Vietnam Healthcare Claims Management Market Size, Share, Trends and Forecast by Product, Component, Solution Type, Delivery Mode, End User, and Region, 2026-2034

Vietnam Healthcare Claims Management Market Overview:

The Vietnam healthcare claims management market size reached USD 72.04 Million in 2025. The market is projected to reach USD 134.81 Million by 2034, exhibiting a growth rate (CAGR) of 7.21% during 2026-2034. The market is driven by the government's ambitious digital transformation initiatives that are modernizing healthcare infrastructure and promoting electronic health records adoption. Moreover, the integration of artificial intelligence and automation technologies in insurance claims processing is enhancing operational efficiency and reducing processing times. Additionally, the expansion of universal health insurance coverage, with nearly 80 million people covered by mid-2025, is generating substantial claims volume and strengthening the Vietnam healthcare claims management market share.

Vietnam Healthcare Claims Management Market Trends:

Government-Driven Digital Healthcare Infrastructure Modernization and Electronic Health Records Adoption

The healthcare sector of Vietnam is undergoing a digital revolution because of the concerted governmental initiatives on the development of an interconnected healthcare ecosystem, which is modern and well-developed. The government has initiated a multi-faceted initiative to streamline the digitization of healthcare and boost the medical infrastructure of the nation with significant investments from the state. This plan shows the government's priorities in the establishment of effective claims management systems as the basis of sustainable financing of healthcare. It will facilitate the adoption of electronic health records in many public and private facilities that will be backed by a single national digital identification system. Additionally, hospitals nationwide are transitioning toward paperless operations and digital payment methods, reflecting a broader commitment to modernization. These reforms are transforming how healthcare claims are recorded, submitted, and processed, stimulating demand for advanced claims management technologies that integrate seamlessly with digital health records. The growing emphasis on standardized data exchange and interoperability is pushing providers and insurers to deploy intelligent platforms capable of real-time processing, automation, and secure digital connectivity.

Artificial Intelligence and Automation Integration in Insurance Claims Processing

The Vietnamese healthcare claims management landscape is being revolutionized by the rapid integration of artificial intelligence and automation technologies that are dramatically improving processing efficiency and accuracy. Healthcare payers and providers are increasingly deploying AI-powered solutions to automate labor-intensive tasks such as document scanning, data extraction, claims validation, and fraud detection, reducing manual intervention and processing times from days to hours or even minutes. Machine learning algorithms are being trained to identify patterns in claims data, flag anomalies, predict claim outcomes, and recommend optimal processing pathways, enabling claims adjusters to focus on complex cases requiring human judgment. The technology is particularly valuable in handling the diverse document types and formats that characterize Vietnam's healthcare system, where claims may originate from public hospitals, private clinics, and various specialized facilities, each with different documentation standards. In 2025, Vietnam achieved a significant milestone when the full digitalization of administrative procedures for medical licensing and certification was completed, with medical professionals now able to complete all processes online through the national licensing management system. This development demonstrates the country's broader commitment to digital transformation and creates a more conducive environment for AI-driven claims processing systems that rely on standardized digital workflows. Insurance companies that have implemented AI solutions are reporting substantial improvements in operational metrics, including faster claims turnaround times, reduced administrative costs, improved accuracy rates, and enhanced customer satisfaction. The competitive advantage offered by these technologies is driving widespread adoption across the industry, with both established insurers and new market entrants investing heavily in AI capabilities to differentiate their services and capture market share in Vietnam's rapidly growing health insurance sector.

Universal Health Insurance Coverage Expansion and Increased Claims Volume

The Vietnam healthcare claims management market growth is being significantly propelled by the government's systematic expansion of universal health insurance coverage, which is generating unprecedented volumes of healthcare claims requiring efficient processing and management systems. By the end of May 2025, Vietnam's insurance industry had provided health insurance coverage for nearly 80 million people, representing an increase of 8.59% compared to the same period in 2025, while the total amount paid for health insurance examination and treatment costs reached approximately VND 63,324 billion (around USD 2.64 billion), marking a substantial 15.59% increase year-over-year. These statistics reflect the substantial growth in both the insured population and healthcare utilization rates as more Vietnamese citizens gain access to insured healthcare services. The government has established ambitious targets to achieve over 95% health insurance coverage by 2026 and universal coverage by 2030, with plans to exempt citizens from basic hospital fees within the scope of health insurance benefits according to a phased roadmap. This expansion is fundamentally transforming Vietnam's healthcare financing landscape, shifting the burden from out-of-pocket payments to a predominantly insurance-based reimbursement system. As coverage expands to previously uninsured populations, including informal sector workers, rural residents, and vulnerable groups receiving government subsidies for premium payments, the diversity and complexity of claims are increasing substantially. Healthcare providers are experiencing dramatic increases in insured patient volumes, requiring robust claims management systems capable of handling high transaction volumes while ensuring accurate reimbursement from multiple payer types, including social health insurance, private insurers, and government programs. The increasing sophistication of health insurance products, with varied benefit packages, co-payment structures, and coverage limitations, demands claims management solutions with advanced rules engines capable of accurately adjudicating claims according to policy terms while maintaining processing speed and efficiency.

Vietnam Healthcare Claims Management Market Segmentation:

IMARC Group provides an analysis of the key trends in each segment of the market, along with forecasts at the country and regional levels for 2026-2034. Our report has categorized the market based on product, component, solution type, delivery mode, and end user.

Product Insights:

• Medical Billing
  • Professional
  • Institutional
• Claims Processing

The report has provided a detailed breakup and analysis of the market based on the product. This includes medical billing (professional and institutional) and claims processing.

Component Insights:

• Services
• Software

A detailed breakup and analysis of the market based on the component have also been provided in the report. This includes services and software.

Solution Type Insights:

• Integrated Solutions
• Standalone Solutions

The report has provided a detailed breakup and analysis of the market based on the solution type. This includes integrated solutions and standalone solutions.

Delivery Mode Insights:

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

A detailed breakup and analysis of the market based on the delivery mode have also been provided in the report. This includes on-premises, cloud-based, and web-based.

End User Insights:

• Healthcare Payers
• Healthcare Providers
• Others

The report has provided a detailed breakup and analysis of the market based on the end user. This includes healthcare payers, healthcare providers, and others.

Regional Insights:

• Northern Vietnam
• Central Vietnam
• Southern Vietnam

The report has also provided a comprehensive analysis of all the major regional markets, which include Northern Vietnam, Central Vietnam, and Southern Vietnam.

Competitive Landscape:

The market research report has also provided a comprehensive analysis of the competitive landscape. Competitive analysis such as market structure, key player positioning, top winning strategies, competitive dashboard, and company evaluation quadrant has been covered in the report. Also, detailed profiles of all major companies have been provided.

Vietnam Healthcare Claims Management Market Report Coverage:

Key Questions Answered in This Report:

• How has the Vietnam healthcare claims management market performed so far and how will it perform in the coming years?
• What is the breakup of the Vietnam healthcare claims management market on the basis of product?
• What is the breakup of the Vietnam healthcare claims management market on the basis of component?
• What is the breakup of the Vietnam healthcare claims management market on the basis of solution type?
• What is the breakup of the Vietnam healthcare claims management market on the basis of delivery mode?
• What is the breakup of the Vietnam healthcare claims management market on the basis of end user?
• What is the breakup of the Vietnam healthcare claims management market on the basis of region?
• What are the various stages in the value chain of the Vietnam healthcare claims management market?
• What are the key driving factors and challenges in the Vietnam healthcare claims management market?
• What is the structure of the Vietnam healthcare claims management market and who are the key players?
• What is the degree of competition in the Vietnam healthcare claims management market?

Key Benefits for Stakeholders:

• IMARC's industry report offers a comprehensive quantitative analysis of various market segments, historical and current market trends, market forecasts, and dynamics of the Vietnam healthcare claims management market from 2020-2034.
• The research report provides the latest information on the market drivers, challenges, and opportunities in the Vietnam healthcare claims management market.
• Porter's five forces analysis assist stakeholders in assessing the impact of new entrants, competitive rivalry, supplier power, buyer power, and the threat of substitution. It helps stakeholders to analyze the level of competition within the Vietnam healthcare claims management industry and its attractiveness.
• Competitive landscape allows stakeholders to understand their competitive environment and provides an insight into the current positions of key players in the market.