The growing usage of advanced technologies to deliver economical business process services, rising adoption of digital technology, increasing focus on consumerism, and the presence of stringent healthcare regulatory policies are certain crucial factors boosting the healthcare payer services market in the coming years. Some of the key participants, such as Accenture, Cognizant, EXL, HP Development Company, L.P., Concentrix Corporation, and others, are primarily focusing on incorporating mobility technology with health plans to engage enrolled members.
Moreover, the growing private healthcare insurance exchanges, increasing IT investments, and with the Affordable Care Act (ACA) in effect, the market is set to grow. The increasing demand to curb the overall administrative costs of member management services, increasing demand for cost effective solutions for the healthcare payer services, and the growing number of healthcare fraud cases are few determinants that are expected to propel the market growth over the forecast period.
Some established players including United Healthcare, Inc., Anthem, Inc., Aetna, Inc., Accenture, Cognizant, Dell, HP Development Company, L.P., and Xerox Corporation are expanding their footprint through the implementation of various technologies such as digital technology and contract models. The technological advancements in the overall healthcare payer services system are anticipated to positively reinforce the market growth.
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Further key findings from the study suggest:
- In 2015, the BPO segment accounted for the maximum revenue share of 51.7%. The growing number of people enrolling for the insurance program, increasing pressure to bend the healthcare cost curve, and the rising implementation of ICD-10 codes are driving this segment’s growth. However, the KPO segment is expected to emerge as the fastest growing with a CAGR of 17.9%. Increasing demand for accurate claim resolution and the reduction of fraud incidences are some of the factors that are expected to drive the market over the forecast period.
- In 2015, North America was a clear leader with a revenue share of 77.31%. The growing insurance enrollment, lack of low-cost skilled professionals, and the increasing demand for an integrated healthcare system are accountable for the large market share captured by this segment.
- Asia Pacific is expected to emerge as the fastest growing region with a CAGR of 10.8% during the forecast period. The Southeast Asian region is one of the major outsourcing destinations in the world. The region includes Malaysia, Singapore, Vietnam, Philippines, India, China, and many more, which are predominately involved in carrying out outsourcing activities. The presence of skilled workforce to provide high-end process services, such as software development and application development management, is one of the prominent factors driving the Asia Pacific healthcare payer services market in the coming years.
- The healthcare payer services market is presently dominated by few key participants, such as United Healthcare, Inc., Anthem, Inc., Aetna, Inc., Cigna, Humana, Inc., Accenture, Xerox Corporation, Genpact, IBM Corporation, and Cognizant. The healthcare payer services players initiate merger & acquisition and corporate development strategies primarily to further expand their reach in various other verticals. For instance, Wipro Limited had acquired HealthPlan Services for approximately USD 460 million to diversify its health insurance product portfolio.
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