Patient Access Solutions Market by Product & Service (Eligibility Verification, Medical Necessity, Prior-authorization, Denial Management), Delivery Mode (Web & Cloud, On-premise), End User (Providers, Outsourcing Companies) - Global Forecast to 2022

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Date: 09-Jan-2018
No. of pages: 145
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“The global patient access solutions market projected to grow at a CAGR of 7.6%.”

The patient access solutions market is expected to reach USD 1.74 billion by 2022 from an estimated USD 1.21 billion in 2017, at a CAGR of 7.6%. Rising volume of denials owing to regulatory changes and increasing patient liability is majorly driving the growth of the patient access solutions market. In addition, patient access solutions help to reduce documentation errors related to medical necessity denials and streamlines front-end staff workflow with automated tracking and authorization which in turn is expected to boost the adoption of patient access solutions among healthcare providers. However, factors such as high deployment costs of these solutions and lack of adequate clinicians with advanced IT skills may hinder the adoption of these solutions among healthcare providers.

“The software segment is expected to register the highest CAGR during the forecast period.”

On the basis of product and service, the patient access solutions market is segmented into software and services. The software segment is expected to register the highest CAGR during the forecast period. The high growth in this segment is attributed to the shift toward electronic management of patient access, declining reimbursement rates, and improving affordability in developed countries

“The healthcare outsourcing companies segment is expected to grow at the highest CAGR during2017 to 2022.”

Based on end user, the patient access solutions market is segmented into healthcare providers, healthcare IT outsourcing companies, and other end users. The healthcare outsourcing companies segment is expected to grow at the highest CAGR during the forecast period. Currently, healthcare providers are opting for outsourcing patient access management as outsourcing these procedures helps healthcare providers to focus more on providing quality patient care and stay in tune with the changing dynamics in the insurance industry. Outsourcing patient access management also reduces the cost healthcare providers spent on patient access management which in turn is accelerating the adoption of patient access solutions among outsourcing companies providing patient access management services.

“APAC is projected to witness the highest growth during the forecast period.”

North America held the largest share of the global patient access solutions market in 2016.On the other hand, the Asia Pacific region is expected to witness the highest CAGR during the forecast period. Countries such as Japan, Australia, New Zealand, South Korea, and Singapore are expected to provide significant growth opportunities for players in the market. Factors such as rising medical tourism, adoption of electronic insurance claims processing, and movement towards digitization are the major factors driving the growth of the patient access solutions market in the Asia Pacific region.

Break of primary participants was as mentioned below:


  • By Company Type – Tier 1–42%, Tier 2–31% and Tier 3–27%

  • By Designation – C-level–30%, Director Level–45%, Others–25%

  • By Region – North America–42%, Europe–28%, Asia Pacific–19%, Rest of the World–11%


Some of the prominent players in the patient access solutions market are McKesson (US), Epic Systems (US), Cerner (US), Cognizant (US), Experian (Ireland), Optum (US), Conifer Health (US), The Advisory Board (US), 3M (US), Craneware (UK), The SSI Group (US), ZirMed (US), Cirius Group (US), and AccuReg Software (US).

Research Coverage:

The report analyzes the various patient access solutions and their adoption pattern. It aims at estimating the market size and future growth potential of the global patient access solution market for different segments such as product and service, delivery mode, end user, and region. The report also includes an in-depth competitive analysis of the key players in this market along with their company profiles, product offerings, recent developments, and key market strategies.

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 one or any combination of the below-mentioned five strategies for strengthening the market.

This report provides insights on the following pointers:


  • Market Penetration: Comprehensive information on product portfolios offered by the top players in the global patient access solutions market. The report analyzes the global patient access solutions market by product and service, delivery mode, end user, and region

  • Product Development/Innovation: Detailed insights on upcoming trends and new product launches in the global patient access solutions market

  • Market Development: Comprehensive information on the lucrative emerging regions by product and service, delivery mode, and end user

  • Market Diversification: Exhaustive information about new products, growing geographies, and recent developments in the global patient access solutions market

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

Patient Access Solutions Market by Product & Service (Eligibility Verification, Medical Necessity, Prior-authorization, Denial Management), Delivery Mode (Web & Cloud, On-premise), End User (Providers, Outsourcing Companies) - Global Forecast to 2022

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 Limitations
1.5 Currency
1.6 Stakeholders

2 Research Methodology
2.1 Research Approach
2.1.1 Secondary Sources
2.1.1.1 Key Data From Secondary Sources
2.1.2 Primary Sources
2.1.2.1 Breakdown of Primaries
2.1.2.2 Key Data From Primary Sources
2.1.2.3 Key Industry Insights
2.2 Market Size Estimation
2.2.1 Bottom-Up Approach
2.2.2 Top-Down Approach
2.3 Data Triangulation
2.4 Assumptions for the Study

3 Executive Summary

4 Premium Insights
4.1 Patient Access Solutions: Market Overview
4.2 Patient Access Solutions Market, By End Users & Region
4.3 Healthcare Access Management Solutions Market: Geographic Snapshot
4.4 Healthcare Access Management Solutions Market: North America Snapshot
4.5 Global Healthcare Access Management Solutions Market for Software

5 Market Overview
5.1 Introduction
5.2 Market Dynamics
5.2.1 Market Drivers
5.2.1.1 Need to Maintain Regulatory Compliance
5.2.1.2 Increasing Patient Volume and Subsequent Growth in the Demand for Health Insurance
5.2.1.3 Growing Importance of Denials Management
5.2.1.4 Declining Reimbursement Rates
5.2.1.5 Rising Need to Curtail Healthcare Costs
5.2.2 Market Restraints
5.2.2.1 Data Breaches and Loss of Confidentiality
5.2.3 Market Opportunities
5.2.3.1 Huge Growth Potential in Emerging Healthcare IT Markets
5.2.4 Market Challenges
5.2.4.1 Dearth of Skilled IT Professionals in the Healthcare Industry
5.2.4.2 Reluctance to Adopt Patient Access Solutions
5.2.4.3 High Deployment Costs

6 Industry Insights
6.1 Introduction
6.2 Current Scenario of Healthcare Claims Management in the US
6.2.1 Manual vs Electronic Claims Management Processes
6.2.2 Lack of Standardization Between Payer Policies
6.3 Adoption Trends for Patient Access Solutions in the US

7 Global Patient Access Solutions Market, By Product and Service
7.1 Introduction
7.2 Services
7.2.1 Support & Maintenance Services
7.2.2 Implementation Services
7.2.3 Training & Education Services
7.3 Software
7.3.1 Eligibility Verification Software
7.3.2 Medical Necessity Management Software
7.3.3 Pre-Certification & Authorization Software
7.3.4 Claims Denial & Appeal Management
7.3.5 Payment Estimation Software
7.3.6 Claims Payment Assessment & Processing Software
7.3.7 Other Software

8 Patient Access Solutions Market, By Delivery Mode
8.1 Introduction
8.2 Web & Cloud-Based Solutions
8.3 On-Premise Solutions

9 Global Patient Access Solutions Market, By End Users
9.1 Introduction
9.2 Healthcare Providers
9.3 Hcit Outsourcing Companies
9.4 Other End Users

10 Patient Access Solutions Market, By Region
10.1 Introduction
10.2 North America
10.2.1 US
10.2.2 Canada
10.3 Europe
10.4 Asia Pacific
10.5 Rest of the World

11 Competitive Landscape
11.1 Overview
11.2 Ranking of Market Players
11.3 Competitive Scenario
11.3.1 Alliances, Partnerships, Collaborations, and Agreements
11.3.2 Mergers and Acquisitions
11.3.3 Product Launches and Enhancements
11.3.4 Expansions

12 Company Profiles
(Business Overview, Products and Services, Recent Developments, SWOT Analysis & MnM View)*
12.1 Mckesson
12.2 Epic Systems
12.3 Cerner
12.4 Cognizant
12.5 Experian
12.6 3M
12.7 Conifer Health
12.8 Optum
12.9 The Advisory Board
12.10 Craneware
12.11 Zirmed
12.12 The Ssi Group
12.13 Cirius Group
12.14 Accureg Software

*Details on Business Overview, Products and Services, Recent Developments, SWOT Analysis & MnM View Might Not Be Captured in Case of Unlisted Companies.

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

List of Tables

Table 1 Impact Analysis: Market Drivers
Table 2 Impact Analysis: Market Restraints
Table 3 Impact Analysis: Market Opportunities
Table 4 Impact Analysis: Market Challenges
Table 5 Estimated Spending on Regulatory Compliance By A Healthcare Provider in the US
Table 6 Average Cost Per Transaction and Saving Opportunity for Healthcare Payers & Providers: Manual vs Electronic
Table 7 Average Time Spent Per Transaction on Manual vs Electronic Claims Management Processes
Table 8 Global Patient Access Solutions Market, By Product and Service, 2015-2022 (USD Million)
Table 9 Global Healthcare Access Management Solutions Market for Services, By Type, 2015-2022 (USD Million)
Table 10 Global Support & Maintenance Services Market, By Country, 2015-2022 (USD Million)
Table 11 Global Implementation Services Market, By Country, 2015-2022 (USD Million)
Table 12 Global Training & Education Services Market, By Country, 2015-2022 (USD Million)
Table 13 Global Patient Access Solutions Market for Software, By Type, 2015-2022 (USD Million)
Table 14 Global Eligibility Verification Software Market, By Country, 2015-2022 (USD Million)
Table 15 Global Medical Necessity Management Software Market, By Country, 2015-2022 (USD Million)
Table 16 Global Pre-Certification & Authorization Software Market, By Country, 2015-2022 (USD Million)
Table 17 Global Claims Denial & Appeal Management Software Market, By Country, 2015-2022 (USD Million)
Table 18 Global Payment Estimation Software Market, By Country, 2015-2022 (USD Million)
Table 19 Global Claims Payment Assessment & Processing Software Market, By Country, 2015-2022 (USD Million)
Table 20 Global Other Software Market, By Country, 2015-2022 (USD Million)
Table 21 Patient Access Solution Market, By Delivery Mode, 2015–2022 (USD Million)
Table 22 Web & Cloud-Based Healthcare Access Management Solutions Market, By Region, 2015–2022 (USD Million)
Table 23 On-Premise Patient Access Solution Market, By Region, 2015–2022 (USD Million)
Table 24 Global Healthcare Access Management Solutions Market, By End Users, 2015-2022 (USD Million)
Table 25 Patient Access Solution Market for Healthcare Providers, By Region, 2015–2022 (USD Million)
Table 26 Healthcare Access Management Solutions Market for Hcit Outsourcing Companies, By Region, 2015–2022 (USD Million)
Table 27 Patient Access Solution Market for Other End Users, By Region, 2015–2022 (USD Million)
Table 28 Healthcare Access Management Solutions Market, By Region, 2015–2022 (USD Million)
Table 29 North America: Patient Access Solution Market, By Country, 2015–2022 (USD Million)
Table 30 North America: Healthcare Access Management Solutions Market, By Product & Service, 2015–2022 (USD Million)
Table 31 North America: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 32 North America: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 33 North America: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 34 North America: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 35 US: Major Reasons for Claims Denials
Table 36 US: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 37 US: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 38 US: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 39 US: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 40 US: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 41 Canada: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 42 Canada: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 43 Canada: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 44 Canada: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 45 Canada: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 46 Europe: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 47 Europe: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 48 Europe: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 49 Europe: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 50 Europe: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 51 APAC: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 52 APAC: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 53 APAC: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 54 APAC: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 55 APAC: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 56 RoW: Patient Access Solution Market, By Product & Service, 2015–2022 (USD Million)
Table 57 RoW: Healthcare Access Management Solutions Market for Services, By Type, 2015–2022 (USD Million)
Table 58 RoW: Healthcare Access Management Solutions Market for Software, By Type, 2015–2022 (USD Million)
Table 59 RoW: Healthcare Access Management Solutions Market, By Delivery Mode, 2015–2022 (USD Million)
Table 60 RoW: Healthcare Access Management Solutions Market, By End Users, 2015–2022 (USD Million)
Table 61 Growth Strategy Matrix (2014–2017)
Table 62 Global Healthcare Access Management Solutions Market Ranking, By Key Player, 2016

List of Figures

Figure 1 Patient Access Solution Market Segmentation
Figure 2 Research Design
Figure 3 Breakdown of Primary Interviews: By Company Type, Designation, and Region
Figure 4 Data Triangulation Methodology
Figure 5 Global Patient Access Solution Market, By Product & Service, 2017 vs 2022 (USD Million)
Figure 6 Global Healthcare Access Management Solutions Market for Services, 2017 vs 2022 (USD Million)
Figure 7 Global Healthcare Access Management Solutions Market, By Delivery Mode, 2017 vs 2022 (USD Million)
Figure 8 Global Healthcare Access Management Solutions Market, By End Users, 2017 vs 2022 (USD Million)
Figure 9 Geographical Snapshot of the Healthcare Access Management Solutions Market
Figure 10 Healthcare Access Management Solutions Market to Witness High Single-Digit Growth Rate in the Forecast Period
Figure 11 Healthcare Providers Commanded the Largest Share of the Healthcare Access Management Solutions Market in 2016
Figure 12 US Accounted for the Largest Share of the Healthcare Access Management Solutions Market in 2016
Figure 13 US Accounts for the Largest Share in North America
Figure 14 Eligibility Verification Accounts for the Largest Share of Software Market
Figure 15 Healthcare Access Management Solutions Market: Drivers, Restraints, Opportunities, and Challenges
Figure 16 Adoption of Electronic Systems for Commercial Medical Health Plans in the US
Figure 17 Adoption and Volume of Electronic Eligibility & Benefit Verifications for Commercial Medical Health Plans and Providers in the US
Figure 18 Adoption of Electronic Prior Authorization for Commercial Medical Health Plans and Providers in the US
Figure 19 Services Segment to Command the Largest Market Share in 2022
Figure 20 Web & Cloud-Based Solutions to Dominate the Healthcare Access Management Solutions Market in 2017
Figure 21 Healthcare Providers to Dominate the Healthcare Access Management Solutions Market in 2017
Figure 22 Healthcare Access Management Solutions Market Growth: Regional Snapshot
Figure 23 North America: Healthcare Access Management Solutions Market Snapshot
Figure 24 Asia Pacific: Healthcare Access Management Solutions Market Snapshot
Figure 25 Key Growth Strategies Adopted Between 2014 and 2017
Figure 26 Mckesson: Company Snapshot
Figure 27 Cerner: Company Snapshot
Figure 28 Cognizant: Company Snapshot
Figure 29 Experian: Company Snapshot
Figure 30 3M: Company Snapshot
Figure 31 Conifer Health: Company Snapshot
Figure 32 Optum: Company Snapshot
Figure 33 The Advisory Board: Company Snapshot
Figure 34 Craneware: Company Snapshot

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