Healthcare Claims Management Market Research Report: By Component (Software and Services), Delivery Mode (On-Premise and Cloud Based), Type (Integrated and Standalone), and by End-User (Healthcare Payers and Providers)- Forecast Till 2027
ID: MRFR/HCIT/4915-HCR | February 2021 | Region: Global | 90 Pages
Table of Contents:
Chapter 1. Report Prologue
Chapter 2. Market Introduction
2.1 Definition
2.2 Scope of the Study
2.2.1 Research Objective
2.2.2 Assumptions
2.2.3 Limitations
Chapter 3. Research Methodology
3.1 Introduction
3.2 Primary Research
3.3 Secondary Research
3.4 Market Size Estimation
Chapter 4. Market Dynamics
4.1 Drivers
4.2 Restraints
4.3 Opportunities
4.4 Challenges
4.5 Macroeconomic Indicators
4.6 Technology Trends & Assessment
Chapter 5. Market Factor Analysis
5.1 Porter’s Five Forces Analysis
5.1.1 Bargaining Power of Suppliers
5.1.2 Bargaining Power of Buyers
5.1.3 Threat of New Entrants
5.1.4 Threat of Substitutes
5.1.5 Intensity of Rivalry
5.2 Value Chain Analysis
5.3 Investment Feasibility Analysis
5.4 Pricing Analysis
Chapter 6. Global Healthcare Claims Management Market, by Component
6.1 Introduction
6.2 Software
Market Estimates & Forecast, by Region, 2020–2027
Market Estimates & Forecast, by Country, 2020–2027
6.3 Services
Market Estimates & Forecast, by Region, 2020–2027
Market Estimates & Forecast, by Country, 2020–2027
Chapter 7. Global Healthcare Claims Management Market, by Delivery Mode
7.1 Introduction
7.2 On-premise
Market Estimates & Forecast, by Region, 2020–2027
Market Estimates & Forecast, by Country, 2020–2027
7.3 Cloud based
Market Estimates & Forecast, by Region, 2020–2027
Market Estimates & Forecast, by Country, 2020–2027
Chapter 8. Global Healthcare Claims Management, by Type
8.1 Integrated
Market Estimates & Forecast, by Region, 2020–2027
Market Estimates & Forecast, by Country, 2020–2027
8.2 Standalone
Market Estimates & Forecast, by Region, 2020–2027
Market Estimates & Forecast, by Country, 2020–2027
Chapter 9. Global Healthcare Claims Management Market, by End-User
9.1 Healthcare Payers
9.2 Providers
Chapter 10. Global Healthcare Claims Management Market, by Region
10.1 Introduction
10.2 Americas
10.2.1 North America
10.2.1.1 US
10.2.1.2 Canada
10.2.2 South America
10.3 Europe
10.3.1 Western Europe
10.3.1.1 Germany
10.3.1.2 France
10.3.1.3 Italy
10.3.1.4 Spain
10.3.1.5 UK
10.3.1.6 Rest of Western Europe
10.3.2 Eastern Europe
10.4 Asia-Pacific
10.4.1 Japan
10.4.2 China
10.4.3 India
10.4.4 Australia
10.4.5 South Korea
10.4.6 Rest of Asia-Pacific
10.5 Middle East & Africa
10.5.1 Middle East
10.5.2 Africa
Chapter 11. Company Landscape
11.1 Introduction
11.2 Market Share Analysis
11.3 Key Development & Strategies
Chapter 12. Company Profiles
12.1 Cerner Corporation
12.1.1 Company Overview
12.1.2 Product Overview
12.1.3 Financials Overview
12.1.4 Key Developments
12.1.5 SWOT Analysis
12.2 McKesson Corporation
12.2.1 Company Overview
12.2.2 Product Overview
12.2.3 Financial Overview
12.2.4 Key Developments
12.2.5 SWOT Analysis
12.3 Athenahealth, Inc.
12.3.1 Company Overview
12.3.2 Product Overview
12.3.3 Financial Overview
12.3.4 Key Development
12.3.5 SWOT Analysis
12.4 eClinicalWorks
12.4.1 Company Overview
12.4.2 Product Overview
12.4.3 Financial Overview
12.4.4 Key Development
12.4.5 SWOT Analysis
12.5 Optum, Inc.
12.5.1 Company Overview
12.5.2 Product Overview
12.5.3 Financial overview
12.5.4 Key Developments
12.5.5 SWOT Analysis
12.6 Conifer Health Solutions
12.6.1 Company Overview
12.6.2 Product Overview
12.6.3 Financial Overview
12.6.4 Key Developments
12.6.5 SWOT Analysis
12.7 nThrive, Inc.
12.7.1 Overview
12.7.2 Product Overview
12.7.3 Financial Overview
12.7.4 Key Developments
12.7.5 SWOT Analysis
12.8 Avaya Inc.
12.8.1 Overview
12.8.2 Product Overview
12.8.3 Financials
12.8.4 Key Developments
12.8.5 SWOT Analysis
12.9 Oracle Corporation
12.9.1 Overview
12.9.2 Product Overview
12.9.3 Financials
12.9.4 Key Developments
12.9.5 SWOT Analysis
12.10 Infor Inc.
12.10.1 Overview
12.10.2 Product Overview
12.10.3 Financials
12.10.4 Key Developments
12.10.5 SWOT Analysis
12.11 Allscripts Healthcare Solutions, Inc.
12.11.1 Overview
12.11.2 Product Overview
12.11.3 Financials
12.11.4 Key Developments
12.11.5 SWOT Analysis
12.12 Accenture plc.
12.12.1 Overview
12.12.2 Product Overview
12.12.3 Financials
12.12.4 Key Developments
12.12.5 SWOT Analysis
12.13 IBM Corporation
12.13.1 Overview
12.13.2 Product Overview
12.13.3 Financials
12.13.4 Key Developments
12.13.5 SWOT Analysis
12.14 Cognizant Technology Solutions Corporation
12.14.1 Overview
12.14.2 Product Overview
12.14.3 Financials
12.14.4 Key Developments
12.14.5 SWOT Analysis
12.15 Genpact Limited
12.15.1 Overview
12.15.2 Product Overview
12.15.3 Financials
12.15.4 Key Developments
12.15.5 SWOT Analysis
Chapter 13 MRFR Conclusion
13.1 Key Findings
13.1.1 From CEO’s View point
13.1.2 Unmet Needs of the Market
13.2 Key Companies to Watch
13.3 Predictions for the Healthcare Claims Management Industry
Chapter 14. Appendix
LIST OF TABLES
Table 1 Global Healthcare Claims Management Market Synopsis, 2020–2027
Table 2 Global Healthcare Claims Management Market Estimates and Forecast, 2020–2027 (USD Million)
Table 3 Global Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 4 Global Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 5 Global Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 6 Global Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 7 Global Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 6 North America: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 7 North America: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 8 North America: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 9 North America: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 10 North America: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 11 US: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 12 US: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 13 US: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 14 US: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 15 US: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 16 Canada: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 17 Canada: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 18 Canada: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 19 Canada: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 20 Canada: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 21 South America: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 22 South America: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 23 South America: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 24 South America: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 25 South America: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 26 Europe: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 27 Europe: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 28 Europe: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 29 Europe: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 30 Europe: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 31 Western Europe: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 32 Western Europe: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 33 Western Europe: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 34 Western Europe: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 35 Western Europe: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 36 Eastern Europe: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 37 Eastern Europe: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 38 Eastern Europe: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 39 Eastern Europe: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 40 Eastern Europe: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 41 Asia-Pacific: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 42 Asia-Pacific: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 43 Asia-Pacific: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 44 Asia-Pacific: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 45 Asia-Pacific: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
Table 46 Middle East & Africa: Healthcare Claims Management Market, by Component, 2020–2027 (USD Million)
Table 47 Middle East & Africa: Healthcare Claims Management Market, by Delivery Mode, 2020–2027 (USD Million)
Table 48 Middle East & Africa: Healthcare Claims Management Market, by Type, 2020–2027 (USD Million)
Table 49 Middle East & Africa: Healthcare Claims Management Market, by End-User, 2020–2027 (USD Million)
Table 50 Middle East & Africa: Healthcare Claims Management Market, by Region, 2020–2027 (USD Million)
LIST OF FIGURES
Figure 1 Research Process
Figure 2 Segmentation for Global Healthcare Claims Management Market
Figure 3 Segmentation Market Dynamics for Global Healthcare Claims Management Market
Figure 4 Global Healthcare Claims Management Market Share, by Component, 2020 (%)
Figure 5 Global Healthcare Claims Management Market Share, by Delivery Mode, 2020 (%)
Figure 6 Global Healthcare Claims Management Market Share, by Type, 2020 (%)
Figure 7 Global Healthcare Claims Management Market Share, by End-User, 2020 (%)
Figure 8 Global Healthcare Claims Management Market Share, by Region, 2020 (%)
Figure 9 North America: Healthcare Claims Management Market Share, by Country, 2020 (%)
Figure 10 Europe: Healthcare Claims Management Market Share, by Country, 2020 (%)
Figure 11 Asia-Pacific: Healthcare Claims Management Market Share, by Country, 2020 (%)
Figure 12 Middle East & Africa: Healthcare Claims Management Market Share, by Country, 2020 (%)
Figure 13 Global Healthcare Claims Management Market: Company Share Analysis, 2020 (%)
Figure 14 Cerner Corporation: Key Financials
Figure 15 Cerner Corporation: Segmental Revenue
Figure 16 Cerner Corporation: Geographical Revenue
Figure 17 McKesson Corporation: Key Financials
Figure 18 McKesson Corporation: Segmental Revenue
Figure 19 McKesson Corporation: Geographical Revenue
Figure 20 Athenahealth, Inc.: Key Financials
Figure 21 Athenahealth, Inc.: Segmental Revenue
Figure 22 Athenahealth, Inc.: Geographical Revenue
Figure 23 eClinicalWorks: Key Financials
Figure 24 eClinicalWorks: Segmental Revenue
Figure 25 eClinicalWorks: Geographical Revenue
Figure 26 Optum, Inc.: Key Financials
Figure 27 Optum, Inc.: Segmental Revenue
Figure 28 Optum, Inc.: Geographical Revenue
Figure 29 Conifer Health Solutions: Key Financials
Figure 30 Conifer Health Solutions: Segmental Revenue
Figure 31 Conifer Health Solutions: Geographical Revenue
Figure 32 nThrive, Inc.: Key Financials
Figure 33 nThrive, Inc.: Segmental Revenue
Figure 34 nThrive, Inc.: Geographical Revenue
Figure 35 Avaya Inc.: Key Financials
Figure 36 Avaya Inc.: Segmental Revenue
Figure 37 Avaya Inc.: Geographical Revenue
Figure 38 Oracle Corporation: Key Financials
Figure 39 Oracle Corporation: Segmental Revenue
Figure 40 Oracle Corporation: Geographical Revenue
Figure 41 Infor Inc.: Key Financials
Figure 42 Infor Inc.: Segmental Revenue
Figure 43 Infor Inc.: Geographical Revenue
Figure 44 Allscripts Healthcare Solutions, Inc.: Key Financials
Figure 45 Allscripts Healthcare Solutions, Inc.: Segmental Revenue
Figure 46 Allscripts Healthcare Solutions, Inc.: Geographical Revenue
Figure 47 Accenture plc.: Key Financials
Figure 48 Accenture plc.: Segmental Revenue
Figure 49 Accenture plc.: Geographical Revenue
Figure 50 IBM Corporation: Key Financials
Figure 51 IBM Corporation: Segmental Revenue
Figure 52 IBM Corporation: Geographical Revenue
Figure 53 Cognizant Technology Solutions Corporation: Key Financials
Figure 54 Cognizant Technology Solutions Corporation: Segmental Revenue
Figure 55 Cognizant Technology Solutions Corporation: Geographical Revenue
Figure 56 Genpact Limited: Key Financials
Figure 57 Genpact Limited: Segmental Revenue
Figure 58 Genpact Limited: Geographical Revenue
Healthcare Claims Management Market
Healthcare claims management market is predicted to reach USD 19.56 billion by 2027, at CAGR 5.2% during the ongoing forecast period
$19.56 billion
Market Size
5.2%
CAGR
North America
Dominating Region
2020-2027
Forecast Period
Segmentation
Key Players
- Cerner Corporation
- McKesson Corporation
- Accenture plc.
- Genpact Limited
- eClinicalWorks
- Cognizant Technology Solutions Corporation
- Oracle Corporation
- IBM Corporation
- Conifer Health Solutions
Drivers
- rising rate of adoption of cloud-based technology-related services
Healthcare Claims Management Market Overview
Healthcare claims management market is predicted to attain good market growth during the ongoing forecast period of 2021-2028. During the historic forecast period that had ended in 2019, the market was valued at a global market sum of USD 10.16 billion. For the ongoing forecast period, the market is expected to attain a Healthcare claims management market value of USD 13.93 billion by attaining a global market CAGR of 5.37% by the end of the period in 2023.
Healthcare claims management market is home to a variety of market processes related to the field of medicine. These processes comprise various tasks and market requirements such as organization, billing, filing, updating, and processing of medical claims related to the diagnosis, treatment, and medication scheduling and dealing of patients.
COVID 19 Analysis of Healthcare claims management market
This management software has rendered great support since the pandemic has hit the lives of people across the world. Since the pandemic has hit the international market, people are finding it difficult to adjust to the new normal trends. Also, the markets and businesses have been majorly disrupted. The non-availability of major factors like labor, raw materials, and investing are acting as major concerns for the functioning of an array of markets that have come to function after the outbreak of the pandemic. These are impacting the competitive degree of the production and manufacturing departments. It is becoming difficult for the departments to maintain a smooth supply chain mechanism by meeting the market demands of the global target audience. The people who have contracted the coronavirus are under hospital care or home isolation which needs to be monitored now and then. To get better and appropriate treatment, they need to make use of such devices or management systems and provide the health concerns and information that is true and best as per one’s knowledge for the improvement of their health.
However, the technological advancement and competitive degree of this management software will increase in the current forecast period. The government is rendering its support to similar ideas. Also, many of them are investing in similar steps across the globe that will lead to the global expansion of the market across various global regions. Also, the prominent market players are up for development for product variation, innovation, creation, mergers and acquisitions, and establishment, followed by the market launches for the target audience that is spread in various regions across the globe.
Healthcare Claims Management Market Dynamics
Drivers
The healthcare claims management market is driven to splendid market growth by the emergence of factors such as an improved degree of focus on quality healthcare services being provided to the target audience and the rising rate of adoption of cloud-based technology-related services. The claims management devices are being appreciated by a large range of global customers and hence, the demand for them is rising. This will lead to healthcare claims management market growth based on the predictions by the experts for the ongoing forecast period that will be ending in 2028.
Restraints
However, the healthcare claims management market is witnessing the integration of claims management solutions, data breaches, loss of confidentiality, and lack of skilled IT professionals in the healthcare departments. These are some of the factors restraining the growth of healthcare claims management market during the ongoing forecast period.
Technology Analysis
The rising employment of technology that is giving rise to the research and development initiatives for the expansion of the healthcare claims management market scenario will benefit the prospects for the market during the period that will be ending in 2028. Also, the funding has increased from the global governments and potential markets that will push the market for expansion initiatives and mergers beneficial in the international market premises and growing competition.
Study Objectives
- The global healthcare claims management market report aims to conduct the market analysis based on the dynamics like drivers and restraints that are available to the market during the forecast period ending in 2028. These factors help in predicting the CAGR rate and final value of the market during the period for successful market functioning.
- The AI healthcare claims management company report helps to study the healthcare claims management market segmentation that is functioning in different locations and hence, have a major role to play in pushing the prominent players to take major steps of innovation and innovation and further, enhance the prevailing competition in the healthcare claims management market.
- The market report helps to analyze the market scope prevalent during the period ending in 2028 by witnessing the steps undertaken by the market players that are reflected in the recent developments undertaken by them during the period.
Segment Overview
The healthcare claims management market share is increasing owing to its demand from populations spread across various regions in the globe. The segments of the market are spread across various market vertices and these also help in having an insight into the revenue cycles and the potential of the market to grow as per the predictions. The market segmentation is stated as follows:
Based on the market components
The healthcare claims management market has been segmented based on components and includes software and services.
Based on the delivery mode
The global market has been segmented into the delivery mode and includes on-premise and cloud-based modes.
Based on the type
The healthcare claims management market size has been segmented based on the type and includes integrated and standalone.
Based on the market end-user
The global market has been segmented into healthcare payers and providers.
Based on the Global regions
The global market is functional in 5 major regions namely North America, the European countries, the APAC region, alongside the Middle East and African region.
Regional Analysis
The available information about the healthcare claims management market shows that the regional American market is expected to dominate the global healthcare claims management market during the forecast period that will be ending in 2028. The main reason behind this growth is the development of new and innovative treatments and technologies. Also, the market is witnessing a heavy inflow and emergence of investments that are increasing by various government agencies that result in a rapid improvement of the healthcare IT infrastructure, and the same is expected to create opportunities for healthcare claims management solutions providers in the years to come, as a part of the forecast period.
Competitive Landscape
The prominent players lending their services to the HCM healthcare claims market and helping it grow as per the predictions as laid down by the experts for the forecast period of 2021-2028 are as follows:
- Cerner Corporation
- McKesson Corporation
- Accenture plc.
- Genpact Limited
- eClinicalWorks
- Cognizant Technology Solutions Corporation
- Optum, Inc.
- Oracle Corporation
- IBM Corporation
- Conifer Health Solutions
- Allscripts Healthcare Solutions, Inc.
- nThrive, Inc
- Avaya Inc.
- Infor Inc.
Recent Developments
- According to the global statistics that relate to the healthcare claims management market have been formulated by the National Health Expenditure Accounts (NHEA). The stats suggest that U.S. health care spending is likely to grow. The amount of expenditure was 4.3 percent in 2016, which is predicted to be reaching a total market value of $3.3 trillion or $10,348 per person which accounted for 17.9 percent during the ongoing forecast period that will be ending in 2028.
- The global market size is further, witnessing an increase in the degree of funding and investment in the healthcare infrastructure and services that are prevalent in the Asia-Pacific region. The players in this region offer the huge market potential for the players to grow in the healthcare claims management solutions market during the ongoing forecast period that is forecasted to be ending in 2028.
- The global market trends are expected to bloom during the forecast period of 2021-2028 owing to the proactive government initiatives to spread awareness and correct information about the benefits of this technology among the masses have supplemented the healthcare claims management market growth.
Intended Audience
- Healthcare insurance companies and payers
- Healthcare IT service providers and dealers
- Healthcare institutions and providers like hospitals, medical groups, physician practices, diagnostic centers, pharmacies, ambulatory centers, and outpatient clinics
- Venture capitalists and dealers
- Healthcare BPO Vendors
- Healthcare KPO Vendors
- Government bodies and public sector
- Corporate entities and groups
- Accountable care organizations
Report Overview
The report helps in predicting the healthcare claims management market growth for the forecast period that ends in 2028 by considering the viewpoints that have been presented by the market leaders and experts. The report discusses the scope of the market by presenting the dynamics available to the market in the period that will be ending in 2028. Further, it plays an important role in having an understanding of the market functioning through its global segmentation and market players. Also, the report discusses the predictions of the mushrooming regions, and the report further mentions the recent developments undertaken by the global players of the market.
Report Scope:
| Report Attribute/Metric | Details |
|---|---|
| Market Size | 2027: Significant Value |
| CAGR | 5.37% (2018-2023) |
| Base Year | 2019 |
| Forecast Period | 2020-2027 |
| Historical Data | 2018 |
| Forecast Units | Value (USD Million) |
| Report Coverage | Revenue Forecast, Competitive Landscape, Growth Factors, and Trends |
| Segments Covered | Component, Delivery mode type and End-user |
| Geographies Covered | North America, Europe, Asia-Pacific, and Rest of the World (RoW) |
| Key Vendors | Cerner Corporation (US), McKesson Corporation (US), Athenahealth (US), eClinicalWorks (US), Optum, Inc. (US), Conifer Health Solutions (US), nThrive (US), Avaya Inc. (USA), Oracle Corporation (US), Infor Inc. (US), Allscripts Healthcare Solutions, Inc. (US), Accenture plc. (Ireland), IBM Corporation (US), Cognizant Technology Solutions Corporation (US) and Genpact Limited (US) |
| Key Market Opportunities | New product launches and R&D Amongst major key Players |
| Key Market Drivers |
|
Frequently Asked Questions (FAQ) :
Healthcare Claims Management Market has shown possibilities of attaining 5.37% CAGR during the forecast period covering 2018 to 2023.
Factors like rise in chronic diseases, aging population, better healthcare quality services, and inclusion of innovative treatments are propelling the growth for the Healthcare Claims Management Market.
Possibility of security breaches, lack of adept professionals to operate the system, and others can hold back the Healthcare Claims Management Market.
Americas would control the maximum Healthcare Claims Management Market share.
Healthcare Claims Management Market would find the Asia Pacific as the fastest-growing region.
