North America Healthcare BPO Market: By Provider Services (Medical Billing, Medical Coding, Medical Transcription, Finance & Account), By Payer Services ((Claims Management (Claims Adjudication. Claims Settlement, Information Management, Claims Repricing, Claims Investigation, Claims Indexing, Litigation Management), Integrated Front-end Services and Back-office Operations, Member Management, Provider Management, Billing and Accounts Management, Analytics and Fraud Management, HR), By Pharmaceutical Service (Research and Development, Manufacturing, Non-clinical Services, Supply Chain Management (SCM) and Logistics, Sales and Marketing, (Performance Reporting (Forecasting, Research, Analytics, Marketing), (Other Non-clinical Functions (Finance and Accounts, HR, IT)), By End users (Hospital, Dental Clinics, Public Service, Others) and Country  

North America Healthcare BPO Market size was valued at US$ 112.99 billion in 2023 and is poised to grow at a CAGR of 8.9% from 2024-2030. Business Process Outsourcing (BPO) is a process in which healthcare providers select the most suited third-party vendor for some specific business process. It allows the 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 by reducing the cost pressures and increasing the overall productivity. Healthcare BPO market provides various solutions, such as customer account setup, front-end services, billing and account receivables, enrollment services, provider network services, claims services, membership services, Medicare services, and pharmacy benefits management.

The major factor that drives the growth of North American healthcare BPO is the increasing development in healthcare IT. Furthermore, new business models & processes and the increasing use of digital technologies in healthcare are increasing the market for healthcare BPO. North America Healthcare BPO Market is expected to grow at the rate of about Good CAGR from 2016 to 2027. The rising geriatric population is anticipated to be the major issue, due to susceptibility to numerous health issues including cardiovascular diseases (CVD), respiratory disorders, cancers, eye care problems, orthopedic disorders, etc. The increasing prevalence of these diseases has led to a growing amount of work for insurance companies. To handle such a large volume of patients and claims data, and to assure rapid turnaround time, the payer companies need to invest in infrastructure, technology, and skilled personnel, leading to higher operational costs which is expected to accelerate the healthcare payer BPO market. The shift from ICD-9 to ICD-10 coding system generated a huge workload for the payers to upgrade their systems, train staff, and thereby increase their financial burden. The ICD-9 code system had 13,000 codes, while the ICD-10 code system had nearly 68,000 codes. This variation has augmented the need for medical coding, HR, accounting, skilled personnel, and other technical operations, thus estimated to positively strengthen industry growth during the forecast timeframe.

North America Healthcare BPO Market Key Developments:

• In October 2016, Quintiles IMS Holdings has completed its merger of Equal's transaction between IMS Health Holdings, Inc. and Quintiles Transnational Holdings Inc.