U.S. 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) Industry Analysis, Share, Growth, Regional Outlook and Forecasts, 2022-2030

According to Nova one advisor, the U.S. Healthcare BPO market size was estimated at USD 201.7 billion in 2022 and is projected to hit around USD 450.7 billion by 2030, growing at a CAGR of 7.9% during the forecast period 2022 to 2030.

The U.S. Healthcare Payer Market has been greatly impacted by the introduction of the Patient Protection and Affordable Care Act (PPACA). This market is particularly driven by claims processing services. As the act expanded insurance access to more than 30 million U.S. citizens, the increased claims processing workload led to large-scale outsourcing of these services by payers. The pivotal factors driving the growth of the U.S. Healthcare provider outsourcing market include the ICD-10 conversion reform and the shortage of skilled personnel, particularly medical coders in the U.S. The demand for outsourced services in the U.S. pharmaceutical industry has increased immensely over the years as pharmaceutical companies are adopting various strategies like downsizing and consolidation of infrastructure in response to a sharp global economic downturn.

Report Scope of the U.S. Healthcare BPO Market

United States Healthcare BPO Market Trends:

The growing demand for healthcare BPOs in the United States to offer quality patient care and reduce the overall cost of revisits and re-treatment of the patients represents one of the key factors driving the market. Moreover, there is an increase in the demand for healthcare BPOs that can provide access to specialists for enhancing the availability of skilled healthcare professionals. This, along with the burgeoning healthcare industry, is propelling the growth of the market in the US. In addition, there is a rise in the non-core activities, such as improved patient care, predictable cash flow, and increased net revenue, of hospitals for better operational benefits. This, coupled with the increasing healthcare expenditure in the country, is contributing to the growth of the market. Besides this, as maintaining patient records, interacting with health insurance agencies, and issuing invoices for medical services are time-consuming, there is a rise in the outsourcing of medical claims by hospitals. Apart from this, the implementation of various reforms and the conversion from the ICD-9 coding system to the ICD-10 coding system by the US Government is bolstering the growth of the market.

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.

Term supply chain administration is the collective name for the entire process of accepting revenues and managing returns. According to the previously cited source, RCM also efficiently and error-free blends payment details with aggregate records, insurer names, client private details, health findings, and medical classifications. As a result, RCM was once used quite regularly inside the medical industry, which is fueling product demand.

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.

 Some of the prominent players in the U.S. Healthcare BPO market include:

• Access Healthcare (US)
• Akurate Management Solutions (US)
• Cognizant (US)
• GeBBS Healthcare Solutions (US)
• Genpact (US)
• IBM Corporation (US)
• IQVIA (US)
• Parexel International (US)
• R1 RCM (US)
• Sutherland Global (US)
• Sykes Enterprises (US)
• UnitedHealth Group (US)
• Xerox Corporation (US)

Segments Covered in the Report

This report forecasts revenue growth at regional & country levels and provides an analysis of the industry trends in each of the sub-segments from 2018-2030. For this study, Nova one advisor has segmented U.S. Healthcare BPO market based on services and region:

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

Key Points Covered in U.S. Healthcare BPO Market Study:

• Growth of U.S. Healthcare BPO in 2022
• Market Estimates and Forecasts (2017-2030)
• Brand Share and Market Share Analysis
• Key Drivers and Restraints Shaping Market Growth
• Segment-wise
• Competition Mapping and Benchmarking
• Recommendation on Key Winning Strategies
• COVID-19 Impact on Demand for U.S. Healthcare BPO and How to Navigate
• Key Product Innovations and Regulatory Climate
• U.S. Healthcare BPO Consumption Analysis
• U.S. Healthcare BPO Production Analysis