Analyzing Projections: Healthcare BPO Market Eyes $468.5 Billion Milestone

The healthcare BPO industry is expected to continue to grow in the near future as healthcare providers look to outsource their non-core business processes and administrative tasks. The industry is expected to experience an increase in demand for services such as medical billing, coding, and claims processing, as well as for services related to the management of patient data. Additionally, the industry is likely to see an increase in demand for services related to healthcare analytics, population health, and artificial intelligence (AI). With the growth of new technology, the industry is likely to experience an increase in demand for services related to data security, information governance, and data integration. Moreover, with the rise of digital healthcare, the industry is likely to experience an increase in demand for services related to telemedicine, e-prescribing, and patient engagement.

Healthcare BPO market in terms of revenue was estimated to be worth $296.4 billion in 2021 and is poised to reach $468.5 billion by 2026, growing at a CAGR of 9.6% from 2021 to 2026 according to a latest report published by MarketsandMarkets™. Growth in this market is primarily driven by the need to reduce rising healthcare costs and the implementation of the Patient Protection and Affordable Care Act (PPACA) are compelling payers and providers to outsource their business processes to low-cost countries in order to reduce their operational costs.

The major source geographies that primarily outsource most of their non-core activities to third parties include North America, Europe, and Rest of the World.

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Healthcare BPO Market Scope:

Notable Healthcare BPO mergers and acquisitions for 2021 – 2022 include:

• UnitedHealth Group’s acquisition of Genoa Healthcare from Walmart.
• CVS Health’s acquisition of MedExpress from Optum.
• CIGNA’s acquisition of HealthSpring from CVS Health.
• Aetna’s acquisition of HealthBridge from Humana.
• Anthem’s acquisition of HealthScope from Aetna.
• Anthem’s acquisition of HealthLink from CVS Health.
• UnitedHealth Group’s acquisition of Change Healthcare from McKesson Corporation.
• CVS Health’s acquisition of Envolve Health from Centene Corporation.
• Cigna’s acquisition of CareCentrix from UnitedHealth Group.
• Aetna’s acquisition of Real Appeal from Optum.

Growth Drivers of Healthcare BPO Market from Macro to Micro:

• Increasing Demand for Cost-Effective Services: The need for cost-effective services is one of the major growth drivers for healthcare BPO market. Healthcare providers are increasingly turning to BPO service providers for cost effective services such as medical billing and coding, transcription, and claims processing.
• Growing Adoption of Electronic Medical Records (EMRs): The adoption of Electronic Medical Records (EMRs) is one of the major drivers for the growth of healthcare BPO market. EMRs enable the healthcare providers to store and access patient information more efficiently, which ultimately reduces operational costs.
• Technological Advancements and Automation: Technological advancements and automation are also driving the growth of healthcare BPO market. Automation of healthcare processes such as medical coding, data entry, and claims processing are helping healthcare organizations to increase their operational efficiency and reduce their costs.
• Growing Need for Risk Management: Risk management is another key growth driver for healthcare BPO market. Increasing focus on compliance and regulatory requirements is driving the need for services such as fraud detection and risk management.
• Increasing Focus on Quality and Patient Safety: Quality and patient safety are another important growth drivers for the healthcare BPO market. Healthcare providers are increasingly turning to BPO service providers for services such as quality control and patient safety management.

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Hypothetic Challenges of Healthcare BPO Market in Near Future:

• Increased Pressure to Reduce Costs: Healthcare BPO providers will face increased pressure to reduce costs and increase efficiency in order to remain competitive.
• Regulatory Compliance: Healthcare BPO providers will need to remain compliant with the ever-changing regulatory environment and ensure that their services meet all of the required standards.
• Technological Advancements: Healthcare BPO providers must stay up-to-date with the latest technology and IT trends in order to remain competitive.
• Data Security: As data is increasingly stored and shared digitally, healthcare BPO providers will need to invest in robust security measures to ensure the safety and privacy of patient data.
• Talent Retention: Healthcare BPO providers will need to develop innovative strategies to attract and retain talented professionals in order to remain competitive.
• Automation: Automation will be an important tool for healthcare BPO providers in order to improve efficiency while reducing costs.

Top 3 Use Cases of Healthcare BPO Market:

• Medical Billing and Coding: Medical billing and coding is one of the most popular use cases of healthcare BPO market. This process involves verifying patient information, coding medical services, and submitting claims to payers for reimbursement. It is an important part of medical records management, as it ensures accurate and timely payment of services rendered.
• Claims Processing: Claims processing is another major use case of healthcare BPO market. It involves verifying the accuracy of claims, validating the eligibility of the patient, and ensuring that all the necessary documents are submitted for reimbursement.
• Patient Care Management: Patient care management is a critical function of the healthcare BPO market. It involves coordinating and managing care across multiple care settings, ensuring patient safety and quality of care, and providing support and guidance to providers and patients. This helps to improve patient outcomes and reduce healthcare costs.

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