The healthcare BPO market is projected to reach USD 468.5 billion by 2026 from USD 296.4 billion in 2021, at a CAGR of 9.6% during the forecast period. Healthcare BPO is a practice in which healthcare organizations outsource their business operations to third-party organizations. The need to reduce rising healthcare costs, increasing demand for niche services and need for structured processes and documentation are compelling payers and providers to outsource their business processes to low-cost countries in order to reduce their operational costs.
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The U.S. Healthcare BPO market had been experiencing consistent growth, driven by various factors, including rising healthcare costs, complex regulatory requirements, the need for operational efficiency, and advancements in technology.
The scope of healthcare BPO services in the United States encompassed a broad range of functions, including:
Revenue Cycle Management (RCM): Managing the financial and administrative aspects of healthcare, such as medical billing and claims processing.
Medical Coding and Billing: Ensuring precise coding and billing processes to facilitate reimbursement for healthcare providers.
Healthcare Customer Support: Outsourcing call centers and customer support services to handle inquiries, appointments, and patient interactions.
Healthcare IT Services: Overseeing and maintaining healthcare IT systems, including electronic health records (EHRs) and data analytics.
Pharmacy Benefits Management: Services related to the management of prescription drug claims and benefits.
Top Healthcare BPO Market Player
Some of the prominent players operating in the Healthcare BPO market are Accenture (Ireland), Cognizant (US), Tata Consultancy Services (India), Xerox Corporation (US), WNS (Holdings) Limited (India), NTT Data Corporation (Japan), IQVIA (US), Mphasis (India), Genpact (US), Wipro (India), Infosys BPM (India), Firstsource Solutions (India), IBM Corporation (US), HCL Technologies (India), Sutherland Global (US), GeBBS Healthcare Solutions (US), Lonza (Switzerland), Omega Healthcare (India), R1 RCM (US), Invensis Technologies (India), UnitedHealth Group (US), Sykes Enterprises (US), Parexel International (US), Access Healthcare (US), and Akurate Management Solutions (US), among others.
Accenture was the largest player in the healthcare BPO market. Being a pioneer in the healthcare BPO, Accenture has successfully established a brand of its own. The company was founded in 1989 and is headquartered in Dublin, Ireland. The company mainly offers management consulting, technology, and outsourcing services.
Cognizant was the second-leading player in the healthcare BPO market. It is a publicly held company, was founded in 1994 and is headquartered in New Jersey, US. The company offers IT consulting, enterprise information management (EIM), and business process outsourcing services across the globe.
Tata Consultancy Services (TCS) was the third-largest player in the healthcare BPO market. TCS, a pioneer in offering innovative, best-in-class consulting and IT solutions and services, such as assurance services, digital enterprise, engineering and industrial services, business services, application services, managed infrastructure services, financial services, logistics, and managed services.
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North American healthcare BPO market to register the largest and highest growth.
North America dominated the healthcare BPO market, with a share of 48.6%, and is expected to register the highest CAGR of 10.6% during the forecast period. The large share of the North American market can be attributed to the increased pressure to reduce healthcare costs and improve services and changing government regulations in the healthcare industry. Growing need for costs curtailment and process efficiencies among pharmaceutical companies is further expected to boost the market growth in coming years.
Healthcare BPO Market Dynamics
Driver: pressure to reduce the rising healthcare costs
Restraint: Hidden outsourcing costs
Opportunity: Growing adoption of artificial intelligence-based tools for drug discovery
Challenge: Data security concerns
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