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Healthcare Claims Management Solutions Market by Type (Software, Hardware, and Services], and Deployment mode (Web-based, Cloud-based, and On-premise) - Global Opportunity Analysis and Industry Forecast, 2014-2022

  • ID: LI 171863
  • Feb 2017
  • 140 pages
  • Price: $4296
$2765

Healthcare Claims Management Solutions Market Overview:

Global Healthcare Claims Management Solutions Market was valued at $3,644 million in 2015, and is expected to reach $5,213 million by 2022, registering a CAGR of 5.1% during the forecast period. Healthcare claims management process involves 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. Moreover, increase in the number of patients covered under medical insurance, rise in premium costs, expensive care for chronic diseases, and surge in the number of medical claims have boosted the growth of the healthcare claims management solutions market.

Healthcare Claims Management Solutions Market Segmentation

Healthcare Claims Management Solutions market segmentation

Segment Review

The global healthcare claims management solutions market is segmented based on type, deployment mode, and geography. Based on type, the market is segmented into software, hardware, and services. In 2015, the software segment accounted for the largest share in the global market, owing to the technological advancements in software and increased use of software for accurate and faster processing of claims. Based on deployment mode, the market is segmented into web-based mode, cloud-based mode, and on-site deployment mode. The web-based deployment segment holds the largest share in the global market, as it covers a vast array of claims business systems that help in saving both time and money.

Top Investment Pockets

Software is the highest revenue contributor to the healthcare claims management solutions market, owing to increasing adoption of advanced claims management software by healthcare payers to facilitate easy, accurate, and faster processing of claims.

Top Investment Pockets in Healthcare Claims Management Solutions Market

Healthcare claims management solutions Market Top investment pockets

Top Impacting Factors

The healthcare claims management solutions market is driven by increase in aging population, rise in incidence of chronic diseases, growth in awareness for care provision, proactive government initiatives to improve insurance coverage among citizens, and surge in use of cloud-based services. However, increase in concerns about patient data safety & security and rise in cybercrime cases are expected to hamper the market growth. The Asia-Pacific region is expected to offer lucrative potential for the healthcare claims management solution providers in the near future. India and China are the two rapidly growing economies in the Asia-Pacific region, followed by South Korea. The government in these countries have taken several efforts to provide better healthcare services and improve healthcare infrastructure. Healthcare IT related services bridge the gap between healthcare entities by curtailing manual errors and plummeting healthcare expenditure. However, the healthcare IT industry in India is at its nascent stage. Therefore, the demand for healthcare IT solutions in the region is expected to increase during the forecast period, owing to increasing incidence of chronic disorders, improving healthcare infrastructure, and increasing demand for better healthcare services. Thus, heavy inflow of investments by various government agencies to improve healthcare IT infrastructure in emerging markets is expected to create opportunities for healthcare claims management solutions providers.

Geographic Analysis:

The North American and European markets hold significant share in the global market, owing to the increased use of software and hardware for processing claims and presence of top insurance companies in these regions. The North America accounted for four-ninths share of the global market in 2015, and is expected to maintain this lead throughout the forecast period. The growth is attributed to the presence of well-established healthcare system in the region, increase in insurance coverage, rise in prevalence of chronic diseases, and technological advancements in the sector.

However, Asia-Pacific region is projected to grow at the highest CAGR of 7.3% from 2016 to 2022, owing to increase in geriatric population and improvement in healthcare infrastructure. In addition, proactive government initiatives to spread awareness about the benefits of this technology among the masses have supplemented the market growth.

The key players profiled in the report include Cerner Corporation, Avaya Inc., Oracle Corporation, Infor Inc., Allscripts Healthcare Solutions, Inc., Athenahealth Inc., Accenture plc., IBM Corporation, Cognizant Technology Solutions Corporation, and Genpact Limited.

The other players operating in the industry are Quest Diagnostics, McKesson Corporation, eClinicalWorks LLC, CareCloud Corporation, The SSI Groups Inc., GE Healthcare, and Siemens Healthcare

Healthcare Claims Management Solutions Market Key Benefits:

  • The study provides an in-depth analysis of the global healthcare claims management market along with current trends and future estimations to elucidate the imminent investment pockets.
  • The report provides a quantitative analysis of the industry for the period of 2014‐2022 to enable the stakeholders to capitalize on the prevailing market opportunities.
  • Extensive analyses of the market based on product type, & deployment mode help in understanding the various trends and prevailing opportunities across geographies.
  • The key market players operating in the market along with their strategies have been profiled to determine the competitive outlook of the industry.

Healthcare Claims Management Solutions Market Key Segments:

By Type

  • Software
  • Hardware
  • Services

By Deployment Mode

  • Web-based
  • Cloud-based
  • On-premise

By Geography

  • North America
  • Europe
  • Asia-Pacific
  • LAMEA
 

Chapter: 1 INTRODUCTION

1.1. REPORT DESCRIPTION
1.2. KEY BENEFITS
1.3. KEY MARKET SEGMENTS
1.4. RESEARCH METHODOLOGY

1.4.1. Secondary research
1.4.2. Primary research
1.4.3. Analyst tools and models

Chapter: 2 EXECUTIVE SUMMARY

2.1. CXO PERSPECTIVE

Chapter: 3 MARKET OVERVIEW

3.1. MARKET DEFINITION AND SCOPE
3.2. KEY FINDINGS

3.2.1. Top investment pockets

3.3. TOP PLAYER POSITIONING
3.4. PORTERS FIVE FORCES ANALYSIS

3.4.1. Bargaining Power of Buyers
3.4.2. Bargaining Power of Suppliers
3.4.3. Threat of Substitution
3.4.4. Threat of New Entrants
3.4.5. Intensity of Competitive Rivalry

3.5. MARKET DYNAMICS

3.5.1. Drivers

3.5.1.1. Rapidly increasing aging population and subsequent rise in the number of chronic diseases
3.5.1.2. Increase in awareness for care provision
3.5.1.3. Government initiatives to improve the insurance cover of their citizens
3.5.1.4. Adoption of Cloud Technology related services

3.5.2. Restraints

3.5.2.1. Increasing concerns regarding the patient data safety & security

3.5.3. Opportunities

3.5.3.1. Increasing investment in the Asia-Pacific region offers huge market potential

Chapter: 4 HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COMPONENT

4.1. OVERVIEW
4.2. SOFTWARE

4.2.1. Key market trends
4.2.2. Key growth factors and opportunities
4.2.3. Market size and forecast

4.3. HARDWARE

4.3.1. Key market trends
4.3.2. Key growth factors and opportunities
4.3.3. Market size and forecast

4.4. SERVICES

4.4.1. Key market trends
4.4.2. Key growth factors and opportunities
4.4.3. Market size and forecast

Chapter: 5 HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY DEPLOYMENT MODE

5.1. OVERVIEW
5.2. WEB-BASED

5.2.1. Market size and forecast

5.3. CLOUD-BASED

5.3.1. Market size and forecast

5.4. ON-PREMISE BASED

5.4.1. Market size and forecast

Chapter: 6 HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY GEOGRAPHY

6.1. OVERVIEW
6.2. NORTH AMERICA

6.2.1. Key market trends
6.2.2. Key growth factors and opportunities
6.2.3. Market size and forecast
6.2.4. U.S.: market size and forecast
6.2.5. Canada: market size and forecast
6.2.6. Mexico: market size and forecast

6.3. EUROPE

6.3.1. Key market trends
6.3.2. Key growth factors and opportunities
6.3.3. Market size and forecast
6.3.4. Germany: market size and forecast
6.3.5. France market size and forecast
6.3.6. UK: market size and forecast
6.3.7. Italy market size and forecast
6.3.8. Spain market size and forecast
6.3.9. Rest of Europe: market size and forecast

6.4. ASIA-PACIFIC

6.4.1. Key market trends
6.4.2. Key growth factors and opportunities
6.4.3. Market size and forecast
6.4.4. Japan: market size and forecast
6.4.5. China market size and forecast
6.4.6. India: market size and forecast
6.4.7. Rest of Asia-Pacific market size and forecast

6.5. LAMEA

6.5.1. Key market trends
6.5.2. Key growth factors and opportunities
6.5.3. Market size and forecast
6.5.4. Latin America: market size and forecast
6.5.5. Middle East market size and forecast
6.5.6. Africa: market size and forecast

Chapter: 7 COMPANY PROFILES

7.1. CERNER CORPORATION

7.1.1. Overview
7.1.2. Operating business segments
7.1.3. Business performance
7.1.4. Key strategic moves and developments

7.2. AVAYA INC.

7.2.1. Overview
7.2.2. Operating business segments
7.2.3. Business performance
7.2.4. Key strategic moves and developments

7.3. ORACLE CORPORATION

7.3.1. Overview
7.3.2. Operating business segments
7.3.3. Business performance
7.3.4. Key strategic moves and developments

7.4. INFOR, INC.

7.4.1. Overview
7.4.2. Operating business segments
7.4.3. Business performance
7.4.4. Key strategic moves and developments

7.5. ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.

7.5.1. Overview
7.5.2. Operating business segments
7.5.3. Business performance
7.5.4. Key strategic moves and developments

7.6. ATHENAHEALTH INC.

7.6.1. Overview
7.6.2. Operating business segments
7.6.3. Business performance
7.6.4. Key strategic moves and developments

7.7. ACCENTURE PLC.

7.7.1. Overview
7.7.2. Operating business segments
7.7.3. Business performance
7.7.4. Key strategic moves and developments

7.8. IBM CORPORATION

7.8.1. Overview
7.8.2. Operating business segments
7.8.3. Business performance
7.8.4. Key strategic moves and developments

7.9. COGNIZANT TECHNOLOGY SOLUTIONS CORPORATION

7.9.1. Overview
7.9.2. Operating business segments
7.9.3. Business performance
7.9.4. Key strategic moves and developments

7.10. GENPACT LIMITED

7.10.1. Overview
7.10.2. Operating business segments
7.10.3. Business performance
7.10.4. Key strategic moves & developments

LIST OF TABLES

TABLE 1 GLOBAL HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COMPONENT, 2014-2022, ($MILLION)
TABLE 2 GLOBAL HEALTHCARE CLAIMS MANAGEMENT SOFTWARE MARKET, BY GEOGRAPHY, 2014-2022 ($MILLION)
TABLE 3 GLOBAL HEALTHCARE CLAIMS MANAGEMENT HARDWARE MARKET, BY GEOGRAPHY, 2014-2022 ($MILLION)
TABLE 4 GLOBAL HEALTHCARE CLAIMS MANAGEMENT SERVICES MARKET, BY GEOGRAPHY, 2014-2022 ($MILLION)
TABLE 5 GLOBAL HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY DEPLOYMENT MODE, 2014-2022 ($ MILLION)
TABLE 6 GLOBAL WEB-BASED HEALTHCARE CLAIMS MANAGEMENT SOLUTION MARKET, BY GEOGRAPHY, 2014-2022 ($MILLION)
TABLE 7 GLOBAL CLOUD-BASED HEALTHCARE CLAIMS MANAGEMENT SOLUTION MARKET, BY GEOGRAPHY, 2014-2022 ($MILLION)
TABLE 8 GLOBAL ON-PREMISE HEALTHCARE CLAIMS MANAGEMENT SOLUTION MARKET, BY GEOGRAPHY, 2014-2022 ($MILLION)
TABLE 9 GLOBAL HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY GEOGRAPHY, 2014-2022($MILLION)
TABLE 10 NORTH AMERICA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COUNTRY, 2014-2022 ($MILLION)
TABLE 11 NORTH AMERICA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COMPONENT, 2014-2022 ($MILLION)
TABLE 12 NORTH AMERICA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY DEPLOYMENT MODE, 2014-2022 ($MILLION)
TABLE 13 EUROPE: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COUNTRY, 2014-2022 ($MILLION)
TABLE 14 EUROPE: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COMPONENT, 2014-2022 ($MILLION)
TABLE 15 EUROPE: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY DEPLOYMENT MODE, 2014-2022 ($MILLION)
TABLE 16 ASIA-PACIFIC: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COUNTRY, 2014-2022 ($MILLION)
TABLE 17 ASIA-PACIFIC: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COMPONENT, 2014-2022 ($MILLION)
TABLE 18 ASIA-PACIFIC: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY DEPLOYMENT MODE, 2014-2022 ($MILLION)
TABLE 19 LAMEA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COUNTRY, 2014-2022 ($MILLION)
TABLE 20 LAMEA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY COMPONENT, 2014-2022 ($MILLION)
TABLE 21 LAMEA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, BY DEPLOYMENT MODE, 2014-2022 ($MILLION)
TABLE 22 CERNER: COMPANY SNAPSHOT
TABLE 23 CERNER: BUSINESS SEGMENTS
TABLE 24 AVAYA: COMPANY SNAPSHOT
TABLE 25 AVAYA: BUSINESS SEGMENTS
TABLE 26 ORACLE: COMPANY SNAPSHOT
TABLE 27 ORACLE: BUSINESS SEGMENTS
TABLE 28 INFOR: COMPANY SNAPSHOT
TABLE 29 INFOR: BUSINESS SEGMENTS
TABLE 30 ALLSCRIPTS: COMPANY SNAPSHOT
TABLE 31 ALLSCRIPTS: BUSINESS SEGMENTS
TABLE 32 ATHENAHEALTH: COMPANY SNAPSHOT
TABLE 33 ATHENAHEALTH: BUSINESS SEGMENTS
TABLE 34 ACCENTURE: COMPANY SNAPSHOT
TABLE 35 ACCENTURE: BUSINESS SEGMENTS
TABLE 36 IBM: COMPANY SNAPSHOT
TABLE 37 IBM: BUSINESS SEGMENTS
TABLE 38 COGNIZANT: COMPANY SNAPSHOT
TABLE 39 COGNIZANT: BUSINESS SEGMENTS
TABLE 40 GENPACT: COMPANY SNAPSHOT
TABLE 41 GENPACT: BUSINESS SEGMENTS

LIST OF FIGURES

FIGURE 1. HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS: MARKET SEGMENTATION
FIGURE 2. TOP INVESTMENT POCKETS IN HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET
FIGURE 3. TOP PLAYER POSITIONING: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET
FIGURE 4. HEALTHCARE CLOUD COMPUTING MARKET
FIGURE 5. TOP COUNTRIES IN CYBER CRIME IN 2015 (%)
FIGURE 6. CYBER ATTACKS BY MEDICAL ENDPOINT DEVICES IN 2015 (%)
FIGURE 7. CYBER ATTACKS IN 2015 (%)
FIGURE 8. U.S.: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 9. CANADA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 10. MEXICO: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 11. GERMANY: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 12. FRANCE: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 13. UK: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 14. ITALY: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 15. SPAIN: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 16. REST OF EUROPE: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 17. JAPAN: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 18. CHINA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 19. INDIA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 20. REST OF ASIA-PACIFIC: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 21. LATIN AMERICA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 22. MIDDLE EAST: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 23. AFRICA: HEALTHCARE CLAIMS MANAGEMENT SOLUTIONS MARKET, 2014-2022 ($MILLION)
FIGURE 24. CERNER TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 25. CERNER - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 26. CERNER - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 27. AVAYA- TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 28. AVAYA - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 29. AVAYA - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 30. ORACLE - TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 31. ORACLE - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 32. ORACLE - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 33. INFOR - TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 34. INFOR - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 35. INFOR - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 36. ALLSCRIPTS - TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 37. ALLSCRIPTS - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 38. ALLSCRIPTS - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 39. ATHENAHEALTH - TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 40. ATHENAHEALTH - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 41. ACCENTURE: TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 42. ACCENTURE - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 43. ACCENTURE - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 44. IBM: TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 45. IBM - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 46. IBM - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 47. COGNIZANT: TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 48. COGNIZANT - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 49. COGNIZANT - REVENUE, BY GEOGRAPHY, 2015 (%)
FIGURE 50. GENPACT: TOTAL REVENUE, 2013-2015 ($MILLION)
FIGURE 51. GENPACT - REVENUE, BY PRODUCT CATEGORY, 2015 (%)
FIGURE 52. GENPACT - REVENUE, BY GEOGRAPHY, 2015 (%)

 

Healthcare claims management is a process of managing claims invoices and medical bills from healthcare providers to efficiently process reimbursement requests for medical treatment. Several healthcare IT companies have developed the software, “healthcare claims management solution” for easier processing, and speedy delivery of information, prevent fraudulent claims, and accurate payment of insurance coverage.

The global healthcare claims management market is driven by factors such as increase in geriatric population, growth in incidence of chronic diseases, rise in awareness for care provision, proactive government initiatives to improve insurance coverage, and surge in adoption of cloud-based services. In addition, heavy inflow of investment in the Asia-Pacific region presents lucrative potential for the market players.

The software segment accounted for the highest share in the healthcare claims management solutions market in 2015, owing to the increased demand for web-based or cloud-based software for analyzing aggrandized claims-related data of healthcare providers. In addition, the adoption of software has increased owing to their customization feature to suit the needs of clients for billing, creating, and maintaining patient database. Leading IT companies have developed software that can ease the efforts required for handling and maintaining data. The web-based segment accounted for the highest share in 2015, owing to the ease in accessing data for claim processing, billing, and updating database. The cloud-based segment is expected to grow at the fastest rate during the forecast period, owing to advancements in cloud technology.

The market is segmented based on region into North America, Europe, Asia-Pacific, and LAMEA. The North American region accounted four-ninths share of the global healthcare claims management solutions market in 2015, and is expected to maintain its dominance throughout the forecast period. This is attributed to the increase in prevalence of chronic diseases and technological advancements in the sector. However, the Asia-Pacific is projected to grow rapidly, registering a CAGR of 7.3% from 2016 to 2022. This is attributed to the increase in geriatric population, rise in the incidence of various diseases, improvement in healthcare infrastructures, and proactive government initiatives to improve insurance coverage have boosted the market growth.

 

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