医療支払者サービス市場規模、シェア、成長分析、サービス別、用途別、最終用途別、地域別-産業別予測2024～2031年

医療支払者サービスの世界市場規模は、2022年に654億米ドルと評価され、2023年の708億3,000万米ドルから2031年には1,340億4,000万米ドルに成長し、予測期間（2024～2031年）のCAGRは8.3％で成長する展望です。

世界の医療支払者サービス市場は、医療サプライチェーンのビジネスプロセスアウトソーシング（BPO）に関連するコストの減少に伴い、大幅な成長が見込まれています。この動向は、在庫管理や医療提供全体の効率化におけるアウトソーシング需要の増加と相まっています。ICD-10コードの導入、医薬品の特許切れ、医療提供コストの減少といった要因が、この成長に大きく寄与しています。さらに、AI、分析、クラウドベースのサービスのような先進技術の統合は市場競争を激化させ、Accentureのような参入企業はサービスのアクセシビリティを強化し、物流コストを削減するソリューションを提供しています。COVID-19パンデミックによってもたらされた課題にもかかわらず、医療支払者は前向きに適応し、戦略的提携を結び、体系的な健康格差への対処を目指したイニシアティブを開始し、市場拡大の可能性をさらに高めています。

目次

イントロダクション

• 調査の目的
• 調査範囲
• 定義

調査手法

• 情報調達
• 二次データと一次データの方法
• 市場規模予測
• 市場の前提条件と制限

エグゼクティブサマリー

• 世界市場の展望
• 供給と需要の動向分析
• セグメント別機会分析

市場力学と展望

• 市場概要
• 市場規模
• 市場力学
  • 促進要因と機会
  • 抑制要因と課題
• ポーターの分析

主要市場の考察

• 重要成功要因
• 競合の程度
• 主要投資機会
• 市場エコシステム
• 市場の魅力指数（2023年）
• PESTEL分析
• マクロ経済指標
• バリューチェーン分析
• 価格分析

医療支払者サービス市場規模：サービス別&CAGR（2024～2031年）

• 市場概要
• BPOサービス
• ITOサービス
• KPOサービス

医療支払者サービス市場規模：用途別&CAGR（2024～2031年）

• 市場概要
• クレーム管理サービス
• 統合されたフロントオフィスサービスとバックオフィス業務
• 会員管理サービス
• プロバイダー管理サービス
• 請求とアカウント管理サービス
• 分析と不正管理サービス
• 人事サービス

医療支払者サービス市場規模：最終用途別&CAGR（2024～2031年）

• 市場概要
• 民間保険会社
• 公的支払者

医療支払者サービス市場規模&CAGR（2024～2031年）

• 北米
  • 米国
  • カナダ
• 欧州
  • ドイツ
  • スペイン
  • フランス
  • 英国
  • イタリア
  • その他の欧州
• アジア太平洋
  • 中国
  • インド
  • 日本
  • 韓国
  • その他のアジア太平洋
• ラテンアメリカ
  • ブラジル
  • その他のラテンアメリカ
• 中東・アフリカ
  • GCC諸国
  • 南アフリカ
  • その他の中東・アフリカ

競合情報

• 上位5社の比較
• 主要企業の市場ポジショニング（2023年）
• 主要市場企業が採用した戦略
• 市場の最近の動向
• 企業の市場シェア分析（2023年）
• 主要企業の企業プロファイル
• 製品ポートフォリオ分析
• セグメント別シェア分析
• 収益の前年比比較（2021～2023年）

主要企業プロファイル

• UnitedHealth Group（UNH）（米国）
• CVS Health（CVS）（米国）
• McKesson Corporation（MCK）（米国）
• Cigna（CI）（米国）
• Elevance Health（ELV）（米国）
• Centene Corporation（CNC）（米国）
• Humana Inc.（HUM）（米国）
• Anthem, Inc.（ANTM）（米国）
• Cognizant Technology Solutions（CTSH）（インド）
• Accenture plc（ACN）（アイルランド）
• Wipro Limited（WIT）（インド）
• Tata Consultancy Services（TCS）（インド）
• Infosys Limited（INFY）（インド）
• HCL Technologies（HCL）（インド）
• DXC Technology Company（DXC）（米国）
• IBM Corporation（IBM）（米国）
• Oracle Corporation（ORCL）（米国）
• Microsoft Corporation（MSFT）（米国）
• Amazon.com, Inc.（AMZN）（米国）
• Google LLC（Alphabet Inc.）（米国）

結論と推奨事項

Global Healthcare Payer Services Market size was valued at USD 65.4 billion in 2022 and is poised to grow from USD 70.83 billion in 2023 to USD 134.04 billion by 2031, growing at a CAGR of 8.3% during the forecast period (2024-2031).

The global healthcare payer services market is poised for substantial growth as the costs associated with healthcare supply chain business process outsourcing (BPO) decline. This trend is coupled with an increasing demand for outsourcing in inventory control and overall healthcare delivery efficiency. Factors like the implementation of ICD-10 codes, patent expirations in pharmaceuticals, and the decreasing costs of healthcare delivery significantly contribute to this growth. Furthermore, the integration of advanced technologies like AI, analytics, and cloud-based services intensifies market competition, with players like Accenture providing solutions that enhance service accessibility and reduce logistics costs. Despite challenges posed by the COVID-19 pandemic, healthcare payers have adapted positively, forming strategic alliances and launching initiatives aimed at addressing systemic health disparities, further bolstering market expansion potential.

Top-down and bottom-up approaches were used to estimate and validate the size of the Global Healthcare Payer Services market and to estimate the size of various other dependent submarkets. The research methodology used to estimate the market size includes the following details: The key players in the market were identified through secondary research, and their market shares in the respective regions were determined through primary and secondary research. This entire procedure includes the study of the annual and financial reports of the top market players and extensive interviews for key insights from industry leaders such as CEOs, VPs, directors, and marketing executives. All percentage shares split, and breakdowns were determined using secondary sources and verified through Primary sources. All possible parameters that affect the markets covered in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data.

Global Healthcare Payer Services Market Segmental Analysis

Global Healthcare Payer Services Market is segmented by services, application, end use and region. Based on services, the market is segmented into BPO services, ITO services and KPO services. Based on application, the market is segmented into claims management services, integrated front office service and back office operations, member management services, provider management services, billing and accounts management services, analytics and fraud management services and hr services. Based on end use, the market is segmented into private payers and public payers. Based on region, the market is segmented into North America, Europe, Asia Pacific, Latin America and Middle East & Africa.

Driver of the Global Healthcare Payer Services Market

The Global Healthcare Payer Services market is significantly driven by the increasing complexity of payer operations, which encompass various challenges such as claims processing, member enrollment, billing, and customer service. As these organizations navigate intricate operational hurdles, they turn to specialized payer service providers for assistance. These providers deliver tailored expertise, advanced technology solutions, and operational support designed to streamline processes and improve overall efficiency. By effectively managing these complexities, payer services help organizations optimize their operations, ultimately contributing to the heightened demand for such services in the healthcare payer market.

Restraints in the Global Healthcare Payer Services Market

In the Global Healthcare Payer Services market, various restraints hinder growth, particularly regarding cost constraints and pricing pressures. Payer organizations grapple with escalating healthcare costs while attempting to keep premiums manageable for their members. This dynamic challenges payer service providers to not only showcase significant cost savings but also to develop competitive pricing models that ensure their sustainability in an increasingly competitive landscape. As the demand for affordable healthcare solutions rises, these organizations must navigate financial pressures effectively to maintain viability and meet the evolving needs of their customers.

Market Trends of the Global Healthcare Payer Services Market

The Global Healthcare Payer Services market is experiencing a significant shift towards value-based care models, driven by the increasing emphasis on improving patient outcomes and achieving cost-efficiency in healthcare delivery. Payer service providers are adapting their strategies and offerings to support these value-based payment frameworks, which prioritize quality over quantity of care. This trend encompasses enhanced care coordination, robust population health management initiatives, and the integration of advanced analytics to monitor and improve patient outcomes. Additionally, as healthcare systems worldwide seek to optimize resources and ensure sustainable care, there is a growing demand for innovative payer solutions that facilitate seamless transitions to value-based care.

Table of Contents

Introduction

• Objectives of the Study
• Scope of the Report
• Definitions

Research Methodology

• Information Procurement
• Secondary & Primary Data Methods
• Market Size Estimation
• Market Assumptions & Limitations

Executive Summary

• Global Market Outlook
• Supply & Demand Trend Analysis
• Segmental Opportunity Analysis

Market Dynamics & Outlook

• Market Overview
• Market Size
• Market Dynamics
  • Drivers & Opportunities
  • Restraints & Challenges
• Porters Analysis
  • Competitive rivalry
  • Threat of substitute
  • Bargaining power of buyers
  • Threat of new entrants
  • Bargaining power of suppliers

Key Market Insights

• Key Success Factors
• Degree of Competition
• Top Investment Pockets
• Market Ecosystem
• Market Attractiveness Index, 2023
• PESTEL Analysis
• Macro-Economic Indicators
• Value Chain Analysis
• Pricing Analysis

Global Healthcare Payer Services Market Size by Services & CAGR (2024-2031)

• Market Overview
• BPO Services
• ITO Services
• KPO Services

Global Healthcare Payer Services Market Size by Application & CAGR (2024-2031)

• Market Overview
• Claims Management Services
• Integrated Front Office Service and Back Office Operations
• Member Management Services
• Provider Management Services
• Billing and Accounts Management Services
• Analytics and Fraud Management Services
• HR Services

Global Healthcare Payer Services Market Size by End Use & CAGR (2024-2031)

• Market Overview
• Private Payers
• Public Payers

Global Healthcare Payer Services Market Size & CAGR (2024-2031)

• North America (Services, Application, End Use)
  • USA
  • Canada
• Europe (Services, Application, End Use)
  • Germany
  • Spain
  • France
  • UK
  • Italy
  • Rest of Europe
• Asia Pacific (Services, Application, End Use)
  • China
  • India
  • Japan
  • South Korea
  • Rest of Asia-Pacific
• Latin America (Services, Application, End Use)
  • Brazil
  • Rest of Latin America
• Middle East & Africa (Services, Application, End Use)
  • GCC Countries
  • South Africa
  • Rest of Middle East & Africa

Competitive Intelligence

• Top 5 Player Comparison
• Market Positioning of Key Players, 2023
• Strategies Adopted by Key Market Players
• Recent Developments in the Market
• Company Market Share Analysis, 2023
• Company Profiles of All Key Players
  • Company Details
  • Product Portfolio Analysis
  • Company's Segmental Share Analysis
  • Revenue Y-O-Y Comparison (2021-2023)

Key Company Profiles

• UnitedHealth Group (UNH) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• CVS Health (CVS) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• McKesson Corporation (MCK) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Cigna (CI) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Elevance Health (ELV) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Centene Corporation (CNC) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Humana Inc. (HUM) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Anthem, Inc. (ANTM) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Cognizant Technology Solutions (CTSH) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Accenture plc (ACN) (Ireland)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Wipro Limited (WIT) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Tata Consultancy Services (TCS) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Infosys Limited (INFY) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• HCL Technologies (HCL) (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• DXC Technology Company (DXC) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• IBM Corporation (IBM) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Oracle Corporation (ORCL) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Microsoft Corporation (MSFT) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Amazon.com, Inc. (AMZN) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Google LLC (Alphabet Inc.) (USA)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments

Conclusion & Recommendations