The healthcare payer BPO market was around USD 15 billion in 2014. It will grow at a CAGR over 9.9% during 2015 to 2022 (forecast period). Critical market drivers include increasing healthcare costs & elderly population and changing regulations. Rising sufferings from various diseases boost the workload of insurance providers.
Processing multiple claims in less turnaround time involves high infrastructural & technological investments. It also requires hiring skilled workers. This augments the operational costs of payer companies. Hence, preference for outsourcing these activities is higher.
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The market benefits from changes in coding systems (like from ICD-9 to ICD-10). While the ICD-9 code system had 13, 000 codes, ICD-10 has close to 68, 000. This calls for increased recruitment across accounting, coding, human resources, etc.
The healthcare payer BPO market is split on the basis of services and regions. Services segments are member, finance & accounts, HR, and claims processing. Claims processing occupied the largest shares (about 56%) in 2014. Medical insurance penetration in developed & developing countries is its key contributor.
However, member services will grow at the fastest rate in the future. This can be attributed to the need for value added services, customer service requirements, and stiff competition. Regions comprise North America, Europe, Asia Pacific, Latin America, and MEA (Middle East & Africa). North America held the largest shares (more than 54%) in 2014.
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Its demand propellers encompass favorable governmental policies & reimbursement frameworks and high claim records. The ‘Affordable Care Act’ provides healthcare & Medicare access to the U.S. population. It has raised member enrollments since its implementation. Asia Pacific should register the fastest growth from 2015 to 2022.
Key regional drivers are high economic developments & insurance penetration and supportive governmental initiatives. Indian governmental schemes like ‘Pradhan Mantri Jeevan Jyoti Bima Yojana’ and ‘Pradhan Mantri Suraksha Bima Yojana’ could also add Asian Pacific sales.
Noteworthy players in the global healthcare payer BPO market comprise Xerox Corporation, Cognizant Technology Solutions, Wipro Ltd., and HCL Technologies Ltd. Their main strength is expertise in BPO delivery. They abide by the regulatory & compliance norms of North America and Europe.
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