Healthcare Payer Bpo Market Opportunities and Forecasts, 2014 - 2022

Global healthcare payer BPO market is expected to reach over USD 34.2 billion by 2022 according to a new report by Grand View Research Inc. Key drivers attributing to the growth are ObamaCare, shift to ICD-10 coding system, growing geriatric population, increasing disease burden and penetration of insurance coverage in emerging economies.

In 2013, as per estimates published by the America’s Health Insurance Plans (AHIP), which is the national trade association representing the health insurance industry, one-sixth of the U.S. economy or nearly USD 2.7 trillion is dedicated to healthcare spending and the number is expected to increase year on year. However, the healthcare system is not able to reap the benefits of such expenditure due to process inefficiencies and use of redundant systems. The estimated loss due to such inefficiencies is nearly 800 billion or approximately 20 to 30 percent of the overall expenditure.

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Increasing healthcare expenditure is a major concern for the U.S. and all the other major economies. In order to reduce the economic burden and provide universal access to healthcare, governments are encouraging outsourcing of payer services to onshore or offshore locations.

The shift from ICD-9 coding system to ICD-10 coding has created huge work load for the payers to upgrade their systems, train their staff and has significantly increased the financial burden. The ICD-9 code system had 13,000 codes, where as the ICD-10 code system has nearly 68,000 codes. This shift from the legacy system to the latest system has significantly increased the need for medical coding, accounting, HR, and other technical professionals, thereby is expected to positively reinforce the healthcare payer BPO outsourcing market growth in the next seven years.

Further key findings from the study suggest:

In 2014, claims processing services...