Healthcare Claims Management Market Overview

Healthcare Claims Management, software that manages medical claims and reimbursement processes is increasingly enabling healthcare providers to optimize their revenues by proper claim management. In a nutshell, healthcare claims management is a bilateral process between patients, healthcare providers, billing company, and insurance provider. Due to the rapid expansion in the healthcare insurance sector over the past few years, the market for claims management is growing rapidly.

Acknowledging the exponential growth, this market perceives currently; Market Research Future (MRFR) in its recently published study report asserts that the global healthcare claims management market will garner exponentials gains registering a CAGR of approximately 5.37% during the forecast period (2018–2023).

The global healthcare claims management market is expected to grow significantly over the assessment period mainly due to the increase in aging population, the rise in the incidences of chronic diseases, improved focus on healthcare quality services, and the advent of innovative treatments & technologies. Growing digitization along with the flourishing healthcare IT market immensely contribute to the escalating market credentials.

The growing population has fuelled the demand for the highest quality of coordinated care. With the growing administrative & operational expenses of healthcare organizations, cost-effective management of claims becomes mandatory. Claims management offers viable solutions by replacing the traditional paper-based systems to optimize cost. Such factors are commutatively escalating the claims management market to the furthered heights.

Additional factors predominantly driving the market growth include; rapidly developing healthcare infrastructures and the augmented uptake of solutions to manage the rapidly increasing claims in the healthcare sector, worldwide. Moreover, technological advancements and improving economic conditions are fostering the market growth of healthcare claims management.

On the other hand, factors such as the increasing concerns of the patients’ data safety & security alongside the threats of data breaches and loss of confidentiality are restricting the market growth. Also, the lack of skilled IT professionals in healthcare is obstructing the growth of medical claims management solutions market.

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Global Healthcare Claims Management Market - Segments

MRFR has segmented its analysis into five key dynamics for enhanced understanding.

By Component : Software and Services among others.

By Delivery Mode : On-premise and Cloud-based among others.

By Type : Integrated and Standalone among others.

By End-user : Healthcare Payers and Providers among others.

By Regions : Europe, North America, APAC, and Rest-of-the-World.

Global Healthcare Claim Management Market - Geographical Analysis

The North America region is expected to continue with its dominance over the global healthcare claims management market throughout the forecast period. The market is heading with the significant market share owing to the favorable government policies, and the rapid adoption of claim management solutions that are availing increasing incentives.

The growing investments in the field of healthcare information technology (HCIT) alongside the presence of regulatory mandates favoring the implementation of healthcare claims management solutions foster the growth of the regional market.

The US and Canada among other North American countries have successfully implemented healthcare IT in their healthcare system, which as a result is boosting the growth in the regional market over the forecast period.

Additionally, the presence of developed infrastructures of healthcare & IT coupled with favorable government initiatives in executing claims management, regulatory framework, and innovations in the field would further propel the market growth in the region.

Europe & Asia Pacific accounts for the second & third largest market, respectively, in the global healthcare claims management market. Factors such as the improved digitization along with the increasing focus on data integration and data governance for the increasing number of claims in the healthcare sector would drive the growth of the European claim management market.

The Asia Pacific claims management market is driven by the developments in technology and healthcare infrastructure. The increasing adoption of claims management systems in the increasing number of healthcare facilities in the region fosters the regional market. Developing countries like India, China, and Japan account for the wide adoption of these management products and services and hence, account for the major contributors to the market growth in the region.

Global Healthcare Claims Management Market - Competitive Landscape

The fiercely competitive market of healthcare claims management appears to be fragmented owing to the presence of numerous large and small-scale players accounting for a substantial market share. These players try to gain competitive advantage through strategic initiatives such as partnership, acquisition, collaboration, expansion, and product/ technology launch. Key Players invest heavily in the R&D to develop a technology that is entirely on a different level compared to their competition.

Healthcare Claims Management Market Key Players:

Some of the players leading the global healthcare claims management market are McKesson Corporation (US), Cerner Corporation (US), Athenahealth (US), Optum, Inc. (US), eClinicalWorks (US), Conifer Health Solutions (US), Avaya Inc. (USA), nThrive (US), Oracle Corporation (US), Allscripts Healthcare Solutions, Inc. (US), Infor Inc. (US), Accenture plc. (Ireland), Cognizant Technology Solutions Corporation (US), Genpact Limited (US), and IBM Corporation (US) among others.

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Healthcare Claims Management Industry/Innovation/Related News:

October 02, 2018 - Waystar, Inc (US), leading provider of integrated cloud-based healthcare revenue cycle management solutions announced its plan to acquire the transaction services technology business owned by Ovation Revenue Cycle Services (US), a leading global provider of transaction services and workflow solutions for health care to add enhanced claims monitoring capabilities to platform.

Ovation Revenue Cycle Services is a part of leading health care insurer UPMC. Ovation's technology uses advanced algorithms to monitor claims at many health systems and hospitals, and this technology will now be integrated into Waystar's platform, giving unprecedented claims visibility to nearly 500,000 healthcare providers.