Healthcare Claims Management Market Research Report – Forecast to 2027

Global Healthcare Claims Management Market Research Report: By Component (Software and Services), by Delivery Mode (On-Premise and Cloud Based), by 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

Please note that the assessment period of report has been updated from 2018-2023 to 2020-2027. Cordially fill the sample form for updated data

Market Scenario


Global healthcare claims management market is expected to grow significantly over the forecast period. It is estimated that the global healthcare claims management market is expected to register a CAGR ~ 5.37% during the forecast period of 2018–2023. Healthcare claims management process comprises of various tasks such as organization, billing, filling, updating, and processing of medical claims related to the diagnosis, treatment, and medication of patients.


The global market is driven by factors such as increase in ageing population, rise in incidence of chronic diseases, improved focus on healthcare quality services and advent of innovative treatments & technologies.


Factors such as increasing concerns regarding the patient data safety and security limit and data breaches and loss of confidentiality, lack of skilled IT professionals in healthcare are restraining the growth of medical claims management solutions market. According to the National Health Insurer Report Card published in 2011 by American Medical Association (AMA), around $17 billion a year (on an average) could be saved by eliminating errors in claims.


Segmentation


The global healthcare claims management market has been segmented into component, delivery mode type and end-user. The market, based on component, has been segmented into software and services. The market, by delivery mode, has been segmented into on-premise and cloud based. The market, by type, has been segmented into integrated and standalone. The market, by end-user has been segmented into healthcare payers and providers.


The market has been segmented, by region, into the Americas, Europe, Asia-Pacific, and the Middle East & Africa. The healthcare claims management market in the Americas has further been segmented into North America and South America, with the North American market divided into the US and Canada. The European healthcare claims management market has been segmented into Western Europe and Eastern Europe. Western Europe has further been classified as Germany, France, the UK, Italy, Spain, and the rest of Western Europe.  The healthcare claims management market in Asia-Pacific has been segmented into Japan, China, India, South Korea, Australia, and the rest of Asia-Pacific. The healthcare claims management market in the Middle East & Africa has been segmented into the Middle East and Africa.


Key players


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) are some of the key players in the global healthcare claims management market.


Regional Market Summary


Global Healthcare Claims Management Market Share (%), by Region, 2017


Healthcare Claims Management Market Share


Source: World Health Organization (WHO), United Nations Department of Economic and Social Affairs (UN-DESA)


Geographically, the Americas is expected to dominate the global healthcare claims management market due to the growing HCIT investments in the region and the presence of regulatory mandates favouring the implementation of healthcare claims management solutions.


Europe is expected to hold the second largest position in the global healthcare claims management market. The market growth in this region is because of the rise in prevalence of chronic diseases, presence of well-established healthcare system and increase in insurance coverage.


Asia-Pacific is estimated to be the fastest growing region in the market due to the improved healthcare infrastructure and increasing geriatric population.


On the other hand, the Middle East & Africa has the least share of the market. This is due to low technological advancements in the field of healthcare IT.


Global Healthcare Claims Management Market, by Component



  • Software



  • Services


Global Healthcare Claims Management Market, by Delivery Mode



  • On-premise

  • Cloud based


Global Healthcare Claims Management Market, by Type



  • Integrated

  • Standalone


Global Healthcare Claims Management Market, by End-User



  • Healthcare Payers

  • Providers


Global Healthcare Claims Management Market, by Region



  • Americas



  • North America

  • US

  • Canada

  • South America



  • Europe



  • Western Europe

  • Germany

  • France

  • Italy

  • Spain

  • UK

  • Rest of Western Europe

  • Eastern Europe



  • Asia-Pacific



  • Japan

  • China

  • India

  • Australia

  • South Korea

  • Rest of Asia-Pacific



  • The Middle East & Africa



  • Middle East

  • Africa


Intended Audience



  • Healthcare insurance payers

  • Healthcare IT service providers

  • Healthcare BPO Vendors

  • Healthcare KPO Vendors

  • Government bodies

  • Corporate entities

  • Healthcare institutions/providers (hospitals, medical groups, physician practices, diagnostic centers, pharmacies, ambulatory centers, and outpatient clinics)

  • Venture capitalists



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.

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