NEW YORK, Jan. 31, 2023 /PRNewswire/ -- As per Zion Market Research study, The global health care provider management market size was worth USD 3.10 billion in 2021 and is estimated to grow to USD 7.05 billion by 2028, with a compound annual growth rate (CAGR) of approximately 14.70 percent over the forecast period.
Health Care Provider Management Market: Overview
Health care providers may access patient status and results through prompt reporting thanks to the healthcare provider network management solution, which offers payers powerful analytics tools and nearly real-time transaction data. Providers can spot suspect reimbursement claims hidden among the billions of accurate ones using machine learning and real-time data. To administer care-management programs, clinicians can forecast hospitalization, readmission, and illness progression by monitoring patient information. Compared to searching numerous systems, the provider network management system saves companies time and money by integrating patient data such as treatment plans, lab test results, authorizations, and medical bills.
The system also has data storage and analysis tools, enabling service providers to spot potential growth areas. Payers can better control costs, collaborate more effectively with providers, and give members the knowledge they need to make wise medical decisions when they have fast access to reliable network data. Payer organizations are now required to efficiently manage their provider networks to lower operating costs while simultaneously enhancing benefit coverage and raising customer satisfaction levels. A provider network of management software has a high price. High-quality treatment costs are high, yet spending more money does not always equate to higher standards of care or greater health.
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Key Industry Insights & Findings of the Health Care Provider Management Market Reports:
- As per the analysis shared by our research analyst, the health care provider management market value will grow at a CAGR of 14.70% over the forecast period.
- In terms of revenue, the global health care provider management market size was valued at around USD 3.10 billion in 2021 and is projected to reach USD 7.05 billion by 2028.
- The growing technological advancements in the healthcare industry and customer satisfaction across the globe are the major factors driving the market's growth.
- By component, the software category dominated the market in 2021.
- By delivery mode, the on-premise delivery method category dominated the market in 2021.
- North America dominated the health care provider management market in 2021.
Zion Market Research published the latest report titled "Health Care Provider Management Market By Component (Services and Software), By Delivery Mode (On-premise Delivery Mode and Cloud-based Delivery Mode), By End User (Verticals and Service Providers), and By Region - Global and Regional Industry Overview, Market Intelligence, Comprehensive Analysis, Historical Data, and Forecasts 2022 - 2028." into their research database.
Industry Dynamics:
Health Care Provider Management Market: Growth Drivers
- Adoption of government regulations to drive market growth.
Payer organizations are now required to efficiently manage their provider networks to lower operating costs while simultaneously enhancing benefit coverage and raising customer satisfaction levels. This is made necessary by the implementation of healthcare mandates like the Patient Protection and Affordable Care Act (PPACA), which includes Medical Loss Ratio (MLR) and Administrative Loss Ratio (ALR). Payers are turning to provider network management due to strict federal regulations, increased workload due to an expanding customer base, and a growing demand to reduce operational and administrative costs.
Health Care Provider Management Market: Restraints
- Infrastructure issues in developing nations to hamper market expansion.
One of the main obstacles to the adoption of HCIT systems is cost. A provider of network management software has a high price. For provider network management systems, the cost of maintenance and software updates may exceed the cost of the software. Support and maintenance costs, which account for nearly 30% of the total cost of ownership, include software upgrades (in response to changing user requirements). Additionally, to enhance the effectiveness of provider network management systems, training for end users is required due to the absence of internal IT experience in the healthcare sector. The cost of owning these systems consequently rises as a result of this, which further restraints the market growth.
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Health Care Provider Management Market: Opportunities
- Sophisticated data analytics to offer market growth opportunities.
Payers encounter many difficulties in managing medical loss ratios and maintaining provider networks because of the changing nature of the healthcare sector. As a result, healthcare payers increasingly emphasize leveraging cutting-edge IT tools like data analytics. Payers must employ data analytics to retain current members and establish efficient care management systems emphasizing managing medical loss ratios. Payers can use analytics for propensity-score shaping, unbiased predictive modeling, clustering, and optimization. Several payers have started employing analytics tools to improve fact-based decision-making, extensively utilizing data, enabling statistical and quantitative analysis, and applying prediction models. This boosts efficiency in tasks like provider contracting.
Global Health Care Provider Management Market: Segmentation
- The global health care provider management market is segregated based on component, delivery mode, end user, and region.
Based on components, the market is divided into services and software. In the component segment of the healthcare provider network management market in 2021, provider network management platforms/software held the highest share. In terms of market share, the services segment is anticipated to dominate the worldwide healthcare provider network management market during the forecast period. The low cost of services in healthcare systems, as well as advancements in claims auto adjudication rates, operational efficacy, and provider relationships, are responsible for the huge proportion of this market. Internal services and external services are additional categories for the services section.
Based on delivery mode, the market is divided into on-premise delivery mode and cloud-based delivery mode. The on-premise delivery method segment dominated the healthcare provider network management market in 2021. On the other side, the segment for cloud-based delivery modes is anticipated to record the highest CAGR during the projected period. Fewer capital expenditures primarily drive the market for cloud-based solutions; operational costs are spent and increased scalability, flexibility, and affordability.
The market is divided into verticals and service providers based on the end user. In the health care provider management market's end-use sector, service providers held the lion's share in 2021. Services utilized by customers in both developed and developing countries are increasing considerably, though the software is also gaining traction.
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List of Key Players in Health Care Provider Management Market:
- Cognizant
- Change Healthcare
- Optum Inc. (A Part Of Unitedhealth Group)
- Ayasdi Inc
- Infosys Bpm Ltd.
- Atos Syntel Inc. (A Subsidiary Of Atos Se)
- Mphasis Limited
- Skygen Usa Llc.
- Evolent Health Inc.
- Osp Labs
- Hgs Ltd.
- Virtusa Corp
- Exl
- Vee Technologies
- Symplr
- Appian
- Virsys12 Llc. (A Salesforce Company)
- Inovalon
- Wipro Limited.
Key questions answered in this report:
- What are the growth rate forecast and market size for Health Care Provider Management Market?
- What are the key driving factors propelling the Health Care Provider Management Market forward?
- What are the most important companies in the Health Care Provider Management Market Industry?
- What segments does the Health Care Provider Management Market cover?
- How can I receive a free copy of the Health Care Provider Management Market sample report and company profiles?
Report Scope:
Report Attribute | Details |
Market size value in 2021 | USD 3.10 Billion |
Revenue forecast in 2030 | USD 7.05 Billion |
Growth Rate | CAGR of almost 14.70 % 2022-2030 |
Base Year | 2020 |
Historic Years | 2016 - 2021 |
Forecast Years | 2022 - 2030 |
Segments Covered | By Product Type, By Application, and By End Use |
Forecast Units | Value (USD Billion), and Volume (Units) |
Quantitative Units | Revenue in USD million/billion and CAGR from 2022 to 2030 |
Regions Covered | North America, Europe, Asia Pacific, Latin America, and Middle East & Africa, and Rest of World |
Countries Covered | U.S., Canada, Mexico, U.K., Germany, France, Italy, Spain, China, India, Japan, South Korea, Brazil, Argentina, GCC Countries, and South Africa, among others |
Companies Covered | Cognizant, Change Healthcare, Optum, Inc. (A Part Of Unitedhealth Group), Ayasdi, Inc, Infosys Bpm, Ltd., Atos Syntel Inc. (A Subsidiary Of Atos Se), Mphasis Limited, Skygen Usa, Llc., Evolent Health, Inc., Osp Labs, Hgs Ltd., Virtusa Corp, Exl, Vee Technologies, Symplr, Appian, Virsys12, Llc. (A Salesforce Company), Inovalon, Wipro Limited. |
Report Coverage | Market growth drivers, restraints, opportunities, Porter's five forces analysis, PEST analysis, value chain analysis, regulatory landscape, market attractiveness analysis by segments and region, company market share analysis, and COVID-19 impact analysis. |
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Recent Developments
- Change Healthcare bought the Prometheus analytics division in 2020, expanding its solution portfolio.
Regional Dominance:
- North America was the largest geographic market in 2021.
The health care provider management market is divided into geographic regions: North America, Latin America, Europe, Asia Pacific, Middle East, and Africa. North America dominated the geographic component of the health care provider management market. The Patient Protection and Affordable Act (PPACA) in the United States, the region's rapidly expanding IT sector, and the growing emphasis on lowering healthcare costs all contribute to the region's strong market growth. The market is predicted to grow due to rising innovation in healthcare expenses, service inquiries, patient care plans, growing attention to federal mandates in the U.S., and rising emphasis on enhancing the quality of care by effectively using payer reporting requirements. Due to the significance and need for healthcare in China, India, and Japan due to their enormous populations and geriatric populations with ailments, Asia Pacific is anticipated to see the quickest increase during the forecast period.
Global Health Care Provider Management Market is segmented as follows:
Health Care Provider Management Market: By Component Outlook (2022-2030)
- Services
- Software
Health Care Provider Management Market: By Delivery Mode Outlook (2022-2030)
- On-premise Delivery Mode
- Cloud-based Delivery Mode
Health Care Provider Management Market: By End User Outlook (2022-2030)
- Verticals
- Service Providers
Health Care Provider Management Market: By Region Outlook (2022-2030)
North America
- The U.S.
- Canada
Europe
- France
- The UK
- Spain
- Germany
- Italy
- Rest of Europe
Asia Pacific
- China
- Japan
- India
- South Korea
- Southeast Asia
- Rest of Asia Pacific
Latin America
- Brazil
- Mexico
- Rest of Latin America
Middle East & Africa
- GCC
- South Africa
- Rest of Middle East & Africa
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