Healthcare Claims Management Market Analysis
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).
The global healthcare claims management market is expected to grow significantly over the assessment period mainly due to the increase in aging population, the rise in the incidences of chronic diseases, improved focus on healthcare quality services, and the advent of innovative treatments & technologies. Growing digitization along with the flourishing healthcare IT market immensely contribute to the escalating market credentials.
The growing population has fuelled the demand for the highest quality of coordinated care. With the ever-increasing administrative & operational expenses of healthcare organizations, cost-effective management of claims becomes mandatory. Claims management offers viable solutions by replacing traditional paper-based systems to optimize cost. Such factors are commutatively escalating the claims management market to the furthered heights.
Additional factors predominantly driving the market growth include; rapidly developing healthcare infrastructures and the augmented uptake of solutions to manage the rapidly increasing claims in the healthcare sector, worldwide. Moreover, technological advancements and improving economic conditions are fostering the market growth of healthcare claims management.
On the other hand, factors such as the increasing concerns of the patients’ data safety & security alongside the threats of data breaches and loss of confidentiality are restricting the market growth. Also, the lack of skilled IT professionals in healthcare is obstructing the growth of the medical claims management solutions market.
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Global Healthcare Claims Management Market – Segments
MRFR has segmented its analysis into five key dynamics for enhanced understanding.
By Component: Software and Services among others.
By Delivery Mode: On-premise and Cloud-based among others.
By Type: Integrated and Standalone among others.
By End-user: Healthcare Payers and Providers among others.
By Regions: North America, Europe, Asia Pacific, and Rest-of-the-World.
Global Healthcare Claim Management Market – Geographical 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.
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.
Global Healthcare Claims Management Market – Competitive Landscape
The fiercely competitive market of healthcare claims management appears to be fragmented owing to the presence of numerous large and small-scale players accounting for a substantial market share. These players adopt strategic initiatives such as partnership, acquisition, collaboration, expansion, and product/ technology launch to gain a competitive advantage in the market. Key Players invest heavily in R&D to develop a technology that is entirely on a different level compared to their competition.
Healthcare Claims Management Market Key Players:
Some of the players leading the global healthcare claims management market are McKesson Corporation (US), Cerner Corporation (US), Athenahealth (US), Optum, Inc. (US), eClinicalWorks (US), Conifer Health Solutions (US), Avaya Inc. (USA), nThrive (US), Oracle Corporation (US), Allscripts Healthcare Solutions, Inc. (US), Infor Inc. (US), Accenture Plc. (Ireland), Cognizant Technology Solutions Corporation (US), Genpact Limited (US), and IBM Corporation (US) among others.
Healthcare Claims Management Industry/Innovation/Related 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.
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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.