing Services, Information Technology Outsourcing Services

2)By Application: Revenue Cycle Management, Healthcare Reimbursement, Medical Billing Outsourcing, Other Applications

3)By End-User: Public Payers, Private Payers

North America was the largest region in the payer services market in 2023. Western Europe was the second-largest region in the global payer services market share. The regions covered in the payer services market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, and Africa.

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Major Driver Impacting Market Growth

The increase in healthcare frauds is expected to drive the payer services market for tightening its security systems. Healthcare fraud includes malpractices such as individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit billing by practitioners for care that they never rendered, filing duplicate claims for the same service rendered, altering the dates and modifying medical records. The healthcare industry continues to suffer losses attributed to frauds and errors. For instance, according to the National Health Care Anti-Fraud Association, in the USA the loss from healthcare fraud was estimated to be $300 billion. Therefore, increasing healthcare fraud in the healthcare industry is propelling the demand for rigid security systems, thereby driving the growth of the payer services market.

Key Industry Players

Major companies operating in the payer services market include United Health Group, Anthem Insurance Companies Inc., Concentrix Corporation, Aetna Inc., CIGNA Corp., HealthPartners, Blue Cross Blue Shield of Massachusetts, Group Health Cooperative, Accenture plc, Cognizant Technology Solutions Corp., Tata Consultancy Services Limited., Xerox Holdings Corporation, WNS (Holdings) Limited., NTT Data Corporation, IQVIA Holdings Inc., Mphasis Limited., Genpact Limited., Wipro Limited., Infosys BPM Limited., Firstsource Solutions Limited., International Business Machines Corporation, HCL Technologies Limited., Lonza Group AG, Omega Healthcare Investors Inc., R1 RCM Inc., Invensis Technologies Pvt Ltd., PAREXEL International Corporation, Optum Inc., Humana Inc., McKesson Corporation, Change Healthcare Inc., Conifer Health Solutions LLC., Experian Health Inc.

The payer services market report table of contents includes: