Healthcare Claims Management Market – Scenario
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 multiplying 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.
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The growing population has fuelled the demand for the highest quality of coordinated care. With the ever-increasing administrative & operational expenses of healthcare organizations, cost-effective management of claims becomes mandatory. Claims management offers viable solutions by replacing 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 the medical claims management solutions market.
Key Players – Healthcare Claims Management Market
Market Research Future (MRFR) recognizes the following companies as the key players in Healthcare Claims Management Market: There are plenty of large and small market players which operate in this market all over the globe.
- Cerner Corporation,
- McKesson Corporation,
- athenahealth, Inc.,
- Optum, Inc.,
- Conifer Health Solutions,
- nThrive, Inc,
- Avaya Inc.,
- Oracle Corporation,
- Infor Inc.,
- Allscripts Healthcare Solutions, Inc.,
- Accenture plc.,
- IBM Corporation,
- Cognizant Technology Solutions Corporation
- Genpact Limited
Segments – Healthcare Claims Management Market
The global market for healthcare claims management is segmented on the basis of component, delivery mode type and end-user.
The component-based segments in the market are software and services.
The modes of delivery covered by the report are on-premise and cloud based.
Type-wise, the market is considered for integrated and standalone.
The market, depending on the end-user, has been segmented based on healthcare payers and providers.
February 2019 – Providence Health & Services (US) has acquired Lumedic Inc. (US), which provides platform for revenue cycle management on the basis of machine learning, patient-centric design and blockchain for claims processing.
February 28, 2019 – QRails, Inc. (the US), a financial technology company offers processing services and other solutions to Health Insurer, banks, and the digital payments industry announced the acquisition of Rete+Pay Inc. (the US), a provider of integrated electronic healthcare and insurance payments solutions.
Rete+Pay has a range of innovative payments solution that enable, faster, more efficient and cost-effective management of medical claims between insurance companies, patients and healthcare providers, offering a secure, HIPAA, and ACA compliant environment. Rete+Pay has been providing insurance companies and healthcare providers innovative ways of reducing or eliminating inefficient billing and payments processes.
The acquisition deal is a significant strategic step for Q-Rails to curtail the huge administration costs of approximately USD 1.2 TN which the Q-Rails healthcare spends annually.
February 28, 2019 – Providence Health & Services (the US) is a non-profit health care system operating multiple hospitals announced acquisition of Lumedic Inc. (the US), a next-generation platform for revenue cycle management built on blockchain, machine learning, and patient-centric design to build a blockchain platform for claims processing.
Providence plans to form a new company using Lunedic’s assets and team, which will maintain the Lumedic brand. Lunedic’s end-to-end revenue cycle management platform which is based on blockchain technology deploys distributed ledger technology, smart contracts, and machine learning.
Regional Analysis – Healthcare Claims Management Market
The North America region heading with its well-established healthcare sector will continue to lead the global healthcare claims management market throughout the forecast period.
Moreover, factors such as the favorable government policies, and the rapid adoption of claim management solutions that are availing increasing incentives are helping the market to achieve significant market share, globally.
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 rising 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 to the growing number of healthcare facilities in the region fosters the regional market. Developing countries like India, China, and Japan account for the broad adoption of these management products and services and hence, account for the major contributors to the market growth in the region.
Some Brief Table of Contents of Report
Chapter 1. Report Prologue
Chapter 2. Market Introduction
2.2 Scope Of The Study
2.2.1 Research Objective
Chapter 3. Research Methodology
3.2 Primary Research
3.3 Secondary Research
3.4 Market Size Estimation
Chapter 4. Market Dynamics
4.5 Macroeconomic Indicators
4.6 Technology Trends & Assessment
Chapter 5. Market Factor Analysis
5.1 Porters Five Forces Analysis
5.1.1 Bargaining Power Of Suppliers
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