Healthcare BPO Market by Payer Services (Claims Management Services [Claims Adjudication Services, Claims Settlement Services, Information Management Services, Claims Repricing, Claims Investigation Services, Claims Indexing Services, Fraud Detection and Management], Integrated Front Office and Back Office Operations, Member Management, Product Development and Business Acquisition Services, Provider Management Services, Care Management, Billing and Accounts Management Services,), Provider Services (Revenue Cycle Management, Patient Enrolmen

Global Healthcare BPO Market Overview

Healthcare BPO Market size was valued at USD 0.11 billion in 2023. The Healthcare BPO Market industry is projected to grow from USD 0.12 billion in 2024 to USD 0.28 billion by 2032, exhibiting a compound annual growth rate (CAGR) of 10.01% during the forecast period (2024 - 2032).

The factors that are driving the growth of the global market are regulatory changes- implementation of PPACA and HIPAA and pressure to reduce rising healthcare costs.

Source: Secondary Research, Primary Research, MRFR Database and Analyst Review

Healthcare BPO Market Trends

Increasing consolidation in the healthcare industry

Globalization and the spread of favorable trade between different countries further boosts market growth. Increasing consolidation of BPO in healthcare industry is expected to boost the market growth. Consolidation of healthcare BPO industry resulted in rising outsourcing activities and intercontinental migration, which have a positive impact on the market growth.

There is an escalating demand for skilled workforce from developing countries such as China & India. The leading American & European companies can outsource BPO services at a lower cost from the companies based in developing regions at a much lower cost than developed countries.

Moreover, BPO services including claims management, member management, provider management, revenue cycle management, patient care, and patient enrolment services are gaining popularity in the healthcare sector. The rise in popularity is due to its wide range of applications for health-care providers and payers. The growing demand for these services is primarily driven by the need to address the challenges of a regulated, evolving, cost-intensive, and value-based healthcare landscape. Utilization of healthcare BPO services has resulted in higher workflow efficiencies and increased quality of patient care. In addition, an increasing adoption of healthcare BPO services is seen in hospitals and healthcare systems that allows privacy of patient information, network security, fraud detection and management, and medical transcription. As healthcare BPO services gain traction across hospitals and healthcare systems, with an emphasis on data privacy, network security, and fraud management, they are poised to continue supporting the expansion of the medical aesthetics market in the years to come.

Healthcare BPO Market Segment Insights

Healthcare BPO Market Service Provider Insights

Based on service, the healthcare BPO market is bifurcated into payer services, provider services and pharmaceutical services. The payer services categories include claims management, integrated front-end services & back-office operations, member management, product development and business acquisition services, provider management services, care management, billing and accounts management services, and others. Further, the claims management segmented into claims adjudication services, claims settlement services, information management services, claims repricing, claims investigation services, claims indexing services, and fraud detection and management. Furthermore, the provider services segmented is divided into revenue cycle management, patient enrollment, patient care, and others, and patient care is also bifurcated into medical transcription and device monitoring. Moreover, pharmaceutical services segment is segmented into research & development, manufacturing, non-clinical services, and others, and bifurcated into supply chain management & logistics and sales and marketing services

In 2023, the claims management category retained the most share, payer services market revenue. This rise is due to an increase in patients using electronic health services, such as electronic health records. The rising frequency of chronic illnesses such as cardiovascular diseases (CVDs) leads to increased hospital admissions and claims, supporting the claims management segment's growth. It primarily targets healthcare organizations (clinics, drugstores, and hospitals, for example) that provide services covered by private insurance plans and are eligible for payment.

The emphasis of healthcare business process outsourcing services is towards delivering reduced administration costs for healthcare providers and enhancing patient satisfaction. Moreover, healthcare BPO services provide insurance, to simplify their processes. Furthermore, low costs, access to specialists, focus on patient care, and critical mistakes can be avoided specially patients’ medical records are factors responsible the market growth.

FIGURE 2: HEALTHCARE BPO MARKET, BY SERVICE PROVIDER, 2023 & 2032 (USD BILLION)

Source: Secondary Research, Primary Research, MRFR Database and Analyst Review

Healthcare BPO Market Regional Insights

By region, the market is divided into North America, Europe, Asia-Pacific, and the Rest of the World. North America accounted for the largest market in 2023, owing to the well-developed technology, high healthcare expenditure, and the presence of the leading players. People in this region are health conscious, which adds fuel to the increasing healthcare spending. Thus, to manage the increasing healthcare revenue, the need for the healthcare BPO services has increased. Moreover, healthcare outsourcing can help companies to save 30%-60% of costs, which will drive the market growth.

Further, the major countries studied are: The US, Canada, Brazil, Germany, France, the UK, Italy, Spain, China, India, Japan, South Korea, and Australia.

FIGURE 3: HEALTHCARE BPO MARKET, BY REGION, 2023 & 2032 (USD BILLION)

Source: Secondary Research, Primary Research, MRFR Database and Analyst Review

Europe accounts for the major share of the market owing to the well-developed technology, high healthcare expenditure, and the presence of the leading players. People in this region are health conscious, which adds fuel to the increasing healthcare spending. Thus, to manage the increasing healthcare revenue, the need for the healthcare BPO services has increased. Moreover, healthcare outsourcing can help companies to save 30%-60% of costs, which will drive the market growth. Furthermore, the demand for niche services and increasing cost savings will boost market growth over the corresponding period. Furthermore, increasing government support for the development of the healthcare sector has fueled the market growth of Europe.

Asia Pacific is the fastest growing market of the healthcare BPO market as result of rapidly changing healthcare sector and presence of huge opportunities for the development of this market. Furthermore, developing healthcare industries & organizations and improving technology have fueled market growth. Moreover, China healthcare BPO market held the largest market share in 2023, and Australia healthcare BPO market is the fastest growing market in the Asia-Pacific region.

Healthcare BPO Market Key Market Players & Competitive Insights

The Healthcare BPO Market is distinguished by the presence of numerous global, regional, and local players catering to the healthcare BPO services and solutions. Furthermore, the regulatory changes- implementation of ppaca and hipaa, pressure to reduce rising healthcare costs, and increasing consolidation in the healthcare industry is further driving the growth of Healthcare BPO Market during the forecast period. The major players have adopted a strategy of obtaining regulatory approval from government agencies for their services and solutions and signing contracts and agreements to broaden their reach. For instance, in April 2023, Cognizant (US) and Microsoft (US) collaborated to introduce cloud-based technology to the healthcare sector. Through this partnership, healthcare payers and providers will have easier access to cutting-edge technological solutions, faster claim processing, and enhanced interoperability, all of which will enhance business operations and the experiences of patients and members.

Moreover, mergers and collaborations were also observed to expand the company's product, service, and solutions portfolio, as well as introduce new services and solutions. The growth of prominent industry players is dependent on various factors, such as market conditions, government support, and industry development. It is also projected that a rise in the investments for R&D will also boost the market's growth in the upcoming future.

Cognizant provides information technology (IT), consulting, and business process outsourcing (BPO) services. The company offers the following products and services: internet of things, enterprise services, cloud enablement, intelligent process automation, application services, infrastructure, security, and enterprise application services; core modernization; digital engineering; digital experience; digital strategy; industry and platform solutions; and quality engineering and assurance. Moreover, in April 2023, Cognizant (US) and Microsoft (US) collaborated together to introduce cloud-based technology to the healthcare sector. Through this partnership, healthcare payers and providers will have easier access to cutting-edge technological solutions, faster claim processing, and enhanced interoperability, all of which will enhance business operations and the experiences of patients and members.

Key Companies in the Healthcare BPO Market include.

• Cognizant (US)


• Infosys Limited (India)


• NTT DATA, Inc (Japan)


• Accenture (Ireland)


• GeBBS (US)


• Parexel International (US)


• Veradigm LLC (US)


• Oracle Corporation (US)


• IBM (US)


• IQVIA Holding, Inc (US)

Pharmaceutical Excipients Industry Developments

October 2023: GeBBS Healthcare Solutions acquired MRA, LLC, (US) a company that offers services for cancer registries, audits, and HIM. Through the transaction, both companies' markets, services, capabilities, and geographic reach are expanded, giving their clients access to an integrated RCM solution offering.

April 2023: Cognizant (US) and Microsoft (US) collaborated together to introduce cloud-based technology to the healthcare sector. Through this partnership, healthcare payers and providers will have easier access to cutting-edge technological solutions, faster claim processing, and enhanced interoperability, all of which will enhance business operations and the experiences of patients and members.

Healthcare BPO Market Segmentation

Healthcare BPO Market Service Provider Outlook

• Payer Services
  
  
  
  • Claims Management Services
    
    
    
    • Claims Adjudication Services
    
    
    • Claims Settlement Services
    
    
    • Information Management Services
    
    
    • Claims Repricing
    
    
    • Claims Investigation Services
    
    
    • Claims Indexing Services
    
    
    • Fraud Detection and Management
    
    
    
    
  
  
  • Integrated Front Office and Back Office Operations
  
  
  • Member Management
  
  
  • Product Development and Business Acquisition Services
  
  
  • Provider Management Services
  
  
  • Care Management
  
  
  • Billing and Accounts Management Services
  
  
  • Others
  
  
  
  


• Provider Services
  
  
  
  • Revenue Cycle Management
  
  
  • Patient Enrollment
  
  
  • Patient Care
    
    
    
    • Medical Transcription
    
    
    • Device Monitoring
    
    
    
    
  
  
  • Others
  
  
  
  


• Pharmaceutical Services
  
  
  
  • Research & Development
  
  
  • Manufacturing
  
  
  • Non-Clinical Services
    
    
    
    • Supply Chain Management & Logistics
    
    
    • Sales and Marketing Services
    
    
    
    
  
  
  
  


• Others

Healthcare BPO Market Regional Outlook

• North America
  
  
  
  • US
  
  
  • Canada
  
  
  • Mexico
  
  
  
  


• Europe
  
  
  
  • Germany
  
  
  • France
  
  
  • UK
  
  
  • Italy
  
  
  • Spain
  
  
  • Rest of Europe
  
  
  
  


• Asia-Pacific
  
  
  
  • China
  
  
  • India
  
  
  • Japan
  
  
  • South Korea
  
  
  • Australia
  
  
  • Rest of Asia-Pacific
  
  
  
  


• Rest of the World
  
  
  
  • Middle East
  
  
  • Africa
  
  
  • South America