Key Players :
Market Research Future (MRFR) recognizes the following companies as the key players in Healthcare Claims Management Market: There are plenty of large and small market players which operate in this market all over the globe.
Some of the key players in the Global Healthcare Claims Management Market are Cerner Corporation, McKesson Corporation, athenahealth, Inc., eClinicalWorks, Optum, Inc., Conifer Health Solutions, nThrive, Inc, Avaya Inc., Oracle Corporation, Infor Inc., Allscripts Healthcare Solutions, Inc., Accenture plc., IBM Corporation, Cognizant Technology Solutions Corporation and Genpact Limited.
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Healthcare Claims Management Market – Outlook
Healthcare Claims Management, software that manages medical claims and reimbursement processes is increasingly enabling healthcare providers to optimize their revenues by proper claim management. In a nutshell, healthcare claims management is a bilateral process between patients, healthcare providers, billing company, and insurance provider. Due to the rapid expansion in the healthcare insurance sector over the past few years, the market for claims management is multiplying rapidly.
Acknowledging the exponential growth, this market perceives currently; Market Research Future (MRFR) in its recently published study report asserts that the global healthcare claims management market will garner exponentials gains registering a CAGR of approximately 5.37% during the forecast period (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 healthcare claims management market is driven by factors such as improved focus on quality healthcare services and adoption of cloud-based technology related services. However, integration of claims management solutions, data breaches, loss of confidentiality, and lack of skilled IT professionals in healthcare are some of the factors restraining the growth of this market.
The Global Healthcare Claims Management Market is currently dominated by many market players. The key players in the market are engaged in new product launches and strategic collaborations to strengthen its market position. For instance, IBM’s IPD Ultera for Disability Claims provides an integrated “disability claims management workbench”, specific to disability claims processing and without the need for a large-scale replacement project.
Industry News:
February 28, 2019 — QRails, Inc. (the US), a financial technology company offers processing services and other solutions to Health Insurer, banks, and the digital payments industry announced the acquisition of Rete+Pay Inc. (the US), a provider of integrated electronic healthcare and insurance payments solutions.
Rete+Pay has a range of innovative payments solution that enable, faster, more efficient and cost-effective management of medical claims between insurance companies, patients and healthcare providers, offering a secure, HIPAA, and ACA compliant environment. Rete+Pay has been providing insurance companies and healthcare providers innovative ways of reducing or eliminating inefficient billing and payments processes.
The acquisition deal is a significant strategic step for Q-Rails to curtail the huge administration costs of approximately USD 1.2 TN which the Q-Rails healthcare spends annually.
February 28, 2019 — Providence Health & Services (the US) is a non-profit health care system operating multiple hospitals announced acquisition of Lumedic Inc. (the US), a next-generation platform for revenue cycle management built on blockchain, machine learning, and patient-centric design to build a blockchain platform for claims processing.
Providence plans to form a new company using Lunedic’s assets and team, which will maintain the Lumedic brand. Lunedic’s end-to-end revenue cycle management platform which is based on blockchain technology deploys distributed ledger technology, smart contracts, and machine learning.
Regional Analysis :
The North America region heading with its well-established healthcare sector will continue to lead the global healthcare claims management market throughout the forecast period.
Moreover, factors such as the favorable government policies, and the rapid adoption of claim management solutions that are availing increasing incentives are helping the market to achieve significant market share, globally.
The growing investments in the field of healthcare information technology (HCIT) alongside the presence of regulatory mandates favoring the implementation of healthcare claims management solutions foster the growth of the regional market.
The US and Canada among other North American countries have successfully implemented healthcare IT in their healthcare system, which as a result is boosting the growth in the regional market over the forecast period.
Additionally, the presence of developed infrastructures of healthcare & IT coupled with favorable government initiatives in executing claims management, regulatory framework, and innovations in the field would further propel the market growth in the region.
Europe & Asia Pacific accounts for the second & third largest market, respectively, in the global healthcare claims management market. Factors such as the improved digitization along with the increasing focus on data integration and data governance for the rising number of claims in the healthcare sector would drive the growth of the European claim management market.
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The Asia Pacific claims management market is driven by the developments in technology and healthcare infrastructure. The increasing adoption of claims management systems to the growing number of healthcare facilities in the region fosters the regional market. Developing countries like India, China, and Japan account for the broad adoption of these management products and services and hence, account for the major contributors to the market growth in the region.
Segments :
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.
Brief TOC
Chapter 1. Report Prologue
Chapter 2. Market Introduction
Chapter 3. Research Methodology
Chapter 4. Market Dynamics
Chapter 5. Market Factor Analysis
Chapter 6. Global Healthcare Claims Management Market, By Component
Chapter 7. Global Healthcare Claims Management Market, By Delivery Mode
Chapter 8. Global Healthcare Claims Management, By Type
Chapter 9. Global Healthcare Claims Management Market, By End-User
Chapter 10. Global Healthcare Claims Management Market, By Region
Chapter 11. Competitive Landscape
Chapter 12. Company Profile
Chapter 13. Conclusion
Chapter 14. Appendix
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