Глобальный рынок управления претензиями в здравоохранении – тенденции отрасли и прогноз до 2030 года

 Анализ и размер рынка управления претензиями в здравоохранении

Старение населения является основной причиной этого во многих странах, все большая часть населения старше 65 лет, а распространенность хронических заболеваний растет по мере старения людей. Кроме того, экономика медицинского страхования изменилась. Средняя стоимость здравоохранения на душу населения во многих странах увеличилась с годовым темпом прироста более 4%. Первоначально страховые планы были разработаны для покрытия расходов на уход за пациентами с тяжелыми, острыми заболеваниями или травматическими повреждениями, но теперь они чаще покрывают предсказуемые риски (и расходы), связанные с хроническими заболеваниями. Кроме того, достижения в качестве здравоохранения (например, инновационные методы лечения, такие как генная терапия) часто приводят к лучшим результатам, но часто увеличивают расходы на здравоохранение.

По данным Data Bridge Market Research, рынок управления претензиями в сфере здравоохранения, объем которого в 2022 году составил 12,29 млрд долларов США, к 2030 году, как ожидается, достигнет 18,15 млрд долларов США при среднегодовом темпе роста 5,0% в прогнозируемый период с 2023 по 2030 год. Помимо информации о рыночных сценариях, таких как рыночная стоимость, темпы роста, сегментация, географический охват и основные игроки, рыночные отчеты, подготовленные Data Bridge Market Research, также включают в себя углубленный экспертный анализ, эпидемиологию пациентов, анализ воронки продаж, анализ ценообразования и нормативную базу.

Масштаб и сегментация рынка управления претензиями в здравоохранении  

Market Definition

Healthcare claims management is a process that includes tasks like organizing, billing, filling, updating, and processing medical claims related to patients' diagnoses, treatment, and medication. In other words, it is software that manages medical claims and reimbursement processes that is increasingly allowing healthcare providers to maximize their revenues through proper claim management. It is a two-way street between patients, healthcare providers, billing companies, and insurance providers.

Global Healthcare Claims Management Market Dynamics

Drivers

• Growing concerns about data privacy

Despite the market's expected growth, there are growing concerns about data privacy. As technology advances, modern technologies such as cloud, mobile, and next-generation databases are increasingly used to manage, store, and retrieve such claims data. These factors have combined to make healthcare data security a persistent concern for the entire healthcare industry. Rules and regulations governing healthcare data are constantly evolving to ensure patients have the data protection they require and deserve. These are certain factors that boost the growth of the market.

• Digitization of software

Healthcare providers and medical offices adopted digitization at a rapid rate. A lot of information about the patients who receive services each day is being gathered. An adequate system is required for health services to organize, manage, and carry out plans efficiently. The ‘Administrative Errors: Technical Series on Safer Primary Care 2016’ report published by the World Health Organization (WHO) estimated that about 5–50% of medical errors in primary care are administrative errors, further prompting the need for digitization. As a result, there is a growing need for medical billing software.

Opportunities

• Rising duplicate insurance claims

The use of software facilitates communication across various domains and subdomains of hospitals. The programme uses cutting-edge approaches to ensure seamless interoperability between insurance companies and hospitals while managing patient data and information about their treatment. The identical claims and a lack of transparency, the insurance firms reportedly reject about one out of every five claims. Thus, the use of advanced methodologies and interoperability between these domains of hospitals will aid in reducing the number of fraudulent claims, further boosting the market growth.

Restraints/Challenges

• Threat of cyber crimes

Concerns over the privacy of the patient's medical history and other personal information have grown as a result of the rise in cybercrime over the past few years. The Indiana Attorney General reported in 2015 that a cyberattack on the Indiana-based company Medical Informatics Engineering compromised the data of more than four million patients from 230 institutions (MIE). Malware, phishing, Man in the Middle attacks, Trojans, and other rising cyber threats are among those limiting market expansion to some extent.

This healthcare claims management market report provides details of new recent developments, trade regulations, import-export analysis, production analysis, value chain optimization, market share, impact of domestic and localized market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, strategic market growth analysis, market size, category market growths, application niches and dominance, product approvals, product launches, geographic expansions, technological innovations in the market. To gain more info on the healthcare claims management market contact Data Bridge Market Research for an Analyst Brief, our team will help you take an informed market decision to achieve market growth.

COVID-19 Impact on the Healthcare Claims Management Market

The pandemic of COVID-19 is expected to have a significant impact on market growth. Since the beginning of the pandemic, there has been tremendous pressure on claim management software developers and providers due to the large number of people becoming infected and then being admitted to hospitals. Claim denials have also increased as a result of the COVID-19 pandemic. COVID-19 had a positive impact on the market. During the COVID-19 pandemic, the general impairment of health for those with SARS-CoV-2 infection lead to increase in claim management solutions, as physiological impact of the pandemic increases the claims related to the healthcare.

Recent developments

• In February 2022, Health Edge and Citius Tech formed a strategic partnership to provide joint go-to-market implementation and consultation services for HealthEdge solutions in Core administration, care management, and payment integrity to health plans pursuing value-based care and streamlined operations.
• In December 2021, HealthEdge Software completed its previously announced acquisition of well frame Inc, a leading digital health management platform.

Global Healthcare Claims Management Market Scope

The healthcare claims management market is segmented on the basis of type, component, delivery mode and end user. The growth amongst these segments will help you analyze meagre growth segments in the industries and provide the users with a valuable market overview and market insights to help them make strategic decisions for identifying core market applications.

Type

• Integrated Solutions
• Standalone Solutions

 Component

• Services
• Software

 Delivery Mode

• On-Premise Delivery Mode
• Cloud-Based Delivery Mode

End User

• Healthcare Payers
• Healthcare Providers
• Others

Healthcare Claims Management Market Regional Analysis/Insights

The healthcare claims management market is analyzed and market size insights and trends are provided by country, type, component, delivery mode and end user as referenced above.

The countries covered in the healthcare claims management market report are U.S., Canada and Mexico in North America, Germany, France, U.K., Netherlands, Switzerland, Belgium, Russia, Italy, Spain, Turkey, Rest of Europe in Europe, China, Japan, India, South Korea, Singapore, Malaysia, Australia, Thailand, Indonesia, Philippines, Rest of Asia-Pacific (APAC) in the Asia-Pacific (APAC), Saudi Arabia, U.A.E, South Africa, Egypt, Israel, Rest of Middle East and Africa (MEA) as a part of Middle East and Africa (MEA), Brazil, Argentina and Rest of South America as part of South America.

North America dominates the healthcare claims management market because of the presence of well-developed healthcare infrastructure and favourable reimbursement policies in the region.

Asia-Pacific is expected to grow at the highest growth rate in the forecast period of 2023 to 2030 owing to the growing healthcare infrastructure.

The country section of the report also provides individual market impacting factors and changes in regulation in the market domestically that impacts the current and future trends of the market. Data points like down-stream and upstream value chain analysis, technical trends and porter's five forces analysis, case studies are some of the pointers used to forecast the market scenario for individual countries. Also, the presence and availability of global brands and their challenges faced due to large or scarce competition from local and domestic brands, impact of domestic tariffs and trade routes are considered while providing forecast analysis of the country data.

Healthcare Infrastructure Growth Installed base and New Technology Penetration

Рынок управления претензиями в здравоохранении также предоставляет вам подробный анализ рынка для каждой страны по росту расходов на здравоохранение на капитальное оборудование, установленной базы различных видов продуктов для рынка управления претензиями в здравоохранении, влияния технологий с использованием кривых линии жизни и изменений в сценариях регулирования здравоохранения и их влияния на рынок управления претензиями в здравоохранении. Данные доступны за исторический период 2011-2021 гг.

Конкурентная среда и анализ доли рынка управления претензиями в здравоохранении

Конкурентная среда рынка управления претензиями в здравоохранении содержит сведения по конкурентам. Включены сведения о компании, финансы компании, полученный доход, рыночный потенциал, инвестиции в исследования и разработки, новые рыночные инициативы, глобальное присутствие, производственные площадки и объекты, производственные мощности, сильные и слабые стороны компании, запуск продукта, широта и широта продукта, доминирование приложений. Приведенные выше данные относятся только к фокусу компаний, связанному с рынком управления претензиями в здравоохранении.

Некоторые из основных игроков, работающих на рынке управления претензиями в сфере здравоохранения:

• Athenahealth (США)
• Plexis Healthcare Systems Inc. (США)
• Cognizant (США)
• Оракул (США)
• Allscripts Healthcare LLC (США)
• nThrive Revenue Systems, LLC (США)
• eClinicalWorks (США)
• Context Healthcare Inc. (США)
• Optum, Inc. (США)
• Корпорация Mckesson (США)
• Системы DST (США)
• Ram Technologies Inc. (США)
• General Electric (США)
• Health Solutions Plus (HSP) (США)
• Conifer Health Solutions, LLC (США)
• Quest Diagnostics Incorporated (США)
• Gebbs Healthcare Solutions (Индия)
• SSI Group, LLC (США)

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