Healthcare Reimbursement Market - Industry Analysis, Market Size, Share, Trends, Application Analysis, Growth And Forecast 2021-2026

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Healthcare Reimbursement Market Overview

The Healthcare Reimbursement Market size is forecast to reach $26.8 billion by 2026, growing at a CAGR of 11.8% during the forecast period 2021-2026. The payment received by hospitals, diagnostic facilities, doctors, and other healthcare providers to provide medical services to the patients is healthcare reimbursement. It is provided based on the quality, complexity, and quantity of healthcare service provided. Hospitals and physicians are paid based on the quality of their services provided and not on the volume. Growing healthcare burden and favourable regulatory policies are the major factors driving the growth of the market. Growing patient volume along with the increased cost of prescription medicine and persistent increase in the cost of healthcare are set to further enhance the overall market demand for the Healthcare Reimbursement Market for the period 2021-2026.

Report Coverage

The report: “Healthcare Reimbursement Market Forecast (2021-2026)”, by Industry ARC, covers an in-depth analysis of the following segments of the Healthcare Reimbursement Market.
By Claims: Underpaid, and Full Paid
By Payers: Private Payers, and Public Payers
By Service Providers: Physician Office, Hospitals, Diagnostic Laboratories, and Others
By Geography: North America (U.S., Canada, Mexico), Europe (Germany, United Kingdom (U.K.), France, Italy, Spain, Russia, and Rest of Europe), Asia Pacific (China, Japan India, South Korea, Australia and New Zealand, and Rest of APAC), South America (Brazil, Argentina, and Rest of South America), and Rest of the World (RoW) (Middle East, and Africa)

Key Takeaways

  • North America dominated the Healthcare Reimbursement Market in 2020 owing to the presence of a strong reimbursement framework and a large number of insurance players. The Healthcare Reimbursement Market scope for different regions will be provided in the final report.
  • An increase in the cost of healthcare and the rising prevalence of chronic diseases are likely to aid the market growth of the Healthcare Reimbursement Market.
  • Detailed analysis of the Strength, Weakness, and Opportunities of the prominent players operating in the market will be provided in the Healthcare Reimbursement Market report.
  • Fraud related to federal and state government health care programs is poised to create hurdles for the Healthcare Reimbursement Market.

Healthcare Reimbursement Market Segment Analysis – By Payers

Private players held the largest share in the Healthcare Reimbursement Market in 2020 and are estimated to grow at a CAGR 14.6% during the forecast period 2021-2026. This is attributed to the fact that a large number of private players are present in the market. Private health coverage is provided in the U.S. by more than 125 health insurance companies. In the U.S. Healthcare reform legislation intended to increase affordability according to the Affordable Care Act is effective since 2014. Incentives are provided for employers to provide health insurance and require people, who are not covered by government and employer insurance companies to purchase private health insurance. Private Payers is set to be the highest growing segment and is estimated to register the highest CAGR over the period 2021-2026.

Healthcare Reimbursement Market Segment Analysis – By Service Providers

Hospitals held the largest share in the Healthcare Reimbursement Market in 2020 and are estimated to grow at a CAGR 12.3% during the forecast period 2021-2026. This is attributed to the rising number of surgeries along with the increasing geriatric population, a large population generates more bargaining power by merging hospital segments to escalate reimbursement. Hospitals are paid based on diagnosis-related groups which represent a fixed amount for every hospital stay. They make a profit by treating a patient and spending less compared to the diagnosis-related group and when they spend more than it to treat patients, they lose money. Owing to the growing patient pool along with increasing government reforms about the adoption of advanced healthcare infrastructure is increasing the growth of the physician office. Physician Office is set to be the highest growing segment and is estimated to register the highest CAGR over the period 2021-2026. 

Healthcare Reimbursement Market Segment Analysis – By Geography

North America dominated the Healthcare Reimbursement Market with a major share of 56.8% in 2020. This is attributed to the presence of a strong reimbursement framework and a large number of insurance players. Rising chronic diseases, such as cardiovascular disease, respiratory diseases, and others are also increasing the growth of the market in this region.
However, Asia Pacific is estimated to grow at a higher CAGR during the forecast period 2021-2026 owing to the increase in private and public healthcare analytics and expenditure along with the high economic development and penetration of insurance services in rural and urban areas.

Healthcare Reimbursement Market Revenue Share, By Geography, 2020(%)



Healthcare Reimbursement Market Drivers

Innovations and Advancements in Technologies

Innovations and advancements in technologies are increasing the growth of the Healthcare Reimbursement Market. Online patient portals help electronic medical record especially to boost patient collections significantly and the portal allows a patient to access their account and pay a bill immediately and maintain their personal health record. Paying bills online not only cuts down on postage and envelopes but also saves both patient and provider money and preserves massive amounts of labor time. Real-time claims management processing is increasing owing to technological advancements. Thus, increasing the growth of the Healthcare Reimbursement Market during the forecast period 2021-2026.

Increasing Prevalence of Chronic Diseases

The increasing prevalence of chronic diseases is increasing the growth of the Healthcare Reimbursement Market. Chronic diseases affect 133 Million Americans that represent more than 40% of the total population of the country and is projected to grow to 157 Million, with 81 Million people having multiple conditions. Increasing cancer treatment awareness, routine medical check-ups, and advanced digital imaging techniques have enhanced the effectiveness and efficiencies of healthcare reimbursement solutions. Early detection of chronic diseases is possible owing to the easy integration with various imaging equipment and has applications in research and development activities. Healthcare Reimbursement is also boosted by medical tourism along with the gradual increase in demand for health insurance. Thus, increasing the growth of the Healthcare Reimbursement Market during the forecast period 2021-2026.

Healthcare Reimbursement Market Challenges

Fraud Related to Federal and State Government Health Care Program

Some of the factors that are set to impede the growth of the X-ray Systems Market are the fraud related to federal and state government healthcare programs. Complications owing to the presence of a complex framework and degraded quality of care being provided to patients is set to hinder the growth of the market.

Healthcare Reimbursement Market Landscape

Product launches, mergers and acquisitions, joint ventures, and R&D activities are key strategies adopted by players in the Healthcare Reimbursement Market. In 2020, the Healthcare Reimbursement Market share is consolidated by the top ten players present in the market. Healthcare Reimbursement Market, top 10 companies are United Health Group, Aviva, Alliance, CVS Health, BNP Paribas, Aetna, Nippon Life Insurance, Agile Health Insurance, Centern Corporation, and The Blue Cross Blue Shield Association among others.

Acquisitions/Product Launches

  • In September 2019, Nippon Life Insurance of Japan acquired 75 percent stake in Reliance Nippon Life Asset Management.
  • In March 2019, Centern Corporation acquired WellCare amounting to $17.3 Billion to establish premier organization providing government-sponsored healthcare programs.

Relevant Reports:

Report Code: HCR 1391
Report Code: HCR 0019

For more Lifesciences and Healthcare Market reports, please click here
1. Healthcare Reimbursement Market - Overview
    1.1 Definitions and Scope
2. Healthcare Reimbursement Market - Executive Summary
    2.1 Market Revenue and Key Trends by Company
    2.2 Key trends by Claims
    2.3 Key trends by Payers
    2.4 Key trends by Service Providers
    2.5 Key trends by Geography
3. Healthcare Reimbursement 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 Reimbursement 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 Reimbursement 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 Reimbursement 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 Reimbursement Market – Strategic Analysis
    7.1 Value Chain Analysis
    7.2 Opportunities Analysis
    7.3 Market Life Cycle
8. Healthcare Reimbursement Market – By Claims(Market Size –$Million/$Billion)
    8.1 Underpaid
    8.2 Full Paid
9. Healthcare Reimbursement Market – By Payers(Market Size –$Million/$Billion)
    9.1 Private Payers
    9.2 Public Payers
10. Healthcare Reimbursement Market – By Service Providers(Market Size –$Million/$Billion)
    10.1 Physician Office
    10.2 Hospitals
    10.3 Diagnostic Laboratories
    10.4 Others
11. Healthcare Reimbursement Market - By Geography(Market Size –$Million/$Billion)
    11.1 North America
        11.1.1 U.S.
        11.1.2 Mexico
        11.1.3 Canada
    11.2 Europe
        11.2.1 U.K.
        11.2.2 France
        11.2.3 Germany
        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 APAC
    11.4 South America
        11.4.1 Brazil
        11.4.2 Argentina
        11.4.3 Rest of South America
    11.5 Rest of the World
        11.5.1 Middle East
        11.5.2 Africa
12. Healthcare Reimbursement Market - Entropy
13. Healthcare Reimbursement 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 Reimbursement Market – Key Company List by Country Premium Premium
15. Healthcare Reimbursement 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
"*Financials for private companies would be provided on a best efforts basis”.

LIST OF TABLES

LIST OF FIGURES

1.US Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
2.Canada Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
3.Mexico Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
4.Brazil Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
5.Argentina Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
6.Peru Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
7.Colombia Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
8.Chile Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
9.Rest of South America Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
10.UK Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
11.Germany Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
12.France Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
13.Italy Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
14.Spain Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
15.Rest of Europe Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
16.China Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
17.India Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
18.Japan Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
19.South Korea Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
20.South Africa Healthcare Reimbursement Market Revenue, 2019-2024 ($M)
21.North America Healthcare Reimbursement By Application
22.South America Healthcare Reimbursement By Application
23.Europe Healthcare Reimbursement By Application
24.APAC Healthcare Reimbursement By Application
25.MENA Healthcare Reimbursement By Application