Healthcare Claims Management Market Research Report – Forecast to 2027

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

Segmentation

By Component Software And Services
Delivery Mode On Premise And Cloud Based
Type Integrated And Standalone
by End-User Healthcare Payers And Providers

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
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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

  • Increase in ageing population
  • Rise in incidence of chronic diseases Improved focus on healthcare quality services
  • Advent of innovative treatments & technologies


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    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.