Healthcare Claims Management Market Size Worth USD 20.1 Billion by 2030 at 4.5% CAGR - Report by Market Research Future (MRFR)

Healthcare Claims Management Market Trends and Insights by Component (Software and Services), Delivery Mode (On-Premise and Cloud Based), Type (Integrated and Standalone), and by End-User (Healthcare Payers and Providers), Competitive Market Growth, Size, Share and Forecast to 2030


New York, USA, Aug. 25, 2022 (GLOBE NEWSWIRE) -- Healthcare Claims Management Market Overview

According to a Comprehensive Research Report by Market Research Future (MRFR), “Healthcare Claims Management Market Information by Component, Delivery Mode, Type, End-User, and Region - Forecast till 2030”, the market will reach USD 20.1 billion by 2030, and attain a CAGR of 4.5% between 2022-2030.

Healthcare Claims Management Market Scope

Healthcare claims management refers to the process involving multiple tasks including organization, billing, filing, processing, and updating of medical claims associated with diagnosis, medication, and treatment of patients. Healthcare claims management software helps manage medical claims as well as reimbursement processes within the healthcare industry.

Following the COVID-19 outbreak, healthcare claims management software is being used for implementing epidemiological prevention and handling strategies, which has helped reduce the pressure on healthcare facilities worldwide.

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Report Scope:

Report AttributeDetails
2030 Market SizeUSD 20.1 Billion
CAGR4.5%
Base Year2021
Forecast Period2022-2030
Historical Data2020
Forecast UnitsValue (USD Billion)
Report CoverageRevenue Forecast, Competitive Landscape, Growth Factors, and Trends
Segments CoveredBy Component, Delivery Mode, Type and End User
Geographies CoveredNorth America, Europe, Asia-Pacific, and Rest of the World (RoW)
Key Market DriversRising rate of adoption of cloud-based technology-related services
Improved degree of focus on quality healthcare services being provided to the target audience

Healthcare Claims Management Market Competitive Landscape:

The important vendors in the healthcare claims management industry are

  • Cerner Corporation (US)
  • McKesson Corporation (US)
  • Athenahealth (US)
  • eClinicalWorks (US)
  • Optum Inc. (US)
  • Conifer Health Solutions (US)
  • nThrive (US)
  • Avaya Inc. (US)
  • Oracle Corporation (US)
  • Infor Inc. (US)
  • Allscripts Healthcare Solutions Inc. (US)
  • Accenture plc. (Ireland)
  • IBM Corporation (US)
  • Cognizant Technology Solutions Corporation (US)
  • Genpact Limited (US)

Healthcare Claims Management Market USP Covered:

Market Drivers:

Technological innovations pertinent to healthcare solutions and software along with the escalating demand for automation in healthcare can translate into considerable demand for healthcare claims management in the ensuing years. The surge in R&D and the notable rise in chronic and infectious conditions worldwide means significant medical data and records, which should heighten market demand. Huge funding from governments to improve the quality of healthcare services, and enhance healthcare infrastructure should further ensure sustained growth of the healthcare claims management market.

Collaborations, acquisitions, product launches, and approvals along with partnerships between the top companies have a strong influence on the worldwide market. Besides, the massive increase in patient volumes, the burgeoning health insurance sector, heightened significance of denials management, and the decline in reimbursement rates should also be favorable.

Rise in the automation trend in the healthcare industry, technological innovations, and the rise in R&D expenditure are a few growth-inducing factors as well.

Market Restraints:

Soaring concerns with regard to patient data security and safety in line with the surge in cybercrimes will challenge the healthcare claims management software developers in the years to come.

The National Health Insurer Report Card’s report of 2011 reveals that nearly USD 20 billion annually can be saved with the prevention of errors and potential cyberattacks in claims.

Healthcare Claims Management Market COVID 19 Analysis

The COVID-19 outbreak as well as the subsequent lockdown has had a brutal effect on the healthcare industry, considering the shutdown of production units and the travel restrictions. The immense pressure on the healthcare sector in view of the expanding patient base suffering from SARS-CoV-2 should be favorable for the healthcare claims management market. The mounting number of patients in line with the declining number of surgeons and medical professionals should further foster the demand for laboratory information systems.

Also, with the lockdown being lifted up across various nations and the prime focus on finding a vaccine for novel coronavirus, laboratory information system developers are now seeing improvements in their business. This will translate into a quicker recovery for the worldwide market in the following years.

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Healthcare Claims Management Market Segmentation

By Market Components

The healthcare claims management industry, depending on components, covers software as well as services.

Healthcare claims management software is a huge market, as the software helps streamline the entire process of medical claims, easing the relationship between the insurance company and the provider. The software’s use helps speed up the complete payment lifecycle of the patient.

By Delivery Mode

The market for healthcare claims management, with respect to delivery mode, includes on-premise along with cloud-based modes.

The cloud-based delivery mode is the top segment and will achieve the fastest growth rate between 2021 and 2028. The cloud-based mode of delivery enjoys considerable demand owing to the relatively lower operational costs coupled with the provision of better flexibility, affordability, and scalability.

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By Type

The types of healthcare claims management software in the market are integrated as well as standalone.

The integrated solutions segment can expect the highest CAGR in the future, thanks to the mounting demand for these solutions, as these enhance the process’s efficiency and bring down costs.

By End-User

The end-users in the market are healthcare payers as well as providers.

Healthcare Claims Management Market Regional Insights

North America holds the biggest healthcare claims management software market, with the region expected to retain its leadership throughout the given period. The region accommodates some of the renowned players that offer highly advanced healthcare systems and solutions. Also, the mushrooming aging population prone to numerous medical conditions along with the surging cases of COVID -19 fosters the need for healthcare claims management software.

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The Asia Pacific is yet another prominent market for healthcare claims management, on account of the mounting awareness regarding medical claims. India and China are the biggest achievers in the regional market, where the healthcare claims management software notes the highest demand. The strong demand is owing to the surging population and the considerable increase in the number of patients affected by various diseases and disorders. The significant economic growth in China and India has resulted in massive improvement of the healthcare infrastructure along with advances in healthcare IT systems. Healthcare companies are forming alliance with pharmaceutical firms as well as biotech labs for the development of new strategies.  

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