Report Overview

According to the deep-dive market assessment study by Growth Plus Reports, the global healthcare BPO market was valued at US$ 323.97 billion in 2022 and is expected to register a revenue CAGR of 9.3% to reach US$ 721.24 billion by 2031.

Healthcare BPO Market Fundamentals 

Healthcare BPO is the process of healthcare payers, providers, and organizations outsourcing business activities. The benefits of healthcare BPO are numerous, including the cheap cost of expert labor, the decrease in administrative and training expenses, and the high profitability of the business for healthcare organizations, payers, and providers. In addition, healthcare BPO raises patient care standards while requiring less money for infrastructure.

Hiring an outside contractor to handle a healthcare organization's non-clinical or non-core tasks is also known as healthcare business process outsourcing (BPO). Hospitals, clinics, and other healthcare facilities outsource work rather than handling it internally. Healthcare firms may concentrate on their core capabilities due to healthcare BPO. Medical professionals may concentrate on treating patients when they outsource certain tasks to a third party. To reduce expenses, businesses typically outsource to international third-party providers. Hospitals may, however, hire healthcare BPO services from within their own country.

The manner in which medical practitioners treat patients is comparable to how healthcare is provided in BPO. Using digital channels like email, chat, or phone conversations, third-party suppliers handle medical data and exchange records with patients. The variety of services is constrained because healthcare BPO doesn't have a physical representation of a hospital or office. Because medical BPO services cannot assess, diagnose, or treat patients, they only serve healthcare practitioners, insurance companies, and governmental organizations.

Healthcare BPO Market Dynamics

The industry is expanding due to several factors, including a sharp rise in clinical process outsourcing (CPO). The Patient Protection and Affordable Care Act (PPACA)'s implementation forced healthcare providers to outsource their non-critical operations, which resulted in fewer mistakes in areas like finance and accounting, customer service, etc. Rising strategic initiatives by large corporations, including product launches, alliances, and others, are another important driver expected to fuel market expansion throughout the projection period. An important business process outsourcing (BPO) operator for government services in the United States, Senture, was bought by Teleperformance, a major worldwide firm in digitally integrated business services, in December 2021. The purchase of the healthcare BPO services from Hinduja Global Solutions by Betaine B.V. was authorized by the Competition Commission of India (CCI) in October 2021. These significant changes are predicted to fuel market expansion. As a result of the aforementioned factors, the healthcare BPO market is anticipated to expand throughout the forecast period.

The growing usage of healthcare IT solutions or BPO services globally is another factor fueling the growth of the global healthcare BPO market. For instance, Access Healthcare, a supplier of healthcare BPO services, planned to invest INR 190 crore in June 2022 to expand its delivery operations and construct a new campus in Chennai. The company's BPO and IT activities will be housed in the new unit, which will also act as the center for technical infrastructure. Advanced healthcare BPO and IT services will be provided to clients via a new campus in the healthcare revenue cycle. In turn, it is anticipated that this will accelerate market expansion.

The growing elderly population and the burden of chronic disease are predicted to present companies in the healthcare BPO market with considerable potential prospects. For instance, the elderly are more likely to develop a number of illnesses. The burden of these diseases is growing, which increases the workload for insurance companies. To manage the high volume of claim and patient records and ensure quick turnaround time, these companies must invest in skilled talent pools, skilled infrastructure, and high operational costs, all of which are expected to support the growth of the global healthcare BPO market.

Healthcare BPO Market Ecosystem 

The global healthcare BPO market is analyzed from the following perspectives services and region.

Healthcare BPO Market by Payer Services

Based on the payer services, the global healthcare BPO market is segmented into human resource management, claims management, customer relationship management (CRM), operational/administrative management, care management, provider management, and other payer services.

Claims management services are likely to dominate the market during the forecast period. The market for healthcare business process outsourcing (BPO) is divided into payer services such as claims management, product development business acquisition (PDBA), member management, provider management, care management, integrated front-end services, back-office operations, billing and accounts management services, and HR services. Claims processing, adjudication, and rejection management are all included in the claims management services. To ensure appropriate payment, it also works with other suppliers and third-party businesses in coordination. 

Developing and implementing new goods and services to meet the demands of payers and providers are necessary for the Product creation Business Acquisition (PDBA) services. Coordination of member benefits, enrollment, and eligibility confirmation are all part of the member management services. Services for provider management include contracting, claims adjudication, and credentialing.

Healthcare BPO Market by Provider Services

Based on the provider services, the global healthcare BPO market is segmented into patient enrollment and strategic planning, patient care service, and revenue cycle management.

The revenue cycle management is likely to grow at a significant revenue CAGR. Revenue cycle management (RCM) is a tool healthcare institutions use to monitor all financial interactions with patients, from their first consultation until the settlement of any outstanding debt. All clinical and administrative tasks involved in monitoring and collecting patient service revenues collectively are referred to as the RCM. Therefore, the growing need for RCM services in healthcare is anticipated to promote sector expansion.

The RCM provides several advantages, including managing administrative tasks, invoicing, and collections. This cutting-edge system uses sophisticated billing, payment processing, and electronic health record technologies to perform administrative tasks. It is evident from the Hyperon study released in September 2022 that the patient care revenue process is challenging and time-consuming at every stage, from initial visits to full payment. RCM procedures that are effective make this simple. Additionally, it adds that without correctly structured RCM procedures, healthcare institutions cannot provide high-quality treatment while preserving their financial stability. As a result, RCM adoption has grown in the healthcare industry, which is fueling sector expansion.

Healthcare BPO Market by Pharmaceuticals Services

Based on pharmaceutical services, the global healthcare BPO market is further segmented into research and development, non-clinical services.

The research and development segment will likely grow at significant revenue CAGR during the forecasted period. Manufacturing, R&D, and non-clinical services comprise the global healthcare BPO industry segments. Due to the increased development of novel drugs and vaccines in response to the increased number of COVID-19 patients, the Research and Development sector now owns the bulk of the market share. The research and development services category includes drug development, clinical trials, and drug discovery. Manufacturing, packaging, shipping, and distribution of medications are all included in the manufacturing services region.

Healthcare BPO Market by Region

Based on the region, the global healthcare BPO market is segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East and Africa. 

North America is expected to dominate the market during the forecast period with a revenue share of 45%. North America now dominates the healthcare BPO industry, and this trend will likely last for the foreseeable future. The United States holds the largest market share in North America. The healthcare sector in the United States, which consists of pharmacies, pharmaceutical firms, medical equipment producers, and healthcare institutions, is expanding quickly. Professionals with specific training who manage these processes are essential to this intricate industry infrastructure. The strong presence of major market participants in the area and the high levels of knowledge regarding outsourcing healthcare IT services are credited with the expansion of the regional market. Additionally, expanding government efforts in the nation will fuel industry expansion there. For instance, the HHS department granted roughly USD 55 million to 29 health facilities sponsored by the HRSA in February 2022 to improve the accessibility and standard of treatment for underprivileged people through virtual care. Patients have benefited greatly from virtual care, particularly during the epidemic. As a result, market growth in the nation is anticipated to be fueled by government initiatives.

The Spokane, Washington-based Healthcare Resource Group Inc. was acquired by CPSI, a healthcare solutions provider, in March 2022. Hospitals and clinics may increase productivity, financial success, and patient pleasure by utilizing HRG's bespoke revenue cycle management ("RCM") technologies and consulting services. As a result, the leading players' actions are anticipated to propel the country's market expansion. However, due to factors including the rise in per capita expenditure, the expansion of corporate outsourcing firms, and a rise in disposable incomes, Asia-Pacific is predicted to see significant growth.

Healthcare BPO Competitive Landscape

Some of the prominent global healthcare BPO market include, 

• Accenture
• Cognizant Technology Solutions
• IQVIA
• Global Growth 
• GeBBS Healthcare Solutions
• UnitedHealth Group
• Genpact
• International Business Machines Corporation (IBM)
• Parexel International Corporation 
• Sutherland Global Services

Healthcare BPO Strategic Development 

• In October 2022, to deliver a tailored, end-to-end solution focusing on all facets of payment integrity, Performant Healthcare Solutions, a leading supplier of technology-enabled payment integrity, eligibility, and associated analytics services, launched a new strategic collaboration with Priority Health.
• In September 2022, a group-purchasing deal for outsourced surgical services with Conductiv was granted to Surgical Solutions, a top supplier of on-site operating rooms and sterile processing assistance. A coalition of providers and buyers has come together under the leadership of Conductiv to revolutionize the process of purchasing services.
• In May 2021, NTT DATA and Score Data decided to collaborate for several years to apply Score Data's nudging algorithms utilizing NTT DATA's machine learning technologies to assist with forecasting the rate of early illness conditions for the general practitioner community and worldwide medical coverage.
• In May 2020, an integrated final stage, coordinated medical practitioner (HCP/HCO) system called HCP/HCO Participation Administration was unveiled by IQVIA. It simplifies the worldwide scheduling, strategic planning, scheduling, and payment of HCP/HCOs.

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