Healthcare claims management process comprises of various tasks such as organization, billing, filling, updating, and processing of medical claims related to the diagnosis, treatment, and medication of patients. The healthcare claims management market is driven by factors such as improved focus on quality healthcare services and adoption of cloud-based technology related services. However, integration of claims management solutions, data breaches, loss of confidentiality, and lack of skilled IT professionals in healthcare are some of the factors restraining the growth of this market.
The global healthcare claims management market is currently dominated by many market players. The key players in the market are engaged in new product launches and strategic collaborations to strengthen its market position. For instance, IBM’s IPD Ultera for Disability Claims provides an integrated “disability claims management workbench”, specific to disability claims processing and without the need for a large-scale replacement project.
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Regional Analysis
The market in the Americas is expected to dominate the global healthcare claims management market during the forecast period owing to the of new and innovative treatments & technologies. Also, heavy inflow of investments by various government agencies to improve healthcare IT infrastructure is expected to create opportunities for healthcare claims management solutions providers. According to the National Health Expenditure Accounts (NHEA), U.S. health care spending grew 4.3 percent in 2016, reaching $3.3 trillion or $10,348 per person which accounted for 17.9 percent. Moreover, the increasing investment in the healthcare infrastructure and services in Asia-Pacific offers huge market potential for the players to grow in healthcare claims management solutions market. In addition, proactive government initiatives to spread awareness about the benefits of this technology among the masses have supplemented the market growth. The market in the Middle East & Africa is likely to account for the smallest share of the global healthcare claims management market. The market growth in this region can be attributed to the high cost of healthcare IT solutions.
Segmentation
The global healthcare claims management market has been segmented into component, delivery mode type and end-user.
The market, based on component, has been segmented into software and services.
The market, by delivery mode, has been segmented into on-premise and cloud based.
The market, by type, has been segmented into integrated and standalone.
The market, by end-user has been segmented into healthcare payers and providers.
Key Players
Some of the key players in the global healthcare claims management market are Cerner Corporation, McKesson Corporation, athenahealth, Inc., eClinicalWorks, Optum, Inc., Conifer Health Solutions, nThrive, Inc, Avaya Inc., Oracle Corporation, Infor Inc., Allscripts Healthcare Solutions, Inc., Accenture plc., IBM Corporation, Cognizant Technology Solutions Corporation and Genpact Limited.
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