ヘルスケアペイヤーサービス市場- サービスタイプ別、用途別、最終用途別、世界予測、2023年～2032年

ヘルスケアペイヤーサービスの世界市場は、2023年から2032年にかけて顕著な成長を記録します。

ヘルスケアコストの上昇と保険手続きの複雑化により、支払サービスのアウトソーシング需要が高まっています。ミリマン・メディカル・インデックス（MMI）によると、平均的な雇用者負担のPPO（Preferred Provider Organization）プランに加入しているアメリカ人4人家族を想定した場合、2023年の医療費は31,065ドルになります。これは2022年から5.6％の上昇です。このMMIは、37歳の女性、47歳の男性、4歳の子供、1歳の子供の4人の家族を反映したものです。

ヘルスケアペイヤーは、請求処理、請求、カスタマーサポートを効率的に管理する費用対効果の高いソリューションを求めています。バリュー・ベース・ケアと集団健康管理へのシフトは、高度なデータ分析とリスク評価能力を必要とし、専門的な支払者サービスの必要性を促しています。さらに、会員エンゲージメントと満足度の向上に注力することで、パーソナライズされたシームレスな体験を提供する革新的な支払者サービスへの需要が高まっています。

ヘルスケアペイヤーサービス市場全体は、サービスタイプ、用途、最終用途、地域によって分類されます。

サービスタイプ別では、KPO分野が2032年までに顕著な評価を記録します。KPOプロバイダーは、請求処理、収益サイクル管理、リスク評価、データ分析などの分野で専門的な知識と深い知識を提供します。ヘルスケア事業者は、業務の合理化、正確性の向上、収益の最適化を目指しており、費用対効果が高く効率的なソリューションを求めてKPOサービスを利用しています。医療費支払者向けサービス市場におけるKPOサービスの需要は、進化を続けるヘルスケアの現場で意思決定を強化し、より良い成果を達成するために、包括的でデータ主導型の洞察力が求められていることが背景にあります。

用途別では、請求・会計管理サービス分野のヘルスケアペイヤーサービス産業が、2023年から2032年にかけて顕著な成長率を示すと思われます。ヘルスケア支払者は、複雑な請求プロセスを管理し、正確な請求処理を行うための効率的なソリューションを求めています。請求件数の増加とタイムリーな払い戻しの必要性から、請求・会計管理サービスのアウトソーシングが不可欠となっています。専門のプロバイダーは、コーディング、請求処理、収益サイクル管理などの専門知識を提供し、業務を合理化して、ヘルスケア支払者の財務パフォーマンスを向上させます。ヘルスケアペイヤーサービス市場におけるこうしたサービスの需要は、シームレスで効率的な支払いプロセスを確保する上で、その重要性を裏付けています。

最終用途については、2032年までに公的支払者セグメントがヘルスケア支払者サービス市場で一定のシェアを獲得する可能性があります。国民に包括的な保障を提供するため、公的支払機関は請求処理、資格確認、会員管理を管理する効率的でコスト効率の高いサービスを必要としています。支払者サービスを専門プロバイダーに委託することで、公的支払者は業務を最適化し、会員の満足度を向上させ、規制要件へのコンプライアンスを確保することができます。

アジア太平洋地域では、人口増加や医療ニーズの高まりにより、2023年から2032年にかけて、医療費支払いサービス産業は高い収益を上げると思われます。慢性疾患の増加により、高度なデータ分析とリスク評価能力が必要とされ、専門的な支払者サービスの必要性が高まっています。さらに、アジア太平洋地域のヘルスケア分野では、デジタル技術や遠隔医療ソリューションの導入が進んでおり、革新的な支払者向けサービスの需要がさらに高まっています。医療アクセスとアウトカムの改善に注力することが、アジア太平洋地域のヘルスケアペイヤーサービス市場の成長を後押ししています。

目次

第1章 調査手法

• 市場の定義
• 基本推定と計算
• 予測パラメータ
• 世界レベルでのCOVID-19影響分析
• データの検証
• データソース
  • 一次データ
  • 2次データ
    • 有料情報源
    • 公的情報源

第2章 エグゼクティブサマリー

第3章 ヘルスケアペイヤーサービス業界洞察

• エコシステム分析
• 業界への影響要因
  • 促進要因
    • 医療保険の普及
    • 効率化とコスト削減を目的としたアウトソーシングの増加
    • 慢性疾患の負担増
    • ヘルスケア詐欺事件の増加
  • 業界の潜在的リスク＆課題
    • データ漏洩と機密保持の喪失リスク
    • サービスのアウトソーシングに伴う高コスト
• 成長可能性分析
• COVID-19の影響分析
• 技術の進歩
• 規制状況
  • 米国
  • 欧州
• 応用可能性
• ポーター分析
• PESTEL分析

第4章 競合情勢、2022年

• イントロダクション
• 企業マトリックス分析
• 主要市場プレーヤーの競合分析
• 競合のポジショニングマトリックス
• 戦略ダッシュボード
• 戦略展望マトリックス

第5章 ヘルスケアペイヤーサービス市場規模・予測：サービスタイプ別

• 主要動向
• BPOサービス
• ITOサービス
• KPOサービス

第6章 ヘルスケアペイヤーサービスの市場規模・予測：用途別

• 主要動向
• 請求管理サービス
• 分析・不正管理サービス
• フロントオフィスとバックオフィスの統合サービス
• 請求・会計管理サービス
• 会員管理サービス
• プロバイダー管理サービス
• 人事サービス

第7章 ヘルスケアペイヤーサービスの市場規模・予測：最終用途別

• 主要動向
• 民間支払者
• 公的支払者

第8章 ヘルスケアペイヤーサービスの市場規模・予測：地域別

• 主要動向
• 北米
  • 米国
  • カナダ
• 欧州
  • ドイツ
  • 英国
  • フランス
  • スペイン
  • イタリア
  • ポーランド
  • スウェーデン
  • オランダ
  • その他欧州
• アジア太平洋
  • 日本
  • 中国
  • インド
  • オーストラリア
  • 韓国
  • インドネシア
  • フィリピン
  • マレーシア
  • その他アジア太平洋地域
• ラテンアメリカ
  • ブラジル
  • メキシコ
  • アルゼンチン
  • コロンビア
  • チリ
  • ペルー
  • その他ラテンアメリカ
• MEA
  • 南アフリカ
  • サウジアラビア
  • アラブ首長国連邦
  • イスラエル
  • トルコ
  • イラン
  • その他のMEA

第9章 企業プロファイル

• Merative（IBM Watson Health）
• Oracle Corporation
• IQVIA Inc
• HGS Ltd.
• Xerox Corporation
• Concentrix Corporation
• Genpact
• HCL Technologies Limited
• Accenture
• Cognizant
• ExlService Holdings, Inc.

Data Tables

• TABLE 1 Product mapping
• TABLE 2 Market revenue, by services (2022)
• TABLE 3 Market share, by application (2022)
• TABLE 4 Market share, by end-use (2022)
• TABLE 5 Market share, by region (2022)
• TABLE 6 Global healthcare payers services market size, by region, 2018 - 2022 (USD Million)
• TABLE 7 Global healthcare payers services market size, by region, 2023 - 2032 (USD Million)
• TABLE 8 Global healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 9 Global healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 10 Global healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 11 Global healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 12 Global healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 13 Global healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 14 Industry impact forces
• TABLE 15 BPO services market size, 2018 - 2022 (USD Million)
• TABLE 16 BPO services market size, 2023 - 2032 (USD Million)
• TABLE 17 ITO services market size, 2018 - 2022 (USD Million)
• TABLE 18 ITO services market size, 2023 - 2032 (USD Million)
• TABLE 19 KPO services market size, 2018 - 2022 (USD Million)
• TABLE 20 KPO services market size, 2023 - 2032 (USD Million)
• TABLE 21 Claims management services market size, 2018 - 2022 (USD Million)
• TABLE 22 Claims management services market size, 2023 - 2032 (USD Million)
• TABLE 23 Analytics and fraud management services market size, 2018 - 2022 (USD Million)
• TABLE 24 Analytics and fraud management services market size, 2023 - 2032 (USD Million)
• TABLE 25 Integrated front office service and back office operations market size, 2018 - 2022 (USD Million)
• TABLE 26 Integrated front office service and back office operations market size, 2023 - 2032 (USD Million)
• TABLE 27 Billing and accounts management services market size, 2018 - 2022 (USD Million)
• TABLE 28 Billing and accounts management services market size, 2023 - 2032 (USD Million)
• TABLE 29 Member management services market size, 2018 - 2022 (USD Million)
• TABLE 30 Member management services market size, 2023 - 2032 (USD Million)
• TABLE 31 Provider management services market size, 2018 - 2022 (USD Million)
• TABLE 32 Provider management services market size, 2023 - 2032 (USD Million)
• TABLE 33 HR services market size, 2018 - 2022 (USD Million)
• TABLE 34 HR services facilities market size, 2023 - 2032 (USD Million)
• TABLE 35 Private payers market size, 2018 - 2022 (USD Million)
• TABLE 36 Private payers market size, 2023 - 2032 (USD Million)
• TABLE 37 Public payers market size, 2018 - 2022 (USD Million)
• TABLE 38 Public payers market size, 2023 - 2032 (USD Million)
• TABLE 39 North America healthcare payers services market size, by country, 2018 - 2022 (USD Million)
• TABLE 40 North America healthcare payers services market size, by country, 2023 - 2032 (USD Million)
• TABLE 41 North America healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 42 North America healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 43 North America healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 44 North America healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 45 North America healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 46 North America healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 47 U.S. healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 48 U.S. healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 49 U.S. healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 50 U.S. healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 51 U.S. healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 52 U.S. healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 53 Canada healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 54 Canada healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 55 Canada healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 56 Canada healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 57 Canada healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 58 Canada healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 59 Europe healthcare payers services Market size, by country, 2018 - 2022 (USD Million)
• TABLE 60 Europe healthcare payers services Market size, by country, 2023 - 2032 (USD Million)
• TABLE 61 Europe healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 62 Europe healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 63 Europe healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 64 Europe healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 65 Europe healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 66 Europe healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 67 Germany healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 68 Germany healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 69 Germany healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 70 Germany healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 71 Germany healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 72 Germany healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 73 UK healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 74 UK healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 75 UK healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 76 UK healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 77 UK healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 78 UK healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 79 France healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 80 France healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 81 France healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 82 France healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 83 France healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 84 France healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 85 Spain healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 86 Spain healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 87 Spain healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 88 Spain healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 89 Spain healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 90 Spain healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 91 Italy healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 92 Italy healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 93 Italy healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 94 Italy healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 95 Italy healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 96 Italy healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 97 Poland healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 98 Poland healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 99 Poland healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 100 Poland healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 101 Poland healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 102 Poland healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 103 Sweden healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 104 Sweden healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 105 Sweden healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 106 Sweden healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 107 Sweden healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 108 Sweden healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 109 The Netherlands healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 110 The Netherlands healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 111 The Netherlands healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 112 The Netherlands healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 113 The Netherlands healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 114 The Netherlands healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 115 Rest of Europe healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 116 Rest of Europe healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 117 Rest of Europe healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 118 Rest of Europe healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 119 Rest of Europe healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 120 Rest of Europe healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 121 Asia Pacific healthcare payers services Market size, by country, 2018 - 2022 (USD Million)
• TABLE 122 Asia Pacific healthcare payers services Market size, by country, 2023 - 2032 (USD Million)
• TABLE 123 Asia Pacific healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 124 Asia Pacific healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 125 Asia Pacific healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 126 Asia Pacific healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 127 Asia Pacific healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 128 Asia Pacific healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 129 Japan healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 130 Japan healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 131 Japan healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 132 Japan healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 133 Japan healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 134 Japan healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 135 China healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 136 China healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 137 China healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 138 China healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 139 China healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 140 China healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 141 India healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 142 India healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 143 India healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 144 India healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 145 India healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 146 India healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 147 Australia healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 148 Australia healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 149 Australia healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 150 Australia healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 151 Australia healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 152 Australia healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 153 South Korea healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 154 South Korea healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 155 South Korea healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 156 South Korea healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 157 South Korea healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 158 South Korea healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 159 Indonesia healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 160 Indonesia healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 161 Indonesia healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 162 Indonesia healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 163 Indonesia healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 164 Indonesia healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 165 Philippines healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 166 Philippines healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 167 Philippines healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 168 Philippines healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 169 Philippines healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 170 Philippines healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 171 Malaysia healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 172 Malaysia healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 173 Malaysia healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 174 Malaysia healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 175 Malaysia healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 176 Malaysia healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 177 Rest of Asia Pacific healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 178 Rest of Asia Pacific healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 179 Rest of Asia Pacific healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 180 Rest of Asia Pacific healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 181 Rest of Asia Pacific healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 182 Rest of Asia Pacific healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 183 Latin America healthcare payers services Market size, by country, 2018 - 2022 (USD Million)
• TABLE 184 Latin America healthcare payers services Market size, by country, 2023 - 2032 (USD Million)
• TABLE 185 Latin America healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 186 Latin America healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 187 Latin America healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 188 Latin America healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 189 Latin America healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 190 Latin America healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 191 Brazil healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 192 Brazil healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 193 Brazil healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 194 Brazil healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 195 Brazil healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 196 Brazil healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 197 Mexico healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 198 Mexico healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 199 Mexico healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 200 Mexico healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 201 Mexico healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 202 Mexico healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 203 Argentina healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 204 Argentina healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 205 Argentina healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 206 Argentina healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 207 Argentina healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 208 Argentina healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 209 Colombia healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 210 Colombia healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 211 Colombia healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 212 Colombia healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 213 Colombia healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 214 Colombia healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 215 Chile healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 216 Chile healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 217 Chile healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 218 Chile healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 219 Chile healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 220 Chile healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 221 Peru healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 222 Peru healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 223 Peru healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 224 Peru healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 225 Peru healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 226 Peru healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 227 Rest of Latin America healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 228 Rest of Latin America healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 229 Rest of Latin America healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 230 Rest of Latin America healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 231 Rest of Latin America healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 232 Rest of Latin America healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 233 Middle East & Africa healthcare payers services market size, by country, 2018 - 2022 (USD Million)
• TABLE 234 Middle East & Africa healthcare payers services market size, by country, 2023 - 2032 (USD Million)
• TABLE 235 Middle East & Africa healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 236 Middle East & Africa healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 237 Middle East & Africa healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 238 Middle East & Africa healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 239 Middle East & Africa healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 240 Middle East & Africa healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 241 Saudi Arabia healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 242 Saudi Arabia healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 243 Saudi Arabia healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 244 Saudi Arabia healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 245 Saudi Arabia healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 246 Saudi Arabia healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 247 South Africa healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 248 South Africa healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 249 South Africa healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 250 South Africa healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 251 South Africa healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 252 South Africa healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 253 UAE healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 254 UAE healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 255 UAE healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 256 UAE healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 257 UAE healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 258 UAE healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 259 Israel healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 260 Israel healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 261 Israel healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 262 Israel healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 263 Israel healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 264 Israel healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 265 Turkey healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 266 Turkey healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 267 Turkey healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 268 Turkey healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 269 Turkey healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 270 Turkey healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 271 Iran healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 272 Iran healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 273 Iran healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 274 Iran healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 275 Iran healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 276 Iran healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)
• TABLE 277 Rest of Middle East and Africa healthcare payers services market size, by service type, 2018 - 2022 (USD Million)
• TABLE 278 Rest of Middle East and Africa healthcare payers services market size, by service type, 2023 - 2032 (USD Million)
• TABLE 279 Rest of Middle East and Africa healthcare payers services market size, by application, 2018 - 2022 (USD Million)
• TABLE 280 Rest of Middle East and Africa healthcare payers services market size, by application, 2023 - 2032 (USD Million)
• TABLE 281 Rest of Middle East and Africa healthcare payers services market size, by end-use, 2018 - 2022 (USD Million)
• TABLE 282 Rest of Middle East and Africa healthcare payers services market size, by end-use, 2023 - 2032 (USD Million)

Charts & Figures

• FIG 1 GMI report coverage: Critical research elements
• FIG 2 Top-down approach
• FIG 3 Market estimation and forecast methodology
• FIG 4 Market forecasting methodology
• FIG 5 Breakdown of primary participants
• FIG 6 Healthcare payers services industry 36 degree synopsis, 2018 - 2032
• FIG 7 Growth potential analysis, by service type
• FIG 8 Growth potential analysis, by application
• FIG 9 Growth potential analysis, by end-use
• FIG 10 Porter's analysis
• FIG 11 PESTEL analysis
• FIG 12 Company matrix analysis, 2022
• FIG 13 Competitive analysis of major market players, 2022
• FIG 14 Competitive positioning matrix
• FIG 15 Strategic dashboard, 2022
• FIG 16 Strategic outlook matrix

Global Healthcare Payer Services Market will register noteworthy progression from 2023 to 2032. The rising healthcare costs and the increasing complexity of insurance processes have led to a growing demand for outsourcing payer services. According to the Milliman Medical Index (MMI), healthcare costs $31,065 in 2023 for a hypothetical American family of four covered by an average employer-sponsored preferred provider organization (PPO) plan. This depicts a 5.6% rise from 2022. The MMI reflects four family members: a 37-year-old female, a 47-year-old male, a 4-year-old child, and a 1-year-old child.

Healthcare payers seek cost-effective solutions to manage claims processing, billing, and customer support efficiently. The shift towards value-based care and population health management requires advanced data analytics and risk assessment capabilities, driving the need for specialized payer services. Additionally, the focus on improving member engagement and satisfaction fuels the demand for innovative payer services that offer personalized and seamless experiences.

The overall Healthcare Payer Services Market is classified based on service type, application, end-user, and region.

Based on service type, the KPO segment will register a noticeable valuation by 2032. KPO providers offer specialized expertise and in-depth knowledge in areas such as claims adjudication, revenue cycle management, risk assessment, and data analytics. As healthcare payers seek to streamline operations, improve accuracy, and optimize revenue, they turn to KPO services for cost-effective and efficient solutions. The demand for KPO services in the healthcare payer services market is driven by the need for comprehensive and data-driven insights to enhance decision-making and achieve better outcomes in the ever-evolving healthcare landscape.

By application, the healthcare payer services industry from the billing and accounts management services segment will showcase a commendable growth rate from 2023 to 2032. Healthcare payers seek efficient solutions to manage complex billing processes and ensure accurate claims processing. With the increasing volume of claims and the need for timely reimbursements, outsourcing billing and accounts management services has become essential. Specialized providers offer expertise in coding, claims adjudication, and revenue cycle management, streamlining operations and improving financial performance for healthcare payers. The demand for these services in the Healthcare Payer Services Market underscores their importance in ensuring seamless and efficient payment processes.

Regarding the end-user, the public payers segment could capture a decent healthcare payer services market share by 2032. To provide comprehensive coverage to the population, public payers require efficient and cost-effective services to manage claims processing, eligibility verification, and member management. Outsourcing payer services to specialized providers allows public payers to optimize operations, improve member satisfaction, and ensure compliance with regulatory requirements.

Regionally, the Asia-Pacific healthcare payer services industry will amass appreciable revenue throughout 2023-2032 due to the region's growing population and increasing healthcare needs. The rising prevalence of chronic diseases necessitates advanced data analytics and risk assessment capabilities, spurring the need for specialized payer services. Additionally, the growing adoption of digital technologies and telehealth solutions in the Asia-Pacific healthcare sector further fuels the demand for innovative payer services. The focus on improving healthcare access and outcomes propels the growth of the Healthcare Payer Services Market in Asia-Pacific.

Table of Contents

Chapter 1 Methodology

• 1.1 Market definition
• 1.2 Base estimates & calculations
• 1.3 Forecast parameters
• 1.4 COVID-19 impact analysis at global level
• 1.5 Data validation
• 1.6 Data Sources
  • 1.6.1 Primary
  • 1.6.2 Secondary
    • 1.6.2.1 Paid sources
    • 1.6.2.2 Public sources

Chapter 2 Executive Summary

• 2.1 Healthcare payers services industry 360 degree synopsis, 2018 - 2032
• 2.2 Business trends
• 2.3 Regional trends
• 2.4 Service type trends
• 2.5 Application trends
• 2.6 End-use trends

Chapter 3 Healthcare Payer Services Industry Insights

• 3.1 Industry ecosystem analysis
• 3.2 Industry impact forces
  • 3.2.1 Growth drivers
    • 3.2.1.1 Rising adoption of health insurance policies
    • 3.2.1.2 Increasing outsourcing of services to increase efficiency and reduce cost
    • 3.2.1.3 Growing burden of chronic disease
    • 3.2.1.4 Rise in healthcare fraud cases
  • 3.2.2 Industry pitfalls & challenges
    • 3.2.2.1 Risk of data breach and loss of confidentiality
    • 3.2.2.2 High cost associated with outsourcing of services
• 3.3 Growth potential analysis
  • 3.3.1 By services type
  • 3.3.2 By application
  • 3.3.3 By end-use
• 3.4 COVID- 19 impact analysis
• 3.5 Technological advancements
• 3.6 Regulatory landscape
  • 3.6.1 U.S.
  • 3.6.2 Europe
• 3.7 Application potential
• 3.8 Porter's analysis
• 3.9 PESTEL analysis

Chapter 4 Competitive Landscape, 2022

• 4.1 Introduction
• 4.2 Company matrix analysis, 2022
• 4.3 Competitive analysis of major market players
• 4.4 Competitive positioning matrix
• 4.5 Strategy dashboard
• 4.6 Strategic outlook matrix

Chapter 5 Healthcare Payers Services Market Size and Forecast, By Service Type (USD Million)

• 5.1 Key trends, by service type
• 5.2 BPO Services
• 5.3 ITO Services
• 5.4 KPO Services

Chapter 6 Healthcare Payers Services Market Size and Forecast, By Application (USD Million)

• 6.1 Key trends, by application
• 6.2 Claims Management Services
• 6.3 Analytics And Fraud Management Services
• 6.4 Integrated Front Office Service And Back Office Operations
• 6.5 Billing And Accounts Management Services
• 6.6 Member Management Services
• 6.7 Provider Management Services
• 6.8 HR Services

Chapter 7 Healthcare Payers Services Market Size and Forecast, By End-use (USD Million)

• 7.1 Key trends, by end-use
• 7.2 Private Payers
• 7.3 Public Payers

Chapter 8 Healthcare Payers Services Market Size and Forecast, By Region (USD Million)

• 8.1 Key trends, by region
• 8.2 North America
  • 8.2.1 U.S.
  • 8.2.2 Canada
• 8.3 Europe
  • 8.3.1 Germany
  • 8.3.2 UK
  • 8.3.3 France
  • 8.3.4 Spain
  • 8.3.5 Italy
  • 8.3.6 Poland
  • 8.3.7 Sweden
  • 8.3.8 The Netherlands
  • 8.3.9 Rest of Europe
• 8.4 Asia Pacific
  • 8.4.1 Japan
  • 8.4.2 China
  • 8.4.3 India
  • 8.4.4 Australia
  • 8.4.5 South Korea
  • 8.4.6 Indonesia
  • 8.4.7 Philippines
  • 8.4.8 Malaysia
  • 8.4.9 Rest of Asia Pacific
• 8.5 Latin America
  • 8.5.1 Brazil
  • 8.5.2 Mexico
  • 8.5.3 Argentina
  • 8.5.4 Columbia
  • 8.5.5 Chile
  • 8.5.6 Peru
  • 8.5.7 Rest of Latin America
• 8.6 MEA
  • 8.6.1 South Africa
  • 8.6.2 Saudi Arabia
  • 8.6.3 UAE
  • 8.6.4 Israel
  • 8.6.5 Turkey
  • 8.6.6 Iran
  • 8.6.7 Rest of MEA

Chapter 9 Company Profiles

• 9.1 Merative (IBM Watson Health)
• 9.2 Oracle Corporation
• 9.3 IQVIA Inc
• 9.4 HGS Ltd.
• 9.5 Xerox Corporation
• 9.6 Concentrix Corporation
• 9.7 Genpact
• 9.8 HCL Technologies Limited
• 9.9 Accenture
• 9.10 Cognizant
• 9.11 ExlService Holdings, Inc.