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市場調查報告書
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1404743

美國醫療保健付款人 BPaaS（業務流程即服務）市場：按解決方案範圍、按買方類型、按價值鏈流程、按買方規模、細分趨勢分析報告：2024-2030 年

U.S. Business Process As A Service In Healthcare Payers Market Size, Share & Trends Analysis Report By Solution Coverage (Traditional BPaaS, Best-of-breed BPaaS), By Buyer Type, By Value Chain Processes, By Buyer Size, & Segment Forecasts, 2024-2030
出版日期: | 出版商: Grand View Research | 英文 92 Pages | 商品交期: 2-10個工作天內

價格

美國醫療保健付款人 BPaaS（業務流程即服務）市場成長與趨勢：

Grand View Research, Inc.最新報告顯示，到2030年，美國醫療支付業務流程即服務市場規模將達到96億美元，2024年至2030年複合年成長率為5.62%。

BPaaS（業務流程即服務）合約是醫療保健付款人業務流程外包收益的重要貢獻者，並且由於COVID-19 加速了向基於價值的護理的轉變，這一比例正在增加。隨著其擴張，這一比例可能會上升。

美國供應商產業對 BPaaS 的採用正在迅速成長。提供者已經存在了一段時間，但《平價醫療法案》使它們變得更加普遍和重要，使它們能夠充分利用 BPaaS 機會。美國的醫療保健系統正在從按服務收費轉向基於價值的護理模式，強調護理品質和患者治療結果而不是提供的服務數量。醫療費用的不斷增加給醫療保健系統帶來了越來越大的壓力，這使得基於價值的醫療保健服務在行業中的滲透率不斷提高。 BPaaS 透過提供進階分析和資料管理工具來幫助醫療保健組織提供基於價值的護理。

特定行業的監管合規性規定了不同行業的合規性要求。健康保險互通性與課責法案 (HIPAA)、經濟和臨床健康健康資訊科技 (HITECH) 以及支付卡產業資料安全標準 (PCI DSS) 均屬於該法。在許多情況下，市場目前支持合規管理作為行政而非監管活動。 BPaaS 供應商將能夠實施 BPaaS 解決方案，以彌合跨行業的合規差距並適應現有法規的變化，從而在整個預測期內提高採用率和行業成長。

美國BPO 市場報告：亮點

  • 根據解決方案涵蓋範圍，市場分為傳統市場和同類最佳市場。由於服務成本低且客戶滿意度高，到 2023 年，傳統 BPaaS 細分市場將佔據最大市場佔有率，超過 75%。
  • 按買家類型分類，到 2023 年，政府買家群體將佔銷售額的大部分，佔比超過 73%。由於醫療成本管理資訊系統 (MMIS) 的模組化實施，政府保險公司歷來是 BPaaS 的主要買家。
  • 到2023年，中小型支付者將佔所有支付者的70%以上，顯示出對BPaaS模式的更大偏好。就計劃類型而言，Medicare Advantage 和託管醫療補助正在成為可行的商業案例，其中 MA 佔據了很大的市場佔有率。
  • 在價值鏈流程中，護理管理等行政流程最有可能採用 BPaaS。然而，付款人越來越認知到 BPaaS 的潛力，不僅在降低醫療保健成本方面，而且在索賠管理、人口健康管理和會員參與等流程中也具有潛力。

目錄

第1章調查方法和範圍

第 2 章執行摘要

第3章 市場變數、趨勢與範圍

  • 市場體系展望
    • 母市場展望
    • 相關/附隨市場展望
  • 市場動態
    • 市場促進因素分析
    • 市場抑制因素分析
  • 商業環境分析工具
    • 波特五力分析
    • PESTLE分析
  • COVID-19 對美國醫療保健付款人 BPaaS（業務流程即服務）市場的影響
  • 法律規範

第4章美國醫療保健付款人 BPaaS（業務流程即服務）市場：解決方案涵蓋範圍估計和趨勢分析

  • 2023 年和 2030 年美國醫療保健付款人 BPaaS（業務流程即服務）市場解決方案涵蓋類型變化分析
  • 美國醫療保健付款人 BPaaS（業務流程即服務）市場：解決方案涵蓋細分儀表板
  • 美國BPaaS
    • 傳統BPaaS
    • 最好的雙酚A

第5章美國醫療保健付款人BPaaS（業務流程即服務）市場：買家類型的估計與趨勢分析

  • 2023 年和 2030 年美國醫療保健付款人 BPaaS（業務流程即服務）市場買家類型變化分析
  • 美國醫療保健付款人 BPaaS（業務流程即服務）市場：買方類型細分儀表板
  • 美國BPaaS
    • 政府採購人
    • 商業買家

第6章醫療保健付款人 BPaaS（業務流程即服務）市場：價值鏈流程估計與趨勢分析

  • 2023 年和 2030 年美國醫療保健付款人 BPaaS（業務流程即服務）市場價值鏈流程變化分析
  • 美國醫療保健付款人 BPaaS（業務流程即服務）市場：價值鏈流程細分儀表板
  • 美國BPaaS
    • 理賠管理
    • 會員參與
    • 護理管理
    • 其他

第7章美國醫療保健付款人BPaaS（業務流程即服務）市場：買家規模估計與趨勢分析

  • 2023 年和 2030 年美國醫療保健支付市場的業務流程即服務 (BPaaS) 買家規模變化分析
  • 美國醫療保健付款人市場中的業務流程即服務 (BPaaS)：買家規模細分儀表板
  • 美國BPaaS
    • 小型買家
    • 中型買家
    • 大買家

第8章競爭分析

  • 參與企業
  • 公司市場分析
  • 策略規劃
    • 新推出
    • 併購
    • 合夥
    • 合作
    • 其他
  • 公司簡介/名單
    • Accenture
    • Cognizant
    • HCL Technologies Limited
    • IBM
    • Infosys Limited
    • NTT DATA Corporation
    • Optum
    • TATA Consultancy Services Limited
    • UST
    • Wipro
    • EXL
    • Softheon, Inc.
    • Genpact
    • Change Healthcare
    • Firstsource
    • Celegence
    • Highmark Health
Product Code: GVR-4-68039-988-7

U.S. Business Process As A Service in Healthcare Payers Market Growth & Trends:

The U.S. business process as a service in healthcare payers market size is expected to reach USD 9.6 billion by 2030, registering a CAGR of 5.62% from 2024 to 2030, according to a new report by Grand View Research, Inc. Business process as a service (BPaaS) engagements contributed significantly to healthcare payer business process outsourcing revenue, and this percentage is likely to rise as the market for payer BPaaS expands due to the move toward value-based care, which has been hastened by COVID-19.

The adoption of BPaaS in the U.S. providers industry is growing quickly. Although providers have been around for a while, the Affordable Care Act made them more common and significant, which makes them well-suited to take advantage of BPaaS opportunity. The U.S. healthcare system is shifting from a fee-for-service to a value-based care model, which emphasizes quality of care and patient outcomes over volume of services provided. Growing pressure on the health system as a result of a constant increase in healthcare costs is contributing to rising penetration of value-based healthcare services in industry. BPaaS can help in delivering value-based care by providing healthcare organizations access to advanced analytics and data management tools.

The industry-specific regulatory compliances specify a range of compliance requirements for various industrial verticals. Health Insurance Portability and Accountability Act (HIPAA), Health Information Technology for Economic and Clinical Health (HITECH), and Payment Card Industry Data Security Standard (PCI DSS) are a few legislations that have impacted industry. In many instances, the market now supports compliance management as an administrative activity rather than a regulatory one. BPaaS providers could implement BPaaS solutions that can bridge compliance gaps between verticals and adapt to changes in existing regulations, leading to industry's growth with a rise in adoption throughout the forecast period as all compliance adherence difficulties can be managed with their assistance.

U.S. Business Process As A Service In Healthcare Payers Market Report Highlights:

  • Based on solution coverage, the market has been segmented into traditional and best-of-breed. Traditional BPaaS segment has accounted for the largest market share of over 75% in 2023, owing to lower cost of service and higher customer satisfaction
  • Based on buyer type, the government buyers segment held the majority of revenue share of over 73% in 2023. Government insurance companies have historically been main buyers for BPaaS due to modular implementations of medicaid management information systems (MMIS)
  • Small and medium-sized payers make up more than 70% of all payers in 2023 and have shown a stronger preference for the BPaaS model. In terms of plan types, medicare advantage and managed Medicaid have emerged as viable business cases, with MA accounting for a significant share percentage of the market
  • Based on value chain processes, administrative processes such as care management have seen the most BPaaS adoption. Payers are, however, progressively becoming aware of BPaaS's potential in processes such as claims management, population health management, and member engagement as well as in reducing medical expenses

Table of Contents

Chapter 1 Methodology and Scope

  • 1.1 Market Segmentation & Scope
    • 1.1.1 Segment Definition
      • 1.1.1.1 Solution coverage
      • 1.1.1.2 Buyer type
      • 1.1.1.3 Value chain processes
      • 1.1.1.4 Buyer size
  • 1.2 Research Methodology
    • 1.2.1 Information procurement
      • 1.2.1.1 Purchased database
      • 1.2.1.2 GVR'S internal database
      • 1.2.1.3 Secondary sources
      • 1.2.1.4 Primary research
  • 1.3 Information or Data Analysis
    • 1.3.1 Data Analysis Models
  • 1.4 Market Formulation & Validation
  • 1.5 Model Details
  • 1.6 List of Secondary Sources
  • 1.7 List of Abbreviations
  • 1.8 Objectives
    • 1.8.1 Objective - 1
    • 1.8.2 Objective - 2
    • 1.8.3 Objective - 3

Chapter 2 Executive Summary

  • 2.1 Market Outlook
  • 2.2 Segment Snapshot
  • 2.3 Competitive Landscape

Chapter 3 Market Variables, Trends & Scope

  • 3.1 Market Lineage Outlook
    • 3.1.1 Parent Market Outlook
    • 3.1.2 Related/Ancillary Market Outlook
  • 3.2 Market Dynamics
    • 3.2.1 Market Driver Analysis
      • 3.2.1.1 Changing regulations
      • 3.2.1.2 Expanding healthcare consumerism
      • 3.2.1.3 Shift towards value-based healthcare
    • 3.2.2 Market Restraint Analysis
      • 3.2.2.1 Risk Concerns Regarding Data Security
      • 3.2.2.2 High costs
  • 3.3 Business Environment Analysis Tools
    • 3.3.1 Porter's Five Forces Analysis
    • 3.3.2 PESTLE Analysis
  • 3.4 Impact of COVID-19 on U.S. Business Process as a Service (BPaaS) in Healthcare Payer Market
  • 3.5 Regulatory Framework

Chapter 4 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Solution Coverage Estimates & Trend Analysis

  • 4.1 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Solution Coverage Type Movement Analysis, 2023 & 2030
  • 4.2 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Solution Coverage Segment Dashboard
  • 4.3 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Size & Forecast and Forecasts, By Solution Coverage (USD Billion)
    • 4.3.1 Traditional BPaaS
      • 4.3.1.1 Traditional BPaaS market, 2018 - 2030 (USD Billion)
      • 4.3.1.2 End-to-end traditional BPaaS
      • 4.3.1.2.1 End-to-end traditional BPaaS market, 2018 - 2030 (USD Billion)
      • 4.3.1.3 Process-specific traditional BPaaS
      • 4.3.1.3.1 Process-specific traditional BPaaS market, 2018 - 2030 (USD Billion)
    • 4.3.2 Best-of-Breed bpaas
      • 4.3.2.1 Best-of-breed bpaas market, 2018 - 2030 (USD Billion)
      • 4.3.2.2 End-to-end best-of-breed BPaaS
      • 4.3.2.2.1 End-to-end best-of-breed BPaaS market, 2018 - 2030 (USD Billion)
      • 4.3.2.3 Process-specific best-of-breed BPaaS
      • 4.3.2.3.1 Process-specific best-of-breed BPaaS market, 2018 - 2030 (USD Billion)

Chapter 5 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Buyer Type Estimates & Trend Analysis

  • 5.1 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Buyer Type Movement Analysis, 2023 & 2030
  • 5.2 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Buyer Type Segment Dashboard
  • 5.3 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Size & Forecast and Forecasts, By Buyer Type (USD Billion)
    • 5.3.1 Government buyers
      • 5.3.1.1 Government Buyers Market, 2018 - 2030 (USD Billion)
      • 5.3.1.2 Medicare advantage
      • 5.3.1.2.1 Medicare Advantage Market, 2018 - 2030 (USD Billion)
      • 5.3.1.3 Managed Medicaid
      • 5.3.1.3.1 Managed Medicaid market, 2018 - 2030 (USD Billion)
    • 5.3.2 Commerical buyers
      • 5.3.2.1 Commercial Buyers Market, 2018 - 2030 (USD Billion)
      • 5.3.2.2 Individual Health Plans
      • 5.3.2.2.1 Individual health plans market, 2018 - 2030 (USD Billion)
      • 5.3.2.3 Employer-sponsored health plan
      • 5.3.2.3.1 Employer sponsored health plan market, 2018 - 2030 (USD Billion)

Chapter 6 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Value Chain Processes Estimates & Trend Analysis

  • 6.1 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Value Chain Processes Movement Analysis, 2023 & 2030
  • 6.2 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Value Chain Processes Segment Dashboard
  • 6.3 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Size & Forecast and Forecasts, By Value Chain Processes (USD Billion)
    • 6.3.1 Claims Management
      • 6.3.1.1 Claims Management Market, 2018 - 2030 (USD Billion)
    • 6.3.2 Member engagement
      • 6.3.2.1 Member engagement market, 2018 - 2030 (USD Billion)
    • 6.3.3 Care management
      • 6.3.3.1 Care management market, 2018 - 2030 (USD Billion)
    • 6.3.4 Others
      • 6.3.4.1 Others market, 2018 - 2030 (USD Billion)

Chapter 7 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Buyer Size Estimates & Trend Analysis

  • 7.1 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Buyer Size Movement Analysis, 2023 & 2030
  • 7.2 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market: Buyer Size Segment Dashboard
  • 7.3 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market Size & Forecast and Forecasts, By Buyer Size (USD Billion)
    • 7.3.1 Small buyers
      • 7.3.1.1 Small Buyers Market, 2018 - 2030 (USD Billion)
    • 7.3.2 Mid-sized buyers
      • 7.3.2.1 Mid-sized buyers market, 2018 - 2030 (USD Billion)
    • 7.3.3 Large buyers
      • 7.3.3.1 Large Buyers Market, 2018 - 2030 (USD Billion)

Chapter 8 Competitive Analysis

  • 8.1 Participant Categorization
  • 8.2 Company Market Position Analysis
  • 8.3 Strategy Mapping
    • 8.3.1 New Launch
    • 8.3.2 Mergers & acquisition
    • 8.3.3 Partnerships
    • 8.3.4 Collaborations
    • 8.5.5 Others
  • 8.4 Company Profiles/ Listing
    • 8.4.1 Accenture
      • 8.4.1.1 Company overview
      • 8.4.1.2 Financial performance
      • 8.4.1.3 Product benchmarking
      • 8.4.1.4 Strategic initiatives
    • 8.4.2 Cognizant
      • 8.4.2.1 Company overview
      • 8.4.2.2 Financial performance
      • 8.4.2.3 Product benchmarking
      • 8.4.2.4 Strategic initiatives
    • 8.4.3 HCL Technologies Limited
      • 8.4.3.1 Company overview
      • 8.4.3.2 Financial performance
      • 8.4.3.3 Product benchmarking
      • 8.4.3.4 Strategic initiatives
    • 8.4.4 IBM
      • 8.4.4.1 Company overview
      • 8.4.4.2 Financial performance
      • 8.4.4.3 Product benchmarking
      • 8.4.4.4 Strategic initiatives
    • 8.4.5 Infosys Limited
      • 8.4.5.1 Company overview
      • 8.4.5.2 Financial performance
      • 8.4.5.3 Product benchmarking
      • 8.4.5.4 Strategic initiatives
    • 8.4.6 NTT DATA Corporation
      • 8.4.6.1 Company overview
      • 8.4.6.2 Financial performance
      • 8.4.6.3 Product benchmarking
      • 8.4.6.4 Strategic initiatives
    • 8.4.7 Optum
      • 8.4.7.1 Company overview
      • 8.4.7.2 Financial performance
      • 8.4.7.3 Product benchmarking
      • 8.4.7.4 Strategic initiatives
    • 8.4.8 TATA Consultancy Services Limited
      • 8.4.8.1 Company overview
      • 8.4.8.2 Financial performance
      • 8.4.8.3 Product benchmarking
      • 8.4.8.4 Strategic initiatives
    • 8.4.9 UST
      • 8.4.9.1 Company overview
      • 8.4.9.2 Financial performance
      • 8.4.9.3 Product benchmarking
      • 8.4.9.4 Strategic initiatives
    • 8.4.10 Wipro
      • 8.4.10.1 Company overview
      • 8.4.10.2 Financial performance
      • 8.4.10.3 Product benchmarking
      • 8.4.10.4 Strategic initiatives
    • 8.4.11 EXL
      • 8.4.11.1 Company overview
      • 8.4.11.2 Financial performance
      • 8.4.11.3 Product benchmarking
      • 8.4.11.4 Strategic initiatives
    • 8.4.12 Softheon, Inc.
      • 8.4.12.1 Company overview
      • 8.4.12.2 Financial performance
      • 8.4.12.3 Product benchmarking
      • 8.4.12.4 Strategic initiatives
    • 8.4.13 Genpact
      • 8.4.13.1 Company overview
      • 8.4.13.2 Financial performance
      • 8.4.13.3 Product benchmarking
      • 8.4.13.4 Strategic initiatives
    • 8.4.14 Change Healthcare
      • 8.4.14.1 Company overview
      • 8.4.14.2 Financial performance
      • 8.4.14.3 Product benchmarking
      • 8.4.14.4 Strategic initiatives
    • 8.4.15 Firstsource
      • 8.4.15.1 Company overview
      • 8.4.15.2 Financial performance
      • 8.4.15.3 Product benchmarking
      • 8.4.15.4 Strategic initiatives
    • 8.4.16 Celegence
      • 8.4.16.1 Company overview
      • 8.4.16.2 Financial performance
      • 8.4.16.3 Product benchmarking
      • 8.4.16.4 Strategic initiatives
    • 8.4.17 Highmark Health
      • 8.4.17.1 Company overview
      • 8.4.17.2 Financial performance
      • 8.4.17.3 Product benchmarking
      • 8.4.17.4 Strategic initiatives

List of Table

Table 1 List of secondary sources

Table 2 List of key companies

Table 3 U.S. Business Process as a Service (BPaaS) in healthcare payers market, by solution coverage, 2018 - 2030 (USD Billion)

Table 4 U.S. Business Process as a Service (BPaaS) in healthcare payers market, by traditional BPaaS, 2018 - 2030 (USD Billion)

Table 5 U.S. Business Process as a Service (BPaaS) in healthcare payers market, best-of-breed BPaaS, 2018 - 2030 (USD Billion)

Table 6 U.S. Business Process as a Service (BPaaS) in healthcare payers market, by buyer type, 2018 - 2030 (USD Billion)

Table 7 U.S. Business Process as a Service (BPaaS) in healthcare payers market, by commercial buyers, 2018 - 2030 (USD Billion)

Table 8 U.S. Business Process as a Service (BPaaS) in healthcare payers market, by value chain processes, 2018 - 2030 (USD Billion)

Table 9 U.S. Business Process as a Service (BPaaS) in Healthcare Payers Market, By Buyer Size, 2018 - 2030 (USD Billion)

List of Figures

  • Fig. 1 U.S. business process as a Service in healthcare payers segmentation
  • Fig. 2 Market research process
  • Fig. 3 Data triangulation techniques
  • Fig. 4 Primary research pattern
  • Fig. 5 Market research approaches
  • Fig. 6 Value chain-based sizing & forecasting
  • Fig. 7 QFD modeling for market share assessment
  • Fig. 8 Market formulation & validation
  • Fig. 9 Market snapshot
  • Fig. 10 Segment outlook
  • Fig. 11 Segment outlook
  • Fig. 12 Competitive landscape
  • Fig. 13 U.S. business process as a service in healthcare payers market lineage
  • Fig. 14 Parent market outlook
  • Fig. 15 Related market outlook
  • Fig. 16 U.S. Business process as a service in Healthcare payers market dynamics
  • Fig. 17 U.S. business process as a service in healthcare payers market: Porter's analysis
  • Fig. 18 U.S. business process as a service in healthcare payers market: PESTLE analysis
  • Fig. 19 U.S. business process as a service in healthcare payers market: Solution coverage movement share analysis, (USD Billion)
  • Fig. 20 U.S. business process as a service in healthcare payers market: Solution coverage segment dashboard
  • Fig. 21 Traditional BPaaS market, 2018 - 2030 (USD Billion)
  • Fig. 22 End-to-end traditional BPaaS market, 2018 - 2030 (USD Billion)
  • Fig. 23 Process specific traditional BPaaS market, 2018 - 2030 (USD Billion)
  • Fig. 24 Best-of-breed BPaaS market, 2018 - 2030 (USD Billion)
  • Fig. 25 End-to-end best-of-breed BPaaS market, 2018 - 2030 (USD Billion)
  • Fig. 26 Process specific best-of-breed BPaaS market, 2018 - 2030 (USD Billion)
  • Fig. 27 U.S. business process as a service in healthcare payers market: Buyer type movement share analysis, (USD Billion)
  • Fig. 28 U.S. business process as a service in healthcare payers market: Buyer type segment dashboard
  • Fig. 29 Government buyers market, 2018 - 2030 (USD Billion)
  • Fig. 30 Medicare advantage market, 2018 - 2030 (USD Billion )
  • Fig. 31 Managed Medicaid market, 2018 - 2030 (USD Billion )
  • Fig. 32 Commercial buyers market, 2018 - 2030 (USD Billion)
  • Fig. 33 Individual health plans market, 2018 - 2030 (USD Billion)
  • Fig. 34 Employer sponsored health plan market, 2018 - 2030 (USD Billion)
  • Fig. 35 U.S. business process as a service in healthcare payers market: Value chain process movement share analysis, (USD Billion)
  • Fig. 36 U.S. business process as a service in healthcare payers market: Value chain processes segment dashboard
  • Fig. 37 Claims management market, 2018 - 2030 (USD Billion)
  • Fig. 38 Member engagement market, 2018 - 2030 (USD Billion)
  • Fig. 39 Care management market, 2018 - 2030 (USD Billion)
  • Fig. 40 Others market, 2018 - 2030 (USD Billion)
  • Fig. 41 U.S. business process as a service in healthcare payers market: Buyer size movement share analysis, (USD Billion)
  • Fig. 42 U.S. business process as a service in healthcare payers market: Buyer size segment dashboard
  • Fig. 43 Small buyers market, 2018 - 2030 (USD Billion)
  • Fig. 44 Mid-sized buyers market, 2018 - 2030 (USD Billion)
  • Fig. 45 Large buyers market, 2018 - 2030 (USD Billion)
  • Fig. 46 Company/competition categorization
  • Fig. 47 Company market position analysis
  • Fig. 48 Strategy mapping
  • Fig. 49 Acquisition mapping