Market Dynamics

Increasing healthcare cost across the globe and rising awareness among consumers related to health insurance and are major factors expected to drive the growth of global market. In addition, high government spending on development of present healthcare sector and adoption of IT solution in order to implement various healthcare reforms this is expected to augment the growth of target market.

Major players focus on business expansion through strategic acquisition in order to enhance the customer base is another factors expected to augment the growth of target market.

In 2020, emids, a provider of digital engineering and transformation solutions to healthcare and life sciences industry acquired FlexTech company the deals with information technology consulting and has expertise in leading payer core administration and population health platforms. The acquisition is expected to help the company to expanded channel partnership opportunities among leading core platform vendors and position.

In 2019, Centauri Health Solutions a global provider of innovative healthcare technology and services acquired HCFS, Inc. a provider of self-pay management solutions. This acquisition is expected to help the company to enhance its market leadership in hospital revenue cycle optimization services.

In 2020, Discovery Health Partners, a global industry expert focused on helping healthcare payers solve payment and revenue integrity challenges acquired Consova’s payment integrity business. This is expected to help the company to enhance the revenue share and data mining expertise and capabilities.

In 2019, Conduent Inc. a global company that acts as a provider of business process services with expertise in transaction-intensive processing and analytics acquired Health Solutions Plus (HSP), a software provider of healthcare payer administration solutions. This is expected to help the company to better serve current and prospective commercial and government payer clients with core administration processing technology.

In 2016, WIPRO a leading global information technology, consulting and business process services acquired HealthPlan Services an independent technology and Business Process as a Service (BPaaS) provider in the U.S. Health Insurance market. This acquisition helped the company to strengthen its position in US market.

However, factor such as risk of data breach and unforeseen costs associated with outsourcing are expected to hamper the growth of global healthcare payer solution market. In addition, migration from legacy system is another factor expected to challenge the growth of target market.

Major players focus on adoption of advanced analytics and approach towards increasing the service portfolio are factors expected to create new opportunities for players operating in the target market over the forecast period. In addition, rising public-private partnership is expected to revenue support the growth of target market.

Segment Analysis by Region

The market in North America is expected to account for major revenue share due to high healthcare cost. In addition, rising awareness among consumers related to insurance is expected to support the growth of regional market.

Increasing merger and acquisition activities by major players on order to enhance the customer base and focus on increasing the product portfolio this are among factors expected to augment the growth of target market.

 Competitive Landscape                                                                                 

The global market is high highly competitive due to presence of large number of players and innovative product offerings. In addition, business expansion activities through partnerships and agreements are factors expected to further increase the competition.

Report coverage

Healthcare Payer Solution Market Segment Analysis, 2019

The global market is segmented into service, application, and end use. The service segment is expected to further bifurcate into business process outsourcing services, information technology outsourcing services, and knowledge process outsourcing services. Among the service segment the business process outsourcing services segment is expected to account for major revenue share.

The application segment is further divided into pharmacy audit & analysis systems, claims management services, fraud management services, computer-assisted coding (CAC) systems, member eligibility management services, provider network management services, and others.

The players profiled in the report are McKesson Corporation, HMS Holdings Corp, International Business Machines Corporation, Change Healthcare, Inc., Accenture plc, Cognizant Technology Solutions Corporation, Hinduja Global Solutions Limited, UnitedHealth Group Incorporated, Inovalon Holdings, Inc., and Wipro Limited.

Market Segmentation

Market By Service

Business Process Outsourcing Services

Information Technology Outsourcing Services

Knowledge Process Outsourcing Services

Market By Application

Pharmacy Audit & Analysis Systems

Claims Management Services

Fraud Management Services

Computer-assisted Coding (CAC) Systems

Member Eligibility Management Services

Provider Network Management Services

Others

Market By End Use

Private Provider

Public Provider

Market By Region

North America

• U.S.
• Canada

Europe

• U.K.
• Germany
• France
• Spain
• Rest of Europe

Asia-Pacific

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

Latin America

• Brazil
• Mexico
• Rest of Latin America

Middle East & Africa

• GCC
• South Africa
• Rest of Middle East & Africa