Healthcare BPO Market - Forecast(2021 - 2026)

Report Code: HCR 0496 Report Format: PDF + Excel (Delivery in 48 Hrs)

Healthcare BPO Market Overview 

Healthcare BPO Market size is valued at $ 258.14Bn by 2019 and is anticipated to grow at a CAGR of 6.15% during the forecast period 2020-2025. The Healthcare BPO Market growth rate is attributed to a rapid increase in clinical process outsourcing (CPO); implementation of PPACA compelled healthcare players to move toward outsourcing and fewer errors in several non-critical functions, like finance and accounting, customer care services, etc. in Healthcare BPO. The main purpose Healthcare Business Process Outsourcing (BPO) is a procedure that enriches resource allocation, boost financial performance, and increase the effectiveness of healthcare providers. Healthcare BPO services allow hospitals and medical professionals to deliver quality patient care. Apart from this, Healthcare Business Processing Outsourcing (BPO) offers customized solutions to the healthcare providers and payers to reduce the complexity of various tedious tasks involved at several stages of the workflow and establishment. These services are also helpful to enrich resource allocation, boost the financial performance of the company/organization, seek strategic growth support as well as reduce operational costs to maximize profit margins. Furthermore, from increasing patient inflow, rising demand for niche services and increasing healthcare spending to the increased government regulations to reduce the overall healthcare costs is anticipated to be a high impact-rendering driver for the growth of the healthcare BPO services industry over the forecast period 2020-2025.

Report Coverage

The report: “Healthcare BPO Market Forecast (2020-2025)”, by Industry ARC, covers an in-depth analysis of the following segments of the Healthcare BPO Market:

By Provider Service: Revenue Cycle Management, Patient Enrolment & Strategic Planning and Patient Care.
By Payer Service: Product Development and Business Acquisition (PDBA), Provider Management, Care Management, Integrated Front-end Services and Back-office Operations, Member Management, Billing & Accounts Management Services, HR Services and Claims Management.
By Pharmaceutical Services: Manufacturing Services, R&D Services and Non-clinical Services.
By Geography: North America, Europe, Asia-Pacific and RoW.

Key Takeaways

  • North America dominated the Healthcare BPO Market with a share of 38% in the year 2019.        
  • The factors such as increasing need for minimizing critical mistakes, increase the cost-saving, and rising number of recovery audits are amongst the major factor projected to impel growth of Healthcare BPO Market.
  • Growing demand for high-end healthcare facilities and multi-specialty hospitals, established medical and central lab infrastructure and training centers are the key factors owing to the growth in the segment during forecast period 2020-2025.

By Provider Services - Segment Analysis

Revenue Cycle Management segment held the largest share in the market over other Provider Services types owing to the decreasing reimbursements in the healthcare industry, reductions in the overall healthcare costs and increasing expenditure by the healthcare IT industry which can be attributed to the segmental revenue growth. Revenue cycle management (RCM) is applied by healthcare organizations to scale and manage the process of healthcare billing and reimbursements. It is done by improving the process of claims management, accelerating explanation of benefits (EOB) reconciliation, improving the quality of information, streamlining denial management, and by automating processes. The RCM solution manages the patient’s bills from entering the hospital to reimbursement of claims. Furthermore, most of hospitals are presently dependent on third-party providers for denial management service, as they lack the expert knowledge and time to manage the reimbursement process. Revenue cycle management market is highly fragmented and the market players are using various strategies such as new product launches, expansions, agreements, joint ventures, partnerships, acquisitions, and others to increase their footprints in this market which is anticipated to propel the market segmental growth in the forecast period 2020-2025.

By Pharmaceutical Services - Segment Analysis

On the basis of Pharmaceutical Services, non-clinical services segment held the major share of the market in terms of revenue and is poised to grow with a CAGR of 5.15%. The reason may be attributed to evolving technologies which acted as the major growth factor in the healthcare IT sector, high return on investment in healthcare IT sector and growth in adoption of innovative technologies. Non-clinical information services is a computer system that allows managing, storing, and rechecking large amount of medical information in hospitals such as details about treatment given to the patients, health history of patients, prescriptions and other specific remarks, related to patient. This entire information is electronically kept together for the present or future use, this system is also popular as hospital information system. Nonclinical support personnel also serve patients on the front lines of care. Their service interactions have a powerful influence on how patients perceive their entire care experience, including the all-important interactions with clinical staff. Furthermore, rising number of hospitals, advanced technology and supporting government initiative and rise in the use of healthcare IT solutions in outpatient care facilities is set to offer lucrative opportunities for the market growth.

By Geography - Segment Analysis

North America dominated the Healthcare BPO Market with a share of 38% in 2019. The application of Healthcare BPO has grown rapidly over the last few years owing to the increasing pressure on healthcare firms to reduce costs and change in regulatory systems in association to growing demands for IT cloud computing and big data in healthcare which continues to expand its market. The U.S. market is witnessed a growth for Healthcare BPO owing to the implication of Patient Protection and Affordable Care Act on March 23, 2010 which provides numerous rights and protections that make health coverage more fair and easy to understand, along with subsidies (through “premium tax credits” and “cost-sharing reductions”) to make it more affordable. And as some rights and protections apply to plans in the Health Insurance Marketplace or other individual insurance, whereas some applies to job-based plans and some to all health coverage with an access to approximately 35million U.S. citizens, so there is a rise in claims processing work which has led to large-scale outsourcing for the service payers. 
However, Asia-Pacific is anticipated to be the fastest-growing segment during the forecast period 2020-2025. Factors such as soaring research and development activities, favorable economic growth rate along with the growing healthcare expenditure in the region is set to encourage healthcare firms to invest more in technologies to simplify healthcare systems, which would thereby bolster the BPO market in this region.

Drivers – Healthcare BPO Market

  • Rise in Healthcare Insurance Seekers and Increasing Government Support 
With rise in the number of people seeking healthcare insurances, there is a pressure to cut various healthcare delivery costs, also there is a rise in consolidation of various healthcare system.  Moreover, increasing incidences of various cardiovascular diseases and the need for emergency health services there is a significant rise in the healthcare BPO market. Furthermore, with increasing support from government through investments in providing better quality treatment procedures, availability of skilled customer care service providers are considered as a Healthcare BPO key driver of the market during the forecast period 2020-2025. 

Challenges – Healthcare BPO Market

  • High cost of installation and outsourced process
The major challenge for the market is the high initial capital investment required for new production plant, R&D cost required adds additional cost for production of various Healthcare BPO and compliance of these Healthcare BPO products in a vast and heterogeneous market. The poor compliance is attributed to limited availability of skilled customer service providers which are anticipated to hamper growth of the global Healthcare BPO market; the main obstacle being the concerns in losing control over the large-scale outsourced process, doubts regarding service quality and threats regarding data security are amongst the factors hindering the market growth in the forecast period 2020-2025.

Healthcare BPO Industry Outlook

Product launches, mergers and acquisitions, joint ventures and geographical expansions are key strategies adopted by players in the Healthcare BPO Market. In 2019, Healthcare BPO Market share is fragmented by the top ten players present in the market. Healthcare BPO Market top 10 companies are Cognizant Technology Solutions, EXLService, Catalent, HCL, Conduent, Invensis, Infinit Healthcare, AGS Health Inc., Omega Healthcare, Pacific Ventures and others.

Acquisitions/Product Launches

  • In January 2019, Conduent Inc. declared that it acquired Health Solutions Plus, a major developer of healthcare payer administration solutions. The acquisition enables Conduent to better serve current and prospective commercial and government payer clients with core administration processing technology.
  • In March 2018, Cognizant Technology Solutions declared that it acquired Bolder Healthcare Solutions, a privately-held provider of revenue cycle management (RCM) solutions to hospitals, physician practices and other specialist healthcare organizations in the United States.

1. Healthcare BPO Market Overview
    1.1 Definitions and Scope
2. Healthcare BPO Market - Executive Summary
    2.1 Market Revenue and Key Trends by Company
    2.2 Key trends by Payer Service
    2.3 Key trends by Pharmaceutical Service
    2.4 Key trends by Geography
3. Healthcare BPO Market – Comparative Analysis
    3.1 Product Benchmarking – Key Companies
    3.2 Financial Analysis – Key Companies
    3.3 Market Value Split by Key Companies
    3.4 Patent Analysis – Key Companies
    3.5 Pricing Analysis
4. Healthcare BPO Market - Startup Companies Scenario (Premium)
    4.1 Key Startup Company Analysis by
        4.1.1 Investment
        4.1.2 Revenue
        4.1.3 Venture Capital and Funding Scenario
5. Healthcare BPO Market – Industry Market Entry Scenario Premium (Premium)
    5.1 Regulatory Framework Overview
    5.2 New Business and Ease of Doing business index
    5.3 Case Studies of Successful Ventures
6. Healthcare BPO Market Forces
    6.1 Market Drivers
    6.2 Market Constraints/Challenges
    6.3 Porters five force model
        6.3.1 Bargaining power of suppliers
        6.3.2 Bargaining powers of customers
        6.3.3 Threat of new entrants
        6.3.4 Rivalry among existing players
        6.3.5 Threat of substitutes 
7. Healthcare BPO Market – Strategic Analysis
    7.1 Value Chain Analysis
    7.2 Opportunities Analysis
    7.3 Market Life Cycle
8. Healthcare BPO Market – By Provider Service (Market Size –$Million/$Billion)
    8.1 Revenue Cycle Management
    8.2 Patient Enrolment & Strategic Planning
    8.3 Patient Care
        8.3.1 Medical Transcription
        8.3.2 Medical Imaging
        8.3.3 Device Monitoring
9. Healthcare BPO Market – By Payer Service (Market Size –$Million/$Billion)
    9.1 Product Development and Business Acquisition (PDBA)
    9.2 Provider Management
    9.3 Care Management
    9.4 Integrated Front-end Services and Back-office Operations
    9.5 Member Management
    9.6 Billing & Accounts Management Services
    9.7 HR Services
    9.8 Claims Management
        9.8.1 Claims Repricing
        9.8.2 Information Management Services
        9.8.3 Fraud Detection and Management
        9.8.4 Claims Investigation Services
        9.8.5 Claims Settlement Services
        9.8.6 Others
10. Healthcare BPO Market – By Pharmaceutical Service (Market Size –$Million/$Billion)
    10.1 Manufacturing Services
    10.2 R&D Services
    10.3 Non-clinical Services
        10.3.1 Sales & Marketing Services
   Marketing Services
   Performance Reporting
        10.3.2 Supply Chain Management and Logistics (SCML)
        10.3.3 Other Non-clinical Services
11. Healthcare BPO Market - By Geography (Market Size –$Million/$Billion)
    11.1 North America
        11.1.1 U.S.
        11.1.2 Canada
        11.1.3 Mexico
    11.2 Europe
        11.2.1 U.K.
        11.2.2 Germany
        11.2.3 France
        11.2.4 Italy
        11.2.5 Spain
        11.2.6 Rest of Europe
    11.3 Asia-Pacific
        11.3.1 China
        11.3.2 India
        11.3.3 Japan
        11.3.4 South Korea
        11.3.5 Australia & New Zealand
        11.3.6 Rest of Asia-Pacific
    11.4 Rest of the World
        11.4.1 Middle East
        11.4.2 Africa
        11.4.3 South America
12. Healthcare BPO Market - Entropy
13. Healthcare BPO Market – Industry/Segment Competition Landscape   (Premium) 
    13.1 Market Share Analysis
        13.1.1 Global Market Share – Key Companies
        13.1.2 Market Share by Region – Key companies
        13.1.3 Market Share by Countries – Key Companies
        13.1.4 Best Practices for Companies
14. Healthcare BPO Market – Key Company List by Country Premium (Premium)
15. Healthcare BPO Market Company Analysis
    15.1 Company 1
    15.2 Company 2
    15.3 Company 3
    15.4 Company 4
    15.5 Company 5
    15.6 Company 6
    15.7 Company 7
    15.8 Company 8
    15.9 Company 9
    15.10 Company 10 and more
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