Patient Access Solutions Market - Growth, Trends, COVID-19 Impact, and Forecasts (2021 - 2026)

The market is segmented By Product and Service, Deployment (Web and Cloud-based Solutions and On-Premise Solutions), End User and Geography

Market Snapshot

Study Period: 2018 - 2026
Base Year: 2020
Fastest Growing Market: Asia Pacific
Largest Market: North America
CAGR: 7.0 %

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Market Overview

The patient access solutions involves denials management, payment estimation and Improve patient collections. Denial management has an important role to play in hospital revenue generation. Most hospitals are now dependent on third-party providers for denial management services, as they lack the expert knowledge and time to manage the reimbursement process. These providers, with dedicated and skilled professionals, handle the denied claim and resubmit them. With their expertise, these providers increase the cash flow of their clients, which is otherwise neglected by the hospitals. It is estimated that over 90% of claim denials can be prevented with support from the providers, who have systems and knowledgeable experts in the field.  Thus the rising need to eradicate claim denials is expected to contribute for the growth of patient access solutions market in the forecast period.

Scope of the Report

As per the scope of the report, the term 'patient access solutions' refers to the solutions that involve efficient claim management and minimizing claim rejection for various hospitals and medical facilities.

By Product and Service
Software
Claims Denial & Appeal Management Solutions
Payment Estimation Solutions
Others
Services
By Deployment
Web and Cloud-based Solutions
On-Premise Solutions
By End User
Healthcare Providers
HCIT Outsourcing Companies
Other End Users
Geography
North America
United States
Canada
Mexico
Europe
Germany
United Kingdom
France
Italy
Spain
Rest of Europe
Asia-Pacific
China
Japan
India
Australia
South Korea
Rest of Asia-Pacific
Middle-East and Africa
GCC
South Africa
Rest of Middle-East and Africa
South America
Brazil
Argentina
Rest of South America

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Key Market Trends

Claim Denial and Appeal Management Segment is Expected to Dominate the Market in the Forecast Years

Based on Software, the market is segmented into Claims Denial & Appeal Management Solutions, Payment Estimation Solutions, and Others. Claim denial and appeal management involves the review of the denial procedure and determining if the denial can be appealed against. The management conducts a root cause analysis for the claim being denied by the insurer. This involves the review of patient documentation and resubmission of the claim. With more healthcare facilities under intense scrutiny and the rise in the number of healthcare claims, a large amount of hospital revenue is being declined by insurers. Hence, with the increasing acceptance of companies that provide these services, they have become more important to hospital facilities, thereby, contributing to the growth of the market studied over the forecast period.

Patient Access Solutions Market 1

North America Holds the Largest Share in the Patient Access Solutions Market

The Patient Access Solutions market holds the largest share in the North America region due to the presence of a high-quality healthcare system and modern medical technology. Most hospitals in United States that are serving patients, who are covered under Medicare or any privates insurances are facing difficulty in processing and submitting claims. Hospitals face challenge in accurately billing patients for a procedure or surgery done. This has created a huge opportunity for companies that provide patient access solutions to bridge the gap. Additionally, most hospitals in United States having recognized that automating the payment estimation with help of IT tools is helping both hospitals and patients to understand the costs in real time and collect payments by reducing the accounts receivable turnaround time. This is likely to contribute towards the growth of the market.

Patient Access Solutions Market 2

Competitive Landscape

The global players into the patient access solutions market are AccuReg Software, Cerner Corporation, Cirius Group Inc., Cognizant, Conifer Health Solutions, LLC, Epic Systems Corporation, Experian PLC, McKesson Corporation, Optum Inc. and ZirMed Inc.

Table of Contents

  1. 1. INTRODUCTION

    1. 1.1 Study Deliverables

    2. 1.2 Study Assumptions

    3. 1.3 Scope of the Study

  2. 2. RESEARCH METHODOLOGY

  3. 3. EXECUTIVE SUMMARY

  4. 4. MARKET DYNAMICS

    1. 4.1 Market Overview

    2. 4.2 Market Drivers

      1. 4.2.1 Need to Maintain Regulatory Compliance

      2. 4.2.2 Rising Importance of Denial Management

      3. 4.2.3 Increasing Number of Insured Patients

    3. 4.3 Market Restraints

      1. 4.3.1 Data Privacy and Confidentiality

    4. 4.4 Porter's Five Forces Analysis

      1. 4.4.1 Threat of New Entrants

      2. 4.4.2 Bargaining Power of Buyers/Consumers

      3. 4.4.3 Bargaining Power of Suppliers

      4. 4.4.4 Threat of Substitute Products

      5. 4.4.5 Intensity of Competitive Rivalry

  5. 5. MARKET SEGMENTATION

    1. 5.1 By Product and Service

      1. 5.1.1 Software

        1. 5.1.1.1 Claims Denial & Appeal Management Solutions

        2. 5.1.1.2 Payment Estimation Solutions

        3. 5.1.1.3 Others

      2. 5.1.2 Services

    2. 5.2 By Deployment

      1. 5.2.1 Web and Cloud-based Solutions

      2. 5.2.2 On-Premise Solutions

    3. 5.3 By End User

      1. 5.3.1 Healthcare Providers

      2. 5.3.2 HCIT Outsourcing Companies

      3. 5.3.3 Other End Users

    4. 5.4 Geography

      1. 5.4.1 North America

        1. 5.4.1.1 United States

        2. 5.4.1.2 Canada

        3. 5.4.1.3 Mexico

      2. 5.4.2 Europe

        1. 5.4.2.1 Germany

        2. 5.4.2.2 United Kingdom

        3. 5.4.2.3 France

        4. 5.4.2.4 Italy

        5. 5.4.2.5 Spain

        6. 5.4.2.6 Rest of Europe

      3. 5.4.3 Asia-Pacific

        1. 5.4.3.1 China

        2. 5.4.3.2 Japan

        3. 5.4.3.3 India

        4. 5.4.3.4 Australia

        5. 5.4.3.5 South Korea

        6. 5.4.3.6 Rest of Asia-Pacific

      4. 5.4.4 Middle-East and Africa

        1. 5.4.4.1 GCC

        2. 5.4.4.2 South Africa

        3. 5.4.4.3 Rest of Middle-East and Africa

      5. 5.4.5 South America

        1. 5.4.5.1 Brazil

        2. 5.4.5.2 Argentina

        3. 5.4.5.3 Rest of South America

  6. 6. COMPETITIVE LANDSCAPE

    1. 6.1 Company Profiles

      1. 6.1.1 AccuReg Software

      2. 6.1.2 Cerner Corporation

      3. 6.1.3 Cirius Group Inc.

      4. 6.1.4 Cognizant

      5. 6.1.5 Conifer Health Solutions, LLC

      6. 6.1.6 Epic Systems Corporation

      7. 6.1.7 Experian PLC

      8. 6.1.8 McKesson Corporation

      9. 6.1.9 Optum Inc.

      10. 6.1.10 ZirMed Inc.

    2. *List Not Exhaustive
  7. 7. MARKET OPPORTUNITIES AND FUTURE TRENDS

**Subject to Availability
**Competitive Landscape covers- Business Overview, Financials, Products and Strategies, and Recent Developments

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Frequently Asked Questions

The Patient Access Solutions Market market is studied from 2018 - 2026.

The Patient Access Solutions Market is growing at a CAGR of 7.0% over the next 5 years.

Asia Pacific is growing at the highest CAGR over 2021- 2026.

North America holds highest share in 2020.

Cerner Corporation, Cognizant, Epic Systems Corporation, McKesson Corporation, Optum Inc. are the major companies operating in Patient Access Solutions Market.

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