Healthcare BPO Market Size, Share, Growth, Trends, and Global Industry Analysis: Size, Share, Growth, Trends, and Industry Analysis By Provider Services (Medical Billing, Medical Coding, Medical Transcription, Finance & Accounts, Others), By Payer Services (Integrated Front-end Services and Back-office Operations, Provider Management, Claims Management, Billing and Accounts Management, HR, Analytics and Fraud Management, Member Management), By Pharmaceutical Service (Manufacturing, Research and Development, Non-clinical Services), By End-User (Hospital, Clinics, Public Service, Pharmaceutical Companies, Others), and Region Forecast 2019-2030

Healthcare BPO Market size was valued at US$ 469.5 billion by 2023 and is poised to grow at a significant CAGR of 9.7% from 2024-2030. Business Process Outsourcing (BPO) is a process where healthcare providers select the most appropriate third-party vendors for some of the specific business procedures. It allows hospitals and medical professionals to spend their energy and valuable time on patient care rather than doing some paperwork in the office.  Healthcare BPO is a solution for clients to adopt intelligent approaches that will support the organization in reducing cost pressures and increasing overall productivity. The market provides various solutions, such as front-end services, customer account setup, billing & account receivables, provider network services, enrollment services, claims services, Medicare services, membership services, and pharmacy benefits management. The major factor that drives the growth of healthcare BPO is the increase in the development of healthcare IT. Furthermore, new business models & processes and the increase in the use of digital technologies in healthcare are driving the growth of the market.

Globally the market is expected to grow with a significant CAGR from 2016 to 2027. The rise in the geriatric population is expected to be a major factor, owing to the susceptibility to several health issues which include respiratory disorders, cardiovascular diseases (CVD), eye care problems, canine orthopedic disorders, cancers, etc., and the rise in the prevalence rate of those diseases led to the increased amount of work for insurance companies. Hence, to handle that much data about the huge pool of patients and data of the payer companies need to invest in technology, skilled personnel, and infrastructure which led to high operational costs which is anticipated to accelerate the healthcare payer BPO market.  Shifting from the ICD-9 to the ICD-10 coding system posed a heavy workload for payers to up gradation of their systems, training of staff in turn increases the financial burden. The ICD-9 code system had 13,000 codes, while the ICD-10 code system had nearly 68,000 codes. This variation augmented the need for HR, accounting, medical coding, skilled personnel, and technical operations, hence anticipated to propel the growth of the market.

Key Developments

• In March 2017, WNS (Holdings) Limited, was acquired. Health Help, which provides benefits management across several key specialty healthcare areas, including Pain Management, Oncology, Cardiology, Orthopaedics Sleep Care and Radiology
• In October 2016, IMS Health Holdings, Inc. merged with Quintiles Transnational Holdings Inc. to form Quintiles IMS Holdings