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Healthcare Claims Management Market: Global Industry Trends, Share, Size, Growth, Opportunity and Forecast 2022-2027

Market Overview:

The global healthcare claims management market size reached US$ 13.03 Billion in 2021. Looking forward, IMARC Group expects the market to reach US$ 22.4 Billion by 2027, exhibiting a growth rate (CAGR) of 9.20% during 2022-2027.

Healthcare claims management solutions include optimizing, filing, updating, and processing medical claims related to a patient's diagnosis, medications, and treatment. Health insurance claims management solutions ensure everything related to the health insurance process. It includes clinical billing software, revenue cycle management software, and healthcare practice management software, which is available to payers, healthcare providers, and insurance companies. For patients, various types of claim management software are available that promote loyalty by allowing a quick and accurate process to resolve claims as quickly as possible. As a result, it streamlines the medical claims process, easing the relationship between providers and insurance companies, and improving patient payment processes.

Healthcare Claims Management Market Trends:

The market is majorly driven by continual technological improvements in healthcare processes. This can be attributed to the growing geriatric population, along with the increasing number of individuals suffering from chronic diseases. In addition to this, the rising complexity of claims administration and the medical billing process is providing an impetus to the market. Moreover, the rising awareness regarding the management of claim denials is resulting in a higher product uptake on the global level. The paradigm shift towards web-based and cloud-based operation modes in healthcare software is also impacting the market positively. The market is further propelled by the rising awareness regarding care provision and a greater emphasis on household expenditures. Apart from this, several government initiatives to improve insurance coverage and the adoption of cloud-based technology-related services are creating lucrative opportunities for healthcare claims management solutions. Furthermore, numerous partnerships, mergers and acquisitions (M&As) and new product launches by the key market players are creating a positive market outlook. Some of the other factors contributing to the market include rapid urbanization, increasing medical expenditure, and extensive research and development (R&D) activities.

Key Market Segmentation:

IMARC Group provides an analysis of the key trends in each sub-segment of the global healthcare claims management market report, along with forecasts at the global, regional and country level from 2022-2027. Our report has categorized the market based on product, component, solution type, delivery mode and end user.

Breakup by Product:

  • Medical Billing
    • Professional
    • Institutional
  • Claims Processing
     

Breakup by Component:

  • Services
  • Software
     

Breakup by Solution Type:

  • Integrated Solutions
  • Standalone Solutions
     

Breakup by Delivery Mode:

  • On-premises
  • Cloud-based
  • Web-based
     

Breakup by End User:

  • Healthcare Payers
  • Healthcare Providers
  • Others
     

Breakup by Region:

  • North America
    • United States
    • Canada
  • Asia-Pacific
    • China
    • Japan
    • India
    • South Korea
    • Australia
    • Indonesia
    • Others
  • Europe
    • Germany
    • France
    • United Kingdom
    • Italy
    • Spain
    • Russia
    • Others
  • Latin America
    • Brazil
    • Mexico
    • Others
  • Middle East and Africa
     

Competitive Landscape:

The competitive landscape of the industry has also been examined along with the profiles of the key players being Accenture plc, Allscripts Healthcare Solutions Inc., Athenahealth, Carecloud Inc, Cognizant, Conifer Health Solutions (Tenet Healthcare Corporation), Mckesson Corporation, Optum Inc. (UnitedHealth Group Incorporated), Oracle Corporation, Plexis Healthcare Systems, Quest Diagnostics and The SSI Group LLC.

Report Coverage:

Report Features Details
Base Year of the Analysis 2021
    Historical Period 2016-2021
Forecast Period 2022-2027
Units US$ Billion
Segment Coverage Product, Component, Solution Type, Delivery Mode, End User, Region
Region Covered  Asia Pacific, Europe, North America, Latin America, Middle East and Africa
Countries Covered United States, Canada, Germany, France, United Kingdom, Italy, Spain, Russia, China, Japan, India, South Korea, Australia, Indonesia, Brazil, Mexico
Companies Covered Accenture plc, Allscripts Healthcare Solutions Inc., Athenahealth, Carecloud Inc, Cognizant, Conifer Health Solutions (Tenet Healthcare Corporation), Mckesson Corporation, Optum Inc. (UnitedHealth Group Incorporated), Oracle Corporation, Plexis Healthcare Systems, Quest Diagnostics and The SSI Group LLC.
Customization Scope 10% Free Customization
Report Price and Purchase Option Single User License: US$ 2499
Five User License: US$ 3499
Corporate License: US$ 4499
Post-Sale Analyst Support 10-12 Weeks
Delivery Format PDF and Excel through Email (We can also provide the editable version of the report in PPT/Word format on special request)

 

Key Questions Answered in This Report:

  • How has the global healthcare claims management market performed so far and how will it perform in the coming years?
  • What has been the impact of COVID-19 on the global healthcare claims management market?
  • What are the key regional markets?
  • What is the breakup of the market based on the product?
  • What is the breakup of the market based on the component?
  • What is the breakup of the market based on the solution type?
  • What is the breakup of the market based on the delivery mode?
  • What is the breakup of the market based on the end user?
  • What are the various stages in the value chain of the industry?
  • What are the key driving factors and challenges in the industry?
  • What is the structure of the global healthcare claims management market and who are the key players?
  • What is the degree of competition in the industry?

1    Preface
2    Scope and Methodology

    2.1    Objectives of the Study
    2.2    Stakeholders
    2.3    Data Sources
        2.3.1    Primary Sources
        2.3.2    Secondary Sources
    2.4    Market Estimation
        2.4.1    Bottom-Up Approach
        2.4.2    Top-Down Approach
    2.5    Forecasting Methodology
3    Executive Summary
4    Introduction

    4.1    Overview
    4.2    Key Industry Trends
5    Global Healthcare Claims Management Market
    5.1    Market Overview
    5.2    Market Performance
    5.3    Impact of COVID-19
    5.4    Market Forecast
6    Market Breakup by Product
    6.1    Medical Billing
        6.1.1 Market Trends
        6.1.2 Key Segments
           6.1.2.1 Professional
           6.1.2.2 Institutional
        6.1.3 Market Forecast
    6.2    Claims Processing
        6.2.1 Market Trends
        6.2.2 Market Forecast
7    Market Breakup by Component
    7.1    Services
        7.1.1 Market Trends
        7.1.2 Market Forecast
    7.2    Software
        7.2.1 Market Trends
        7.2.2 Market Forecast
8    Market Breakup by Solution Type
    8.1    Integrated Solutions
        8.1.1 Market Trends
        8.1.2 Market Forecast
    8.2    Standalone Solutions
        8.2.1 Market Trends
        8.2.2 Market Forecast
9    Market Breakup by Delivery Mode
    9.1    On-premises
        9.1.1 Market Trends
        9.1.2 Market Forecast
    9.2    Cloud-based
        9.2.1 Market Trends
        9.2.2 Market Forecast
    9.3    Web-based
        9.3.1 Market Trends
        9.3.2 Market Forecast
10    Market Breakup by End User
    10.1    Healthcare Payers
        10.1.1 Market Trends
        10.1.2 Market Forecast
    10.2    Healthcare Providers
        10.2.1 Market Trends
        10.2.2 Market Forecast
    10.3    Others
        10.3.1 Market Trends
        10.3.2 Market Forecast
11    Market Breakup by Region
    11.1    North America
        11.1.1 United States
           11.1.1.1 Market Trends
           11.1.1.2 Market Forecast
        11.1.2 Canada
           11.1.2.1 Market Trends
           11.1.2.2 Market Forecast
    11.2    Asia-Pacific
        11.2.1 China
           11.2.1.1 Market Trends
           11.2.1.2 Market Forecast
        11.2.2 Japan
           11.2.2.1 Market Trends
           11.2.2.2 Market Forecast
        11.2.3 India
           11.2.3.1 Market Trends
           11.2.3.2 Market Forecast
        11.2.4 South Korea
           11.2.4.1 Market Trends
           11.2.4.2 Market Forecast
        11.2.5 Australia
           11.2.5.1 Market Trends
           11.2.5.2 Market Forecast
        11.2.6 Indonesia
           11.2.6.1 Market Trends
           11.2.6.2 Market Forecast
        11.2.7 Others
           11.2.7.1 Market Trends
           11.2.7.2 Market Forecast
    11.3    Europe
        11.3.1 Germany
           11.3.1.1 Market Trends
           11.3.1.2 Market Forecast
        11.3.2 France
           11.3.2.1 Market Trends
           11.3.2.2 Market Forecast
        11.3.3 United Kingdom
           11.3.3.1 Market Trends
           11.3.3.2 Market Forecast
        11.3.4 Italy
           11.3.4.1 Market Trends
           11.3.4.2 Market Forecast
        11.3.5 Spain
           11.3.5.1 Market Trends
           11.3.5.2 Market Forecast
        11.3.6 Russia
           11.3.6.1 Market Trends
           11.3.6.2 Market Forecast
        11.3.7 Others
           11.3.7.1 Market Trends
           11.3.7.2 Market Forecast
    11.4    Latin America
        11.4.1 Brazil
           11.4.1.1 Market Trends
           11.4.1.2 Market Forecast
        11.4.2 Mexico
           11.4.2.1 Market Trends
           11.4.2.2 Market Forecast
        11.4.3 Others
           11.4.3.1 Market Trends
           11.4.3.2 Market Forecast
    11.5    Middle East and Africa
        11.5.1 Market Trends
        11.5.2 Market Breakup by Country
        11.5.3 Market Forecast
12    SWOT Analysis
    12.1    Overview
    12.2    Strengths
    12.3    Weaknesses
    12.4    Opportunities
    12.5    Threats
13    Value Chain Analysis
14    Porters Five Forces Analysis

    14.1    Overview
    14.2    Bargaining Power of Buyers
    14.3    Bargaining Power of Suppliers
    14.4    Degree of Competition
    14.5    Threat of New Entrants
    14.6    Threat of Substitutes
15    Price Analysis
16    Competitive Landscape

    16.1    Market Structure
    16.2    Key Players
    16.3    Profiles of Key Players
        16.3.1    Accenture plc
           16.3.1.1 Company Overview
           16.3.1.2 Product Portfolio
           16.3.1.3 Financials
           16.3.1.4 SWOT Analysis
        16.3.2    Allscripts Healthcare Solutions Inc.
           16.3.2.1 Company Overview
           16.3.2.2 Product Portfolio
           16.3.2.3 Financials
           16.3.2.4 SWOT Analysis
        16.3.3    Athenahealth
           16.3.3.1 Company Overview
           16.3.3.2 Product Portfolio
        16.3.4    Carecloud Inc
           16.3.4.1 Company Overview
           16.3.4.2 Product Portfolio
           16.3.4.3 Financials
        16.3.5    Cognizant
           16.3.5.1 Company Overview
           16.3.5.2 Product Portfolio
           16.3.5.3 Financials
           16.3.5.4 SWOT Analysis
        16.3.6    Conifer Health Solutions (Tenet Healthcare Corporation)
           16.3.6.1 Company Overview
           16.3.6.2 Product Portfolio
        16.3.7    Mckesson Corporation
           16.3.7.1 Company Overview
           16.3.7.2 Product Portfolio
           16.3.7.3 Financials
           16.3.7.4 SWOT Analysis
        16.3.8    Optum Inc. (UnitedHealth Group Incorporated)
           16.3.8.1 Company Overview
           16.3.8.2 Product Portfolio
        16.3.9    Oracle Corporation 
           16.3.9.1 Company Overview
           16.3.9.2 Product Portfolio
           16.3.9.3 Financials
           16.3.9.4 SWOT Analysis
        16.3.10    Plexis Healthcare Systems
           16.3.10.1 Company Overview
           16.3.10.2 Product Portfolio
        16.3.11    Quest Diagnostics
           16.3.11.1 Company Overview
           16.3.11.2 Product Portfolio
           16.3.11.3 Financials
           16.3.11.4 SWOT Analysis
        16.3.12    The SSI Group LLC
           16.3.12.1 Company Overview
           16.3.12.2 Product Portfolio

List of Figures

Figure 1: Global: Healthcare Claims Management Market: Major Drivers and Challenges
Figure 2: Global: Healthcare Claims Management Market: Sales Value (in Billion US$), 2016-2021
Figure 3: Global: Healthcare Claims Management Market Forecast: Sales Value (in Billion US$), 2022-2027
Figure 4: Global: Healthcare Claims Management Market: Breakup by Product (in %), 2021
Figure 5: Global: Healthcare Claims Management Market: Breakup by Component (in %), 2021
Figure 6: Global: Healthcare Claims Management Market: Breakup by Solution Type (in %), 2021
Figure 7: Global: Healthcare Claims Management Market: Breakup by Delivery Mode (in %), 2021
Figure 8: Global: Healthcare Claims Management Market: Breakup by End User (in %), 2021
Figure 9: Global: Healthcare Claims Management Market: Breakup by Region (in %), 2021
Figure 10: Global: Healthcare Claims Management (Medical Billing) Market: Sales Value (in Million US$), 2016 & 2021
Figure 11: Global: Healthcare Claims Management (Medical Billing) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 12: Global: Healthcare Claims Management (Claims Processing) Market: Sales Value (in Million US$), 2016 & 2021
Figure 13: Global: Healthcare Claims Management (Claims Processing) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 14: Global: Healthcare Claims Management (Services) Market: Sales Value (in Million US$), 2016 & 2021
Figure 15: Global: Healthcare Claims Management (Services) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 16: Global: Healthcare Claims Management (Software) Market: Sales Value (in Million US$), 2016 & 2021
Figure 17: Global: Healthcare Claims Management (Software) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 18: Global: Healthcare Claims Management (Integrated Solutions) Market: Sales Value (in Million US$), 2016 & 2021
Figure 19: Global: Healthcare Claims Management (Integrated Solutions) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 20: Global: Healthcare Claims Management (Standalone Solutions) Market: Sales Value (in Million US$), 2016 & 2021
Figure 21: Global: Healthcare Claims Management (Standalone Solutions) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 22: Global: Healthcare Claims Management (On-premises) Market: Sales Value (in Million US$), 2016 & 2021
Figure 23: Global: Healthcare Claims Management (On-premises) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 24: Global: Healthcare Claims Management (Cloud-based) Market: Sales Value (in Million US$), 2016 & 2021
Figure 25: Global: Healthcare Claims Management (Cloud-based) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 26: Global: Healthcare Claims Management (Web-based) Market: Sales Value (in Million US$), 2016 & 2021
Figure 27: Global: Healthcare Claims Management (Web-based) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 28: Global: Healthcare Claims Management (Healthcare Payers) Market: Sales Value (in Million US$), 2016 & 2021
Figure 29: Global: Healthcare Claims Management (Healthcare Payers) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 30: Global: Healthcare Claims Management (Healthcare Providers) Market: Sales Value (in Million US$), 2016 & 2021
Figure 31: Global: Healthcare Claims Management (Healthcare Providers) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 32: Global: Healthcare Claims Management (Other End Users) Market: Sales Value (in Million US$), 2016 & 2021
Figure 33: Global: Healthcare Claims Management (Other End Users) Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 34: North America: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 35: North America: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 36: United States: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 37: United States: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 38: Canada: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 39: Canada: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 40: Asia-Pacific: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 41: Asia-Pacific: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 42: China: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 43: China: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 44: Japan: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 45: Japan: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 46: India: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 47: India: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 48: South Korea: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 49: South Korea: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 50: Australia: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 51: Australia: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 52: Indonesia: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 53: Indonesia: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 54: Others: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 55: Others: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 56: Europe: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 57: Europe: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 58: Germany: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 59: Germany: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 60: France: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 61: France: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 62: United Kingdom: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 63: United Kingdom: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 64: Italy: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 65: Italy: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 66: Spain: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 67: Spain: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 68: Russia: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 69: Russia: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 70: Others: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 71: Others: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 72: Latin America: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 73: Latin America: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 74: Brazil: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 75: Brazil: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 76: Mexico: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 77: Mexico: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 78: Others: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 79: Others: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 80: Middle East and Africa: Healthcare Claims Management Market: Sales Value (in Million US$), 2016 & 2021
Figure 81: Middle East and Africa: Healthcare Claims Management Market: Breakup by Country (in %), 2021
Figure 82: Middle East and Africa: Healthcare Claims Management Market Forecast: Sales Value (in Million US$), 2022-2027
Figure 83: Global: Healthcare Claims Management Industry: SWOT Analysis
Figure 84: Global: Healthcare Claims Management Industry: Value Chain Analysis
Figure 85: Global: Healthcare Claims Management Industry: Porter's Five Forces Analysis

List of Tables

Table 1: Global: Healthcare Claims Management Market: Key Industry Highlights, 2021 and 2027
Table 2: Global: Healthcare Claims Management Market Forecast: Breakup by Product (in Million US$), 2022-2027
Table 3: Global: Healthcare Claims Management Market Forecast: Breakup by Component (in Million US$), 2022-2027
Table 4: Global: Healthcare Claims Management Market Forecast: Breakup by Solution Type (in Million US$), 2022-2027
Table 5: Global: Healthcare Claims Management Market Forecast: Breakup by Delivery Mode (in Million US$), 2022-2027
Table 6: Global: Healthcare Claims Management Market Forecast: Breakup by End User (in Million US$), 2022-2027
Table 7: Global: Healthcare Claims Management Market Forecast: Breakup by Region (in Million US$), 2022-2027
Table 8: Global: Healthcare Claims Management Market: Competitive Structure
Table 9: Global: Healthcare Claims Management Market: Key Players


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