Healthcare Payer BPO Market by Global Demand, Latest Technology and Outlook 2022-2030

The Global Healthcare Payer BPO Market size is estimated to be USD 24.29 billion in 2019 and is predicted to reach USD 67.94 billion by 2030 with a CAGR of 9.8% from 2020-2030.

Healthcare BPO is an exercise of outsourcing healthcare projects to the third party organizations by healthcare organizations such as payers, providers and other life science organizations. These services enable payers to increase efficiencies and outcomes, reduce risks and costs, and provide cost-effective services to its customers and contribute to the operating margin of the payers.

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Top Companies: Xerox Corporation, Genpact Limited, Capgemini, Hinduja Global Solutions, HCL Technologies Ltd, Condulent, Cognizant Technology Solutions, EXL Service Holdings Inc., and Wipro Limited and others.

Market Dynamics and Trends:

Healthcare payer BPO services mainly concentrates on the operational side of the payer business particularly focusing on improving the efficiency of the business process. Some of the key business processes that are highly targeted include claims processing, enrollments, contact center, and data entry. Currently, BPO services are being shifted from its traditional practices towards advancements, which help in facing the challenges related to strategic thinking and modern innovations. Adoption of these services has immensely increased the efficiency, and brought down the cost of the process for payers who mainly focus on cost arbitration. Payer BPO enables continued improvements by reducing claim overpayments, revenue leakages and improve turn around. Its applications for critical, consumer-centric services such as predictive analytics, and robotic process automation are opening new avenues in the industry growth.

Currently the healthcare industry is experiencing an increase in the healthcare cost. In order to reduce healthcare delivery costs, healthcare payers focus on implementing methods to increase health plans in increasing the member base, manage regulations, consolidate the healthcare systems, and manage regulatory compliance in the services. This is expected to the major driver for the healthcare payer BPO market. In addition to this, growing geriatric population, increasing disease burden and penetration of insurance coverage in emerging economies are some other factors fuelling the growth of this market. However, due to the uncertainty in health policies, payers continue to withdraw from health insurance exchanges due to increases losses borne by them. This is likely to restrain the market growth during the forecast period.

Changing dynamics of the healthcare industry has impacted the revenue growth of the companies operating in the healthcare BPO market. Some of the major payers are dominate this market based on their strong product and service offerings, and their large geographic presence. Companies such as Cognizant, Condulent, and DXC Technology adopt strategic alliances and partnerships to strengthen their industry position and gain maximum market share on the global level. Moreover, increasing investments in expanding the geographic reach creates a competitive environment, which in turn increases the market size of global healthcare payer BPO industry.

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Market Segmentations and Scope of the Study:

Global healthcare payer BPO market share is analysed on the basis of services, end user, and geography. On the basis of type of services, the market is segmented into claims processing services, integrated front-end services and back-office operations, member management, HR services, product development and business acquisition (PDBA), provider management, care management, and billing & accounts management services. By end user the market is segmented into healthcare private insurance companies, government agencies, and employers and private exchanges. The regional analysis of the healthcare payer BPO market comprises of North America, Europe, Asia Pacific, and Rest of the World.

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