Healthcare BPO Market Overview
Healthcare Business Process Outsourcing (BPO) is a procedure that enriches resource allocation, boost financial performance and increase the effectiveness of healthcare providers. Healthcare BPO services allow hospitals and medical professionals to deliver the quality patient care. The global healthcare BPO market size was worth $ XX billion in 2018 and is forecasted to reach $ XX billion by 2026, at a CAGR of XX% during the forecast period (2019-2026).
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Healthcare BPO Market Dynamics
Growing demand for high-end healthcare facilities and multi-specialty hospitals, established medical and central lab infrastructure and training centers is contributing to the growth of healthcare and life sciences industry thereby fuelling the demand for medical process outsourcing. Factors that are responsible for the growth of the market include rapid increase in clinical process outsourcing (CPO), implementation of PPACA compelled healthcare player to move toward outsourcing, and fewer errors in several non-critical functions, like finance and accounting, customer care services, etc.
In addition, developments in digital technologies leading to a shift from electronic records to telemedicine is further allowing many healthcare providers to deliver services in innovative ways. A Medical Transcription (MT) service is one of the services with voice notes being recorded and translated into various languages. The digitization of data by skilled personnel saves time of doctors while examining patients. In addition, implementation of robotic process automation, big data, and artificial intelligence (AI) are expected to boost the market further by assisting in collection of patient data. For instance, HGS handles the enrollment process of patients looking for insurance. The company uses bots for autofilling information in the right fields and saving time.
The cloud-based BPO is also growing trend in the market, which is developing business outsourcing processes, helping healthcare organizations to reduce cost by using global delivery models and secures data access. Cloud BPO or Business-Process-as-a-Service (BPaaS) is a business model to scale the processes with low expenditure costs. For instance, Infosys is the reputed partner of Aetna Inc., a pharmaceutical major in the U.S. It provided knowledge training to its personnel for handling queries of patients effectively thereby saving costs for the company. In addition, it developed a management information system (MIS) for compiling a database of patients and their respective health-related data for easy access in case of claims. Hence, the adoption of cloud-based BPO services is increasing due to its several benefits which is expected to contribute to the growth of the healthcare BPO market during the forecast period.
Healthcare BPO Market Segment Analysis
On the basis of provider service, the healthcare BPO market is segmented into patient enrollment and strategic planning, revenue cycle management, and patient care service. Among these, revenue cycle management is expected to grow at the highest CAGR during the forecast period, due to several factors such as increasing initiatives taken by governments for implementing RCM solutions, decreasing reimbursements in the healthcare industry, and rising expenditure by the healthcare IT industry. Several hospitals are dependent on third-party providers for denial management service, due to the lack of expert knowledge and time to manage the reimbursement process. Most common billing errors include lack of specificity, failure to verify insurance, filing an incomplete claim, missing filing deadlines, and coding errors. Most of the care providers are overcoming the challenge by working with third-party medical billing professionals who are expert in the overall revenue cycle management. Thus, the revenue cycle management service providers are increasingly in demand to overcome the revenue loss to hospitals, due to billing errors, can be prevented by specialty.
Healthcare BPO Market Geographical Analysis
North America holds the dominant market share for healthcare BPO in 2018, and it is expected to maintain the growth over the forecast period, owing to the presence of large number of US based companies providing all kind of healthcare BPO services. Also, growing big data, healthcare IT, cloud computing along with increasing government initiatives, and improvements are some of the factors driving the growth of the healthcare BPO market in this region. The market players are entering into strategies such as collaboration, acquisitions and others to expand their business. For instance, in September 2018, American BPO Company, Access Healthcare has acquired its Indian rival Pacific BPO, which specializes in providing cost and process optimization solutions to businesses in the healthcare industry.
The Asia-Pacific healthcare BPO market is growing at the highest CAGR during the forecast period (2019-2026), owing to rising demand in emerging countries such as India. Factors like a mature pharmaceutical and medical education system, low cost base, large English-speaking population; large talent pool and diverse set of business process outsourcing (BPO) providers including local and multinational BPO companies are driving outsourcing in healthcare in India. India has become the most preferred outsourcing destinations globally with its high-quality and low-cost services. The recent US regulation on Patient Protection and Affordable Care Act (PPACA) together with the proposed introduction of ICD-10 standards has driven to the Indian medical process outsourcing (MPO) market.
Healthcare BPO Market Competitive Landscape
The Healthcare BPO market is highly competitive and fragmented market. The market has large competition among the major players having a global presence and a substantial market share. Some of the key players include IBM, Accenture, Gebbs Healthcare Solutions, Eli Global, Gebbs, Parexel, United Health Group, Truven Health, IQVIA, Vee Bill, and Invensis Technologies.
The key players are adopting various growth strategies such as mergers & acquisitions, partnerships, and collaborations which are contributing to the growth of the healthcare BPO market globally. For instance,
In May 2019, MiraMed Global Services, Inc. (MiraMed), a leader in healthcare revenue cycle management (RCM) services and business process outsourcing (BPO) solutions, has completed its merger with Medac, Inc., a leading provider of anesthesia revenue cycle management.
In January 2019, Conduent Inc acquired Health Solutions Plus, a major developer of healthcare payor administration solutions. The acquisition enables Conduent to better serve current and prospective commercial and government payer clients with core administration processing technology.
In March 2018, Cognizant acquired Bolder Healthcare Solutions, a privately-held provider of revenue cycle management (RCM) solutions to hospitals, physician practices and other specialist healthcare organizations in the United States.
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