The “Healthcare BPO Market - Payer (Claims processing), Provider (Medical Billing & Coding) and Pharmaceutical (Clinical trial & Contract manufacturing) Outsourcing – Global analysis & Forecasts (2011-2016)” analyzes and studies the major market drivers, restraints, and opportunities in regions such as U.S., Eastern Europe, Asia, and Rest of the world.
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The global healthcare BPO market is growing at a healthy CAGR of 21.4%. Pharmaceutical outsourcing accounts for the largest share of 64.3%, but will grow at a CAGR of 14.6% from 2011 to 2016 since the market is saturated. Healthcare provider outsourcing has the highest growth rate of 31.9% from 2011 to 2016 and accounts for 15.7% to the total market. The healthcare payer outsourcing market will also grow at about 30% in the forecast period; it contributes 20% to the total market.
Claims processing, is one of the costly functions of the payer industry, has the highest share in the healthcare payer outsourcing market, accounting for 59%, followed by member services/customer care services. The payer in U.S. were using 30 cent of the premium dollar paid on administrative cost, but due to the Health Insurance Portability and Accountability (HIPAA) act, the payer has to spend 80%-85% on improving the services and providing quality healthcare. This is forcing the payer to cut the administrative costs, while outsourcing is the best solution available to reduce cost and maintain the quality.
In the year 2009, the payer industry in U.S. comprised of 1,300 health insurance companies. This represents a huge market for outsourcing which is yet to be tapped as only 10% of the work is outsourced currently.
Insurance companies have traditionally been among the slowest adopters of outsourcing/off shoring services. But the recent situation of shrinking margins, higher claims disbursement and increasing competition, has forced many insurance companies to look at outsourcing to improve efficiencies and align resources towards the core functions of product development and innovation.
The major players in the payer and provider of healthcare BPO market are Accenture (Ireland), Medusind (U.S.), GeBBS Healthcare (U.S.), Omega Healthcare (India) and Inventive (U.S.). The pharmaceutical outsourcing market is captured by players such as Quintiles (U.S.), Covance (U.S.), PPD (U.S.), Parexel (U.S.), Charles Rivers Laboratories (U.S.) and ICON (Ireland) in the CRO space; while in the CMO market the major competitors are Lonza (Switzerland), Catalent (U.S.), Boehringer Ingelheim (Germany), DSM Pharma (U.S.), and Jubilant Life Sciences (India).
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