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Healthcare Claims Management Market by Component (Software, and Services), Delivery Mode (On-Premise, and Cloud Based), Type (Integrated, and Standalone), End User (Healthcare Payers, Providers) - Global Forecast to 2023

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Date: 21-Jun-2018
No. of pages: 139
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“The healthcare claims management market is projected to grow at a CAGR of 5.3% during the forecast period.”

The global healthcare claims management market is projected to reach USD 13.93 billion by 2023 from an estimated value of USD 10.77 billion in 2018, at a CAGR of 5.3%. The key factors driving the growth of this market are increasing patient volumes, expanding health insurance market, growing importance of denials management, and declining reimbursement rates. On the other hand, the high cost of deployment of claims management solutions could be a challenging factor for this market.

“The cloud-based segment is projected to grow at the highest CAGR during the forecast period.”

Based on delivery mode, the healthcare claims management market is segmented into on-premise and cloud-based. The cloud-based segment is expected to grow at the highest CAGR during the forecast period. The high growth of this segment can be attributed to the comparatively lower capital expenses and operational costs incurred along with better scalability, flexibility, and affordability.

“Asia to witness the highest growth during the forecast period.”

Asia is expected to grow at the highest CAGR during the forecast period of 2018–2023. Factors such as the investments to modernize the healthcare infrastructure and growing adoption of healthcare IT solutions in China, measures to boost the quality of healthcare delivery in Japan, rapid growth of the healthcare industry in India, and government initiatives to boost the implementation of healthcare IT in Singapore are contributing to the high growth in Asia during the forecast period.

Break of primary participants was as mentioned below:


  • By Company Type – Tier 1- 54%, Tier 2- 34%, Tier 3- 12%

  • By Designation – C-level–31%, Director Level–19%, Others–50%

  • By Region – North America–46%, Europe–25%, Asia–18%, RoW-11%


Some of the major players in the healthcare claims management include Cerner Corporation (US), McKesson Corporation (US), a then health (US), eClinical Works (US), Optum, Inc, (US), Conifer Health Solutions (US), and nThrive (US).

Research Coverage:

The report analyzes the healthcare claims management market and aims at estimating the market size and the future growth potential of this market based on various segments such as component, type, delivery mode, end user, and region. The report also includes an in-depth regulatory analysis for various regions across the globe and the competitive analysis of the key players in this market along with their company profiles, recent developments, and key strategies adopted by them to remain competitive in the market.

Reasons to Buy the Report

The report will enrich established firms as well as new entrants/smaller firms to gauge the pulse of the market, which in turn would help them, garner a greater share. Firms purchasing the report could use any one or a combination of the below-mentioned strategies.

This report provides insights on the following pointers:


  • Market Penetration: Comprehensive information on the solutions offered by the top players in the global healthcare claims management market. The report analyzes the global bariatric surgery devices market by type, component, delivery mode, end user, and region.

  • Product Deployments/Launches: Detailed insights on upcoming trends, new product launches, and deployments in the global healthcare claims management market

  • Market Development: Comprehensive information on the lucrative emerging markets by type, component, delivery mode, end user, and region

  • Market Diversification: Exhaustive information about new products, growing geographies, recent developments, and investments in the global healthcare claims management market

  • Competitive Assessment: In-depth assessment of market shares, growth strategies, products, and capabilities of leading players in the global market

Healthcare Claims Management Market by Component (Software, and Services), Delivery Mode (On-Premise, and Cloud Based), Type (Integrated, and Standalone), End User (Healthcare Payers, Providers) - Global Forecast to 2023

Table of Contents

1 Introduction
1.1 Objectives of the Study
1.2 Market Definition
1.3 Market Scope
1.3.1 Markets Covered
1.3.2 Years Considered for the Study
1.4 Currency
1.5 Limitations
1.6 Stakeholders

2 Research Methodology
2.1 Research Data
2.1.1 Secondary Data
2.1.1.1 Secondary Sources
2.1.2 Primary Data
2.1.2.1 Key Data From Primary Sources
2.1.2.2 Breakdown of Primaries
2.1.2.3 Key Industry Insights
2.2 Market Size Estimation
2.3 Market Breakdown and Data Triangulation
2.4 Assumptions for the Study

3 Executive Summary

4 Premium Insights
4.1 Healthcare Claims Management Solutions: Market Overview
4.2 Healthcare Claims Management Solutions Market, By End User (2018)
4.3 Healthcare Claims Management Solutions Market Share, By Type (2018 vs 2023)
4.4 Geographical Snapshot of the Healthcare Claims Management Solutions Market

5 Market Overview
5.1 Introduction
5.2 Market Dynamics
5.2.1 Market Drivers
5.2.1.1 Increasing Patient Volumes
5.2.1.2 Expanding Health Insurance Market
5.2.1.3 Process Improvements in Healthcare Organizations
5.2.1.4 Growing Importance of Denials Management
5.2.1.5 Declining Reimbursement Rates
5.2.2 Market Restraints
5.2.2.1 High Cost of Deployment
5.2.3 Market Opportunities
5.2.3.1 Emerging Countries
5.2.3.2 Cloud-Based Solutions
5.2.3.3 Artificial Intelligence in Health Insurance
5.2.3.4 Rising Adoption of Electronic Health Records
5.2.4 Market Challenges
5.2.4.1 Integration of Claim Management Solutions
5.2.4.2 Data Breaches and Loss of Confidentiality
5.2.4.3 Lack of Skilled It Professionals in Healthcare

6 Healthcare Claims Management Solutions Market, By Component
6.1 Introduction
6.2 Services
6.3 Software

7 Healthcare Claims Management Solutions Market, By Type
7.1 Introduction
7.2 Integrated Solutions
7.3 Standalone Solutions

8 Healthcare Claims Management Solutions Market, By Delivery Mode
8.1 Introduction
8.2 On-Premise Delivery Mode
8.3 Cloud-Based Delivery Mode

9 Healthcare Claims Management Solutions Market, By End User
9.1 Introduction
9.2 Healthcare Payers
9.3 Healthcare Providers
9.4 Other End Users

10 Healthcare Claims Management Solutions Market, By Region
10.1 Introduction
10.2 North America
10.2.1 US
10.2.2 Canada
10.3 Europe
10.3.1 UK
10.3.2 Germany
10.3.3 France
10.3.4 Italy
10.3.5 Rest of Europe
10.4 Asia
10.5 Rest of the World

11 Competitive Landscape
11.1 Overview
11.2 Competitive Scenario
11.2.1 Product Launches, Deployments, and Enhancements
11.2.2 Agreements, Partnerships, Contracts, and Collaborations
11.2.3 Acquisitions
11.2.4 Expansions

12 Company Profile
(Introduction, Products & Services, Strategy, & Analyst Insights, Developments, MnM View)*
12.1 Athenahealth
12.2 Cerner Corporation
12.3 Allscripts Healthcare Solutions
12.4 Eclinicalworks
12.5 Optum, Inc. (A Subsidiary of Unitedhealth Group Inc.)
12.6 Mckesson Corporation
12.7 Conifer Health Solutions
12.8 Gebbs Healthcare Solutions
12.9 The SSI Group
12.10 GE Healthcare
12.11 Nthrive
12.12 DST Systems
12.13 Cognizant Technology Solutions
12.14 Quest Diagnostics
12.15 Context 4 Healthcare
12.16 Ram Technologies
12.17 Health Solutions Plus (HSP)
12.18 Plexis Healthcare Systems

*Details on Marketsandmarkets View, Introduction, Product & Services, Strategy, & Analyst Insights, New Developments Might Not Be Captured in Case of Unlisted Companies.

13 Appendix
13.1 Discussion Guide
13.2 Knowledge Store: Marketsandmarkets’ Subscription Portal
13.3 Introducing RT: Real-Time Market Intelligence
13.4 Available Customizations
13.5 Related Reports
13.6 Author Details

List of Tables

Table 1 Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 2 Healthcare Claims Management Services Market, By Region, 2016–2023 (USD Billion)
Table 3 Healthcare Claims Management Software Market, By Region, 2016–2023 (USD Billion)
Table 4 Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 5 Integrated Healthcare Claims Management Solutions Market, By Region, 2016–2023 (USD Billion)
Table 6 Standalone Healthcare Claims Management Solutions Market, By Region, 2016–2023 (USD Billion)
Table 7 Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 8 On-Premise Healthcare Claims Management Solutions Market, By Region, 2016–2023 (USD Billion)
Table 9 Cloud-Based Healthcare Claims Management Solutions Market, By Region, 2016–2023 (USD Billion)
Table 10 Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Billion)
Table 11 Healthcare Claims Management Solutions Market for Healthcare Payers, By Region, 2016–2023 (USD Billion)
Table 12 Healthcare Claims Management Solutions Market for Healthcare Providers, By Region, 2016–2023 (USD Billion)
Table 13 Healthcare Claims Management Solutions Market for Other End Users, By Region, 2016–2023 (USD Million)
Table 14 Healthcare Claims Management Solutions Market, By Region, 2016–2023 (USD Billion)
Table 15 North America: Healthcare Claims Management Solutions Market, By Country, 2016–2023 (USD Billion)
Table 16 North America: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 17 North America: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 18 North America: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 19 North America: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Billion)
Table 20 US: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 21 US: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 22 US: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 23 US: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Billion)
Table 24 Canada: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 25 Canada: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 26 Canada: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 27 Canada: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 28 Europe: Healthcare Claims Management Solutions Market, By Country, 2016–2023 (USD Billion)
Table 29 Europe: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 30 Europe: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 31 Europe: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 32 Europe: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 33 Healthcare Claims Management Solutions for Fraud Analytics
Table 34 UK: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 35 UK: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 36 UK: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 37 UK: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 38 Germany: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 39 Germany: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 40 Germany: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 41 Germany: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 42 France: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Million)
Table 43 France: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 44 France: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Million)
Table 45 France: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 46 Italy: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Million)
Table 47 Italy: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 48 Italy: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Million)
Table 49 Italy: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 50 RoE: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Million)
Table 51 RoE: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 52 RoE: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Million)
Table 53 RoE: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 54 Asia: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Billion)
Table 55 Asia: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Billion)
Table 56 Asia: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Billion)
Table 57 Asia: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 58 RoW: Healthcare Claims Management Solutions Market, By Component, 2016–2023 (USD Million)
Table 59 RoW: Healthcare Claims Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 60 RoW: Healthcare Claims Management Solutions Market, By Delivery Mode, 2016–2023 (USD Million)
Table 61 RoW: Healthcare Claims Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 62 Product Launches, Deployments, and Enhancements (2014–2018)
Table 63 Agreements, Partnerships, Contracts, and Collaborations (2014–2018)
Table 64 Acquisitions, 2014–2018
Table 65 Expansions (2014–2018)

List of Figures

Figure 1 Research Methodology: Healthcare Claims Management Solutions Market
Figure 2 Research Design
Figure 3 Sampling Frame: Primary Research
Figure 4 Market Size Estimation Methodology: Bottom-Up Approach
Figure 5 Market Size Estimation Methodology: Top-Down Approach
Figure 6 Data Triangulation Methodology
Figure 7 Services to Dominate the Healthcare Claims Management Solutions Market, By Component, in 2018
Figure 8 On-Premise Delivery Mode to Account for the Largest Share of the Market, By Delivery Mode, in 2018
Figure 9 Asia to Witness the Highest Market Growth During the Forecast Period
Figure 10 Expanding Health Insurance Market to Drive Market Growth During the Forecast Period
Figure 11 Healthcare Payers to Account for the Largest Share of the Healthcare Claims Management Solutions Market in 2018
Figure 12 Integrated Solutions Will Continue to Dominate the Healthcare Claims Management Solutions Market in 2023
Figure 13 Asian Region to Witness the Highest Growth Rate During the Forecast Period
Figure 14 Healthcare Claims Management Solutions Market: Drivers, Restraints, Opportunities, and Challenges
Figure 15 Healthcare Claims Management Solutions Market, By Region
Figure 16 North America: Healthcare Claims Management Solutions Market Snapshot
Figure 17 Europe: Healthcare Claims Management Solutions Market Snapshot
Figure 18 Asia: Healthcare Claims Management Solutions Market Snapshot
Figure 19 RoW: Healthcare Claims Management Solutions Market Snapshot
Figure 20 Key Developments in the Healthcare Claims Management Solutions Market Between 2014 and 2018
Figure 21 Company Snapshot: Athenahealth (2017)
Figure 22 Company Snapshot: Cerner (2017)
Figure 23 Company Snapshot: Allscripts Healthcare Solutions (2017)
Figure 24 Company Snapshot: Optum, Inc. (2017)
Figure 25 Company Snapshot: Mckesson Corporation (2017)
Figure 26 Company Snapshot: GE Healthcare (2017)
Figure 27 Company Snapshot: DST Systems (2017)
Figure 28 Company Snapshot: Cognizant Technology Solutions (2017)
Figure 29 Company Snapshot: Quest Diagnostics Incorporated (2017)

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