Healthcare BPO Market (By Provider Service: Revenue Cycle Management, Patient Enrolments, Patient Care; By Payer Service: Claims Management, Product Development Business Acquisition (PDBA), Member Management, Provider Management, Care Management, Integrated Front-End Services and Back-office Operations, Billing and accounts management services, HR Services; By Life Science Service)- Global Industry Analysis, Share, Growth, Regional Outlook and Forecasts, 2022-2030

The global Healthcare BPO market size was estimated at USD 334.15 billion in 2021 and is expected to surpass around USD 755.76 billion by 2030 and poised to grow at a compound annual growth rate (CAGR) of 9.49% during the forecast period 2022 to 2030.

Key Takeaways:

• North America region held highest revenue share of 48% in 2021.
• Europe region accounted 30.5% revenue share in 2021.
• By provider service, the revenue cycle management segment captured highest revenue share in 2021.
• Based on payer service, the claims management segment accounted highest share in 2021 and is expected to grow at a strongest CAGR between years 2022 to 2030.
• BY pharmaceutical service, the research & development segment is anticipated to hit notable growth over the forecast time period 2022 to 2030.

Healthcare services have been constantly evolving to balance the multiple aspects of managing operational costs, bottom-line of companies, and regulations all toward improving patient outcomes. Constant urge to drive better patient and customer experiences in the face of ever-receding bottom line and budget constraints have brought forth new business models. The drive for healthcare BPO market stems from relentless efforts to make healthcare services more customer-centric, and to empower patient-doctor interactions.

Business proposition for healthcare business process outsourcing partners has gained strength in the growing role of their services in improving patient care, boost health outcomes, and aid in cost-optimizing for healthcare providers.

The ecosystem of players in the healthcare BPO market is wide. Broadly myriad time-consuming tasks are outsourced through BPO services, which help in lowering operational costs. Some of the key end users are research and development, manufacturing, sales and analytics. Common areas where healthcare services in the healthcare BPO market are sought include medical coding and billing, claims processing, and data processing services.

Report Scope of the Healthcare BPO Market

Key Trends Shaping Forces of Growth in Healthcare BPO Market

The growing trend of payers and providers in healthcare industry to seek business models that focus on patient-centric business outcomes is propelling prospects in the healthcare BPO market. Past couple of decades have seen healthcare sector worldwide keen on adopting intelligence automation notably the use of artificial intelligence technologies in automation in operations. The trend has seen prevention of costly medical mistakes for healthcare providers on one hand and optimizing the use of assets in superior patient outcomes.

Technology companies including those with prominent presence in healthcare IT in emerging economies have geared toward tapping into the incredible revenue streams in developed nations. Healthcare providers in these countries prefer to outsource claims processing for boosting productivity gains. Growing adoption of omnichannel customer service strategy by healthcare providers for offering a consistent experience across all customer channels is a trend, engendering the attractiveness of services in the healthcare BPO market.

Healthcare BPO Market Dynamics:

Drivers: Pressure to reduce the rising healthcare costs

Cost savings form an important consideration in outsourcing, as by doing so, companies can reduce costs on resource management, labor, and space. There is pressure on the margins of healthcare payers due to the rise of health insurance exchanges (online marketplaces to obtain health insurance from competing providers) in the US. This enables consumers to obtain coverage from competing private healthcare providers and is likely to accelerate the adoption of outsourcing to rationalize costs.
As healthcare continues to take up a larger part of the overall economy, structural changes—such as the push toward paying for value, greater emphasis on care management, and increased cost-sharing with consumers—are taking a stronger hold, pulling back against the rapid healthcare spending growth. However, medical costs have hovered around the same level—between 6% and 7% over the last five years—which can be expected to drive healthcare expenditure. Rising healthcare costs are thus expected to considerably boost offshore outsourcing and, in turn, the growth of the global healthcare BPO market.

Restraints:  Hidden outsourcing costs

Improper planning and financial allotment for outsourcing activities often lead to a negative impact on cost savings and the business value that can be derived from outsourcing. Companies planning finances while outsourcing their business processes fail to take into account unforeseen costs, such as those incurred while evaluating and selecting a vendor, managing offshore contracts, process transition and enhancing security and severance pay for employees.
Economic growth in emerging countries has also resulted in rising labor costs, thus raising questions over the value for money that will be offered by these countries. Additionally, customized services and solutions provided by vendors are likely to cost 15–30% more than standard services. In the event of the client exiting a contract prematurely, costs increase and expose both the buyer and the provider to litigation, thus increasing legal expenses as well. When cost savings are not as high as expected, clients refrain from outsourcing. This may hinder the growth of the healthcare BPO market.

Opportunities: Growing adoption of artificial intelligence-based tools for drug discovery

Artificial intelligence and machine learning, in particular, make the drug discovery process more efficient and substantially improve success rates at the early stages of drug development. This will help healthcare BPO service providers to bring about major breakthroughs, as artificial intelligence also plays an important role in the discovery of drugs for chronic diseases such as cancer. Owing to its capabilities, AI significantly reduces the time taken to bring a cancer-combatting drug to the market, which will lead to significant growth in the healthcare BPO services market.

Several pharmaceutical companies are increasingly focusing on partnering with established and emerging AI-driven companies to leverage the power of AI-based solutions for boosting their drug discovery programs. The increasing number of drugs developed will impact the CRO services market due to the increasing number of clinical trials and research on them. Such factors have encouraged the adoption of AI for drug discovery by various pharmaceutical and biotechnology companies.

Challenges: Data security concerns

In healthcare, approximately one-third of data breaches result in medical identity theft mainly due to a lack of internal control over patient information, lack of top management support, outdated policies and procedures or non-adherence to existing ones, and inadequate personnel training. This makes patient confidentiality a major challenge in the healthcare industry. As per the National Center of Biotechnology Information (NCBI), in 2018, the number of data breaches reported was 2,216 from 65 countries. Out of these, the healthcare industry faced 536 breaches (the highest number of breaches among all industries). The average cost of a data breach in 2019 was USD 3.92 million, while a healthcare data breach typically costs USD 6.45 million. This cost was the highest in the US as compared to other countries (Source: IBM). With increasing healthcare data breaches and the cost involved in it, Cybersecurity Ventures predicts that the healthcare industry has spent more than USD 65 billion cumulatively on cybersecurity products and services over the five-year period from 2017 to 2021. As Healthcare BPO processes involve data transfer between healthcare organizations and BPO service providers, creating a secure communication platform is a major challenge faced by vendors catering to the healthcare industry. This may hamper the healthcare BPO market until secure solutions are available.

Provider Service Insights

Billing monitoring is a tool used by medical institutions to monitor all economic communication with customers, after their first consultation until the settlement of any outstanding recovery debt. All medical and management tasks that are needed to manage and recover care delivery payments collectively are referred to as the RCM. Therefore, it is anticipated that the growing demand for RCM products in hospitals will promote segment expansion.

In 2021, billing planning held the greatest customer base, and it is anticipated that it would continue to hold that position throughout the projected timeframe. The decrease in medical costs, expanding government attempts to integrate billing and coding technologies, and rising healthcare sector spending may all be contributing factors to the category expansion. This RCM provides the supplier with several advantages, including managing admin duties as well as invoicing and receivables. This cutting-edge system uses complex accounting, merchant services, and electronic medical record technologies to perform admin duties. According to Jul 2022 post "Billing Control in Medical," since many clinics manage to account for utilizing inefficient manual processes, human mistakes, such as mistakes in entering data, are the chief reason for payment problems.

Payer Service Insights

The Medical BPO region is based upon the services that the aid measures. Types of assistance provided by suppliers include customer onboarding, reimbursement policies, and quality experience. The clinical situation has improved the quality of medical improvements. The biggest market position for worldwide health Outsourcing is held by the claims processing category by 2021 and therefore is anticipated to keep this position throughout the forecast timeframe. Claiming management is a strategy that manages complaints while creating initiatives to minimize expenses and reduce theft while maintaining client satisfaction. The market is anticipated to witness a result.

Life Science Service Insights

During the projected timeframe, technological advancements are predicted to have the highest growth. The company's overall expansion could be attributed to rising expenditure for novel medications and vaccinations in response to an increase in COVID-19 patients. According to health system predictions, the business technology development sector is predicted to grow at a rapid pace since that is still a marketplace where consumers are not fully informed and because the COVID epidemic still seems to be active.

Regional Insights

North America held the largest share of the healthcare BPO market, accounting for 48.0% in 2021, followed by Europe (30.9%) and the RoW (20.8%). Pharmaceutical companies in the region, especially the US, are facing significant pressures related to drug prices as the Medicare Prescription Drug Coverage (Part D) offers prescription drug coverage to everyone with Medicare. Additionally, the patent expiration of several blockbuster drugs is expected to affect the revenue of large pharmaceutical companies in the US and Canada. Taking these factors into consideration, a number of pharmaceutical companies are focusing on cost reduction through outsourcing, subsequently driving the market growth in North America.

Some of the prominent players in the Healthcare BPO Market include:

• Accenture (Ireland)
• Access Healthcare (US)
• Akurate Management Solutions (US)
• Cognizant (US)
• Firstsource Solutions (India)
• GeBBS Healthcare Solutions (US)
• Genpact (US)
• HCL Technologies (India)
• IBM Corporation (US)
• Infosys BPM (India)
• Invensis Technologies (India)
• IQVIA (US)
• Lonza (Switzerland)
• Mphasis (India)
• NTT Data Corporation (Japan)
• Omega Healthcare (India)
• Parexel International (US)
• R1 RCM (US)
• Sutherland Global (US)
• Sykes Enterprises (US)
• Tata Consultancy Services (India)
• UnitedHealth Group (US)
• Wipro (India)
• WNS (Holdings) Limited (India)
• Xerox Corporation (US)

Segments Covered in the Report

This report forecasts revenue growth at global, regional, and country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2017 to 2030. For this study, Nova one advisor, Inc. has segmented the global Healthcare BPO market

By Provider Service

• Revenue Cycle Management    
• Patient Enrolments         
• Patient Care      
• Medical Transcription
• Medical Imaging
• Device Monitoring

By Payer Service

• Claims Management
• Claims Adjudication Services
• Claims Settlement Services
• Information Management Services
• Claims Repricing
• Claims Investigation Services
• Claims Indexing Services
• Fraud Detection & Management
• Product Development & Business Acquisition (PDBA)              
• Member Management         
• Provider Management         
• Care Management 
• Integrated Front-End Services and Back-office Operations    
• Billing and accounts management services  
• HR Services

By Life Science Service

• Manufacturing
• R&D
• Non-Clinical Services             
• Supply Chain Management & Logistics
• Sales and Marketing Services
• Forecasting
• Performance Reporting
• Analytics
• Research
• Marketing
• Other Non-Clinical Services

By Geography

North America

• U.S.
• Canada

Europe

• Germany
• France
• United Kingdom
• Rest of Europe

Asia Pacific

• China
• Japan
• India
• Southeast Asia
• Rest of Asia Pacific

Latin America

• Brazil
• Rest of Latin America

Middle East & Africa (MEA)

• GCC
• North Africa
• South Africa
• Rest of Middle East & Africa