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市场调查报告书
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1404743

美国医疗保健付款人 BPaaS（业务流程即服务）市场：按解决方案范围、按买方类型、按价值链流程、按买方规模、细分趋势分析报告：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个工作天内

价格

美国医疗保健付款人 BPaaS（业务流程即服务）市场成长与趋势：

Grand View Research, Inc.最新报告显示，到2030年，美国医疗支付业务流程即服务市场规模将达到96亿美元，2024年至2030年复合年增长率为5.62%。

BPaaS（业务流程即服务）合约是医疗保健付款人业务流程外包收益的重要贡献者，并且由于COVID-19 加速了向基于价值的护理的转变，这一比例正在增加。随着其扩张，这一比例可能会上升。

美国供应商产业对 BPaaS 的采用正在迅速成长。提供者已经存在了一段时间，但《平价医疗法案》使它们变得更加普遍和重要，使它们能够充分利用 BPaaS 机会。美国的医疗保健系统正在从按服务收费转向基于价值的护理模式，强调护理品质和患者治疗结果而不是提供的服务数量。医疗费用的不断增加给医疗保健系统带来了越来越大的压力，这使得基于价值的医疗保健服务在行业中的渗透率不断提高。 BPaaS 透过提供进阶分析和资料管理工具来帮助医疗保健组织提供基于价值的护理。

特定行业的监管合规性规定了不同行业的合规性要求。健康保险互通性与课责法案 (HIPAA)、经济和临床健康健康资讯科技 (HITECH) 以及支付卡产业资料安全标准 (PCI DSS) 均属于该法。在许多情况下，市场目前支持合规管理作为行政而非监管活动。 BPaaS 供应商将能够实施 BPaaS 解决方案，以弥合跨行业的合规差距并适应现有法规的变化，从而在整个预测期内提高采用率和行业成长。

美国BPO 市场报告：亮点

  • 根据解决方案涵盖范围，市场分为传统市场和同类最佳市场。由于服务成本低且客户满意度高，到 2023 年，传统 BPaaS 细分市场将占据最大市场占有率，超过 75%。
  • 按买家类型划分，到 2023 年，政府买家群体将占销售额的大部分，占比超过 73%。由于医疗成本管理资讯系统 (MMIS) 的模组化实施，政府保险公司历来是 BPaaS 的主要买家。
  • 到2023年，中小型支付者将占所有支付者的70%以上，显示出对BPaaS模式的更大偏好。就计划类型而言，Medicare Advantage 和託管医疗补助正在成为可行的商业案例，其中 MA 占据了很大的市场份额。
  • 在价值链流程中，护理管理等行政流程最有可能采用 BPaaS。然而，付款人越来越认识到 BPaaS 的潜力，不仅在降低医疗保健成本方面，而且在索赔管理、人口健康管理和会员参与等流程中也具有潜力。

目录

第一章调查方法和范围

第 2 章执行摘要

第三章 市场变数、趋势与范围

  • 市场体系展望
    • 母市场展望
    • 相关/附随市场展望
  • 市场动态
    • 市场驱动因素分析
    • 市场抑制因素分析
  • 商业环境分析工具
    • 波特五力分析
    • PESTLE分析
  • COVID-19 对美国医疗保健付款人 BPaaS（业务流程即服务）市场的影响
  • 法律规范

第四章美国医疗保健付款人 BPaaS（业务流程即服务）市场：解决方案涵盖范围估计和趋势分析

  • 2023 年和 2030 年美国医疗保健付款人 BPaaS（业务流程即服务）市场解决方案涵盖类型变化分析
  • 美国医疗保健付款人 BPaaS（业务流程即服务）市场：解决方案涵盖细分仪表板
  • 美国BPaaS
    • 传统BPaaS
    • 最好的双酚A

第五章美国医疗保健付款人BPaaS（业务流程即服务）市场：买家类型的估计与趋势分析

  • 2023 年和 2030 年美国医疗保健付款人 BPaaS（业务流程即服务）市场买家类型变化分析
  • 美国医疗保健付款人 BPaaS（业务流程即服务）市场：买方类型细分仪表板
  • 美国BPaaS
    • 政府采购人
    • 商业买家

第六章医疗保健付款人 BPaaS（业务流程即服务）市场：价值链流程估计与趋势分析

  • 2023 年和 2030 年美国医疗保健付款人 BPaaS（业务流程即服务）市场价值链流程变化分析
  • 美国医疗保健付款人 BPaaS（业务流程即服务）市场：价值链流程细分仪表板
  • 美国BPaaS
    • 理赔管理
    • 会员参与
    • 护理管理
    • 其他的

第7章美国医疗保健付款人BPaaS（业务流程即服务）市场：买家规模估计与趋势分析

  • 2023 年和 2030 年美国医疗保健支付市场的业务流程即服务 (BPaaS) 买家规模变化分析
  • 美国医疗保健付款人市场中的业务流程即服务 (BPaaS)：买家规模细分仪表板
  • 美国BPaaS
    • 小型买家
    • 中型买家
    • 大买家

第八章竞争分析

  • 参与企业
  • 公司市场分析
  • 策略规划
    • 新推出
    • 併购
    • 合伙
    • 合作
    • 其他的
  • 公司简介/名单
    • 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