The "Global Healthcare Claims Management Market Size, Share & Trends Analysis Report by Product (Medical Billing, Claims Processing), by Component, by Solution Type, by Deployment Mode, by End-use, and Segment Forecasts, 2022-2030" report has been added to ResearchAndMarkets.com's offering.
The global healthcare claims management market size is expected to reach USD 136.67 billion by 2030. It is expected to expand at a CAGR of 23.4% from 2022 to 2030.
Companies Mentioned
- Mckesson Corporation
- The SSI Group, Inc
- Quest Diagnostics
- Kareo
- Optum, Inc (A Subsidiary Of Unitedhealth Group)
- Conifer Health Solutions
- Carecloud
- Eclinicalworks
- IBM
- Cerner Corporation
The rising complexity of claims administration and the medical billing process is one of the most immediate concerns confronting health insurance companies and other private payers.
The capacity to digitize every stage of the claims process, implying process improvement, from data entry to claims management and billing processing, holds enormous promise for increasing medical billing and claims management efficiency and accuracy. When done correctly, the end result may be cheaper expenses and a better customer experience. Thus, improvements to the overall healthcare organization's process are expected to propel the industry growth.
Furthermore, the growing importance of denial management is expected to further boost the industry growth. According to a Kaiser Family Foundation recent analysis, around 17% of in-network claims were refused across HealthCare.gov issuers in 2019 and approximately 14% were denied in 2018. Specific issuer rates differed greatly from these averages. As a result, financial strategists who are truly focused on the transition from volume to value undervalue it. This is a mistake since dealing with rejections is as important now as it was decades ago.
The global COVID-19 pandemic has had a mixed impact on the overall market. Furthermore, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was designed in developed countries such as the U.S. to provide healthcare resources required to combat COVID-19. The CARES Act incorporated medical billing rules, which resulted in an increase in claim denials and their management. This will further boost the overall market for medical billing and healthcare claims management.
Despite the expected rise in the market, there have been rising concerns in terms of data privacy. For instance, modern technologies such as cloud, mobile, and next-generation databases are increasingly being used to manage, store, and retrieve such claims data as technology advances. These elements have conspired to form healthcare data security an ongoing concern for the overall healthcare industry. To guarantee that patients have the data protection they need and deserve, rules and regulations governing healthcare data are always evolving.
Due to the clear nascent nature of technology innovation in the medical billing and claims processing market, share is widely distributed across various competitors. This is bolstered by the fact that a large number of businesses have joined the market due to the minimum capital requirements for establishing and maintaining technological infrastructure. However, there has been a reduced risk of entry to some extent due to the complexity in the healthcare medical billing and claims processing market dynamics.
Key Topics Covered:
Chapter 1 Research Methodology & Scope
Chapter 2 Executive Summary
Chapter 3 Healthcare Claims Management Market Variables, Trends & Scope
3.1 Market Lineage Outlook
3.1.1 Parent Market Analysis
3.1.2 Ancillary Market Analysis
3.1.3 Penetration & Growth Prospect Mapping
3.2 Healthcare Claims Management Market Dynamics
3.2.1 Market Driver Analysis
3.2.1.1 Improvements To The Overall Healthcare Organizations Process
3.2.1.2 Growing Importance Of Denials Management
3.2.1.3 Increasing Patient Volumes And Health Insurance
3.2.2 Market Restraints Analysis
3.2.2.1 Growing Concerns Around Patient Data Privacy And Security
3.2.3 Unmet Needs/Opportunity Analysis
3.2.3.1 Innovative New Vendors/Suppliers
3.3 Healthcare Claims Management Market Analysis Tools: Porter's Five Forces Analysis
3.4 Pestel Analysis
3.5 Regulatory Framework
3.5.1 Data Privacy-Related Compliance And Standards
3.5.2 Insurance-Related Regulations In Some Of The Prominent Markets (As These Are Directly Associated With Claims)
3.6 The U.S. Claims Denials And Appeals Data For 2019, By Issuer
3.7 Competitor Product Price-Based Analysis
Chapter 4 Healthcare Claims Management Market: Covid-19 Impact
4.1 Covid-19 Impact Analysis
4.1.1 Current And Future Impact Analysis
4.1.2 Impact Of Covid-19 On Market Players
Chapter 5 Healthcare Claims Management Market: Product Estimates & Trend Analysis
Chapter 6 Healthcare Claims Management Market: Component Estimates & Trend Analysis
Chapter 7 Healthcare Claims Management Market: Solution Type Estimates & Trend Analysis
Chapter 8 Healthcare Claims Management Market: Deployment Mode Estimates & Trend Analysis
Chapter 9 Healthcare Claims Management Market: End-Use Estimates & Trend Analysis
Chapter 10 Healthcare Claims Management Market: Regional Estimates & Trend Analysis, By Product, Component, Solution Type, Deployment Mode, And End-Use
Chapter 11 Competitive Landscape
11.1 Market Participation Categorization
11.2 Companies
11.2.1 Company Market Position Analysis
11.2.2 Major Deals & Strategic Alliances
11.2.3 Detailed List Of Players
Chapter 12 Company Profile
For more information about this report visit https://www.researchandmarkets.com/r/650mc8
View source version on businesswire.com: https://www.businesswire.com/news/home/20220830005756/en/
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