According to the latest report by IMARC Group, titled “United States Healthcare BPO Market: Regional Industry Trends, Share, Size, Growth, Opportunity and Forecast 2023-2028,” the United States healthcare BPO market size reached US$ 129.9 Billion in 2022. Healthcare business process outsourcing (BPO) refers to the delegation of certain operations related to healthcare, such as billing, coding, patient scheduling, data entry, and record maintenance, to a third-party service provider. This process enables healthcare providers, including hospitals, clinics, and medical practitioners, to focus more on their core competencies such as patient care and treatment, while the administrative and backend operations are taken care of by specialized BPO companies. There are three primary segments of healthcare BPO: payer services, provider services, and pharmaceutical services. Payer services include insurance claims processing, policy renewal, and membership services. Provider services involve medical coding, billing, patient enrollment, and record maintenance. Pharmaceutical services cover drug discovery, clinical trials, manufacturing, and post-marketing surveillance. The advantages of healthcare BPO are numerous. They include cost reduction, efficiency improvement, access to specialized skills, and better focus on core healthcare services. However, it's important to ensure that these outsourced services meet the stringent regulatory standards of the healthcare industry, especially when it comes to patient privacy and data security.
United States Healthcare BPO Market Trends:
The rising healthcare costs are propelling many healthcare providers to seek more economical strategies for managing administrative and clinical operations which represents one of the key factors driving the growth of the market across the globe. Outsourcing these tasks provides a viable cost-efficient solution. It allows these organizations to greatly reduce operational expenses and direct their focus toward their main competencies, namely patient care, and wellness services. This shift towards outsourced services acts as a key driver in the expansion of the healthcare BPO market. The market is also driven by the intricate labyrinth of healthcare regulations and the mounting necessity for compliance with these standards. Navigating the ever-evolving regulatory landscape in healthcare is resource-intensive and requires a certain level of expertise. BPO firms with a specialization in healthcare offer the necessary proficiency and help ease compliance, which is mitigating the risk of punitive regulatory penalties. In line with this, the emergence and implementation of advanced technologies like artificial intelligence (AI), machine learning (ML), and data analytics are fueling the growth of the market. These technological developments are enhancing the efficacy and accuracy of many BPO services, such as medical billing, coding, patient scheduling, and others. In turn, the growing reliance on technology is further accelerating the expansion of the healthcare BPO industry. In addition to this, the increasing volume of patient data requires strong management and stringent security measures which is influencing the growth of the market. The challenges of managing electronic health records (EHRs) and upholding data security protocols often lead healthcare providers to outsource these tasks to BPO companies that possess the necessary capabilities. Apart from this, the increased willingness among healthcare providers to adopt new business models to improve patient outcomes, such as value-based care, is creating a positive outlook for the market across the country. Looking forward, the market value is projected to reach US$ 204.8 Billion by 2028, expanding at a CAGR of 7.8 % during 2023-2028.
- Based on payer service, the market has been classified into human resource management, claims management, customer relationship management, operational and administrative management, care management, provider management, and others. Currently, claims management holds the largest market share in the country.
- On the basis of provider service, the market has been segmented into patient enrollment and strategic planning, patient care service, and revenue cycle management. Presently, claims management is dominating the largest market across the country.
- Based on pharmaceutical service, the market has been segregated into manufacturing services, research and development services, and non-clinical services. Currently, manufacturing services holds the largest market share in the country.
- On a geographical front, the market has been segmented into Northeast, Midwest, South, and West.
- The competitive landscape of the market has also been examined with some of the key players.
|Base Year of the Analysis
||Payer Service, Provider Service, Pharmaceutical Service, Region
||Northeast, Midwest, South, West
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