US Healthcare BPO Market Size
| Study Period | 2019 - 2029 |
| Base Year For Estimation | 2023 |
| Market Size (2024) | USD 133 Billion |
| Market Size (2029) | USD 231 Billion |
| CAGR (2024 - 2029) | 8.11 % |
| Market Concentration | Low |
Major Players
*Disclaimer: Major Players sorted in no particular order |
Need a report that reflects how COVID-19 has impacted this market and its growth?
US Healthcare BPO Market Analysis
The US Healthcare BPO Market size is estimated at USD 133 billion in 2024, and is expected to reach USD 231 billion by 2029, growing at a CAGR of 8.11% during the forecast period (2024-2029).
The United States healthcare BPO market is expected to register a CAGR of 8.11% during the forecast period.
COVID-19's influence on the BPO business was complex and multifaceted, and many BPO firms were still adopting changes to accommodate its consequences. The BPO business was extremely fortunate to be able to operate digitally, allowing BPO firms to continue to operate with minimal health and safety issues for employees. According to the study article published in May 2023, despite the devastating impact of the COVID-19 epidemic, BPO organizations continue to adapt to new challenges. BPO organizations had to adjust to changes in consumer behavior, migrate to remote work arrangements, and create ways to provide services that require remote access to specialized tools and equipment.
The United States healthcare system favors new opportunities and growth due to the quick adoption of advanced technologies, which include pharmacies, pharmaceutical companies, medical equipment manufacturers, and medical care facilities. This industry's infrastructure relies on specialized professionals who oversee these operations. High awareness levels about outsourcing healthcare IT services and the strong presence of prominent market players in the region are attributed to the regional market's growth.
Another key driving factor is the increasing strategic actions of leading firms, such as product launches, alliances, and others, which are expected to drive market expansion throughout the forecast period. For example, in December 2021, Teleperformance announced the acquisition of Senture, a major business process outsourcing (BPO) operator for government services in the United States. Additionally, in October 2022, Confie announced the opening of a new service center in Tijuana as part of the ongoing expansion of its business process outsourcing division (BPO). Confie's new facility, the company's second in Mexico, will help support the company's rapid expansion in outsourcing services as well as future growth.
Furthermore, rising government initiatives in the country are anticipated to drive market growth in the country. For instance, in February 2022, the Department of Health and Human Services (HHS) awarded nearly USD 55 million to 29 HRSA-funded health centers to increase healthcare access and quality for underserved populations through virtual care. Virtual care has been a game-changer for patients, especially during the pandemic. Thus, the initiatives by government organizations are expected to drive market growth in the country.
Furthermore, the increasing number of people seeking insurance, pressure to cut healthcare delivery costs, consolidation of the healthcare system, pharmaceutical companies facing patent cliffs, and the mandatory implementation of ICD-10 codes (10th revision of the International Statistical Classification of Diseases and Related Health Problems) are the major factors propelling the growth of the United States healthcare BPO market.
Thus, the market is expected to grow in the United States due to the abovementioned factors, such as various government initiatives and strategic actions by market players. However, data integrity and confidentiality may restrain market growth.
US Healthcare BPO Market Trends
Claims Management is Expected to Grow with High CAGR in the Forecast Period
Claims processing outsourcing (CPO) is a relatively new business concept for insurance firms. This has emerged as the preferred option for organizations aiming to minimize operating expenses while improving service quality. The relationship between policyholders, healthcare providers, and insurance companies is essential for understanding the medical billing and coding process details.
Medical claims management is the process that deals with the billing, filling, updating, and processing of medical claims related to the patient's diagnosis, treatments, and medications. Many hospitals and medical facilities outsource these tasks to medical claims management firms, as maintaining patient records, interacting with health insurance agencies, and medical service invoices are time-consuming processes.
The increased burden of chronic diseases, the aging population, and rising healthcare claims activity are driving segment expansion. For instance, according to Cancer Facts and Figures 2023, published in January 2023 by the American Cancer Society, an estimated 1.9 million new cancer cases will be diagnosed in the United States in 2023, among which prostate cancer is estimated to be 288,300, followed by 238,340 cases of lung cancer, and 300,590 cases of female breast cancer. Therefore, with a rising burden of chronic diseases such as cancer, healthcare providers claim the request to insurance companies to offset the treatment cost incurred in cancer, which drives the demand for claim management services, thereby boosting segment growth.
Furthermore, strategic activities by market players, such as partnerships, are expected to boost the market over the forecast period. For instance, in January 2021, Tractable announced a collaboration with Hartford to use artificial intelligence to speed up claims processing.
Thus, all the factors above, such as the growing burden of chronic diseases and strategic activities by the market players, are expected to boost the segment's growth.
Revenue Cycle Management Segment is Expected to Hold a Significant Share Over the Forecast Period
Revenue cycle management (RCM) is a tool healthcare institutions use to monitor all financial interactions with patients, from their first appointment until the settlement of any outstanding debt. All clinical and administrative tasks involved in managing and collecting patient service revenues collectively are called the RCM. Therefore, the growing need for RCM services in healthcare is anticipated to promote segment expansion.
The RCM provides various advantages to the supplier, from billing and collections to administrative responsibilities. It is a cutting-edge system that manages administrative tasks via sophisticated billing, payment processing, and electronic health record systems—according to a June 2022 article published by the Medical Group Management Association (MGMA), medical practices that outsource their RCM experience increased performance in collections, staff efficiency, and more. Thus, owing to the benefits associated with the RCM and growing adoption, RCM is expected to boost the segment growth over the forecast period.
The market players are focusing on new partnerships and agreements to bolster their market positions, which is ultimately responsible for segment growth. For instance, in July 2022, Waystar, a revenue cycle management (RCM) vendor, planned to buy Patientco in the latest transaction involving an RCM vendor and a patient payment company.
Further, the RCM vendor hopes the combination will improve the patient's financial experience by providing user-friendly options for medical costs. In December 2022, Luminis Health, situated in Annapolis, Maryland, selected VisiQuate, an AI-powered analytics firm, to handle its revenue cycle management operations. Similarly, in November 2022, Cornerstone Specialty Hospitals partnered with CareCloud to take on its revenue cycle management services in West Monroe, Louisiana.
Thus, all the factors above, such as the enormous benefits of RCM outsourcing and strategic collaboration between healthcare companies and market vendors, are expected to boost the segment's growth.
US Healthcare BPO Industry Overview
The United States healthcare BPO market is fragmented and consists of several big and even small-scale players. The competitive landscape includes an analysis of a few international as well as local companies that hold significant market shares and are well known. Some of the major players in the market studied are Accenture PLC, Genpact Limited, IBM Corporation, Parexel International, and Cognizant, among others.
US Healthcare BPO Market Leaders
Accenture PLC
Genpact Limited
Parexel International
Cognizant
IBM Corporation
*Disclaimer: Major Players sorted in no particular order
US Healthcare BPO Market News
- May 2023: Atento, a major provider of customer relationship and business process outsourcing (CRM/BPO) services, reported that Frost & Sullivan recognized it as a leader in the Frost Radar for Customer Experience and Outsourcing services in Latin America for 2022.
- March 2022: CPSI, a healthcare solutions company, acquired Healthcare Resource Group Inc., based in Spokane, Washington. HRG is a leading provider of customized revenue cycle management ('RCM') solutions and consulting services that enable hospitals and clinics to improve efficiency, profitability, and patient satisfaction.
US Healthcare BPO Market Report - Table of Contents
1. INTRODUCTION
1.1 Study Assumptions and Market Definition
1.2 Scope of the Study
2. RESEARCH METHODOLOGY
3. EXECUTIVE SUMMARY
4. MARKET DYNAMICS
4.1 Market Overview
4.2 Market Drivers
4.2.1 Rapid Increase in Clinical Process Outsourcing (CPO)
4.2.2 Increasing R&D in the Healthcare Industry
4.3 Market Restraints
4.3.1 Data Integrity and Confidentiality
4.4 Porter's Five Forces Analysis
4.4.1 Threat of New Entrants
4.4.2 Bargaining Power of Buyers/Consumers
4.4.3 Bargaining Power of Suppliers
4.4.4 Threat of Substitute Products
4.4.5 Intensity of Competitive Rivalry
5. MARKET SEGMENTATION (Market Size by Value - USD)
5.1 By Payer Service
5.1.1 Human Resource Management
5.1.2 Claims Management
5.1.3 Customer Relationship Management (CRM)
5.1.4 Operational/Administrative Management
5.1.5 Care Management
5.1.6 Provider Management
5.1.7 Other Payer Services
5.2 By Provider Service
5.2.1 Patient Enrollment and Strategic Planning
5.2.2 Patient Care Service
5.2.3 Revenue Cycle Management
5.3 By Pharmaceutical Service
5.3.1 Research and Development
5.3.2 Manufacturing
5.3.3 Non-clinical Services
5.3.3.1 Supply Chain Management and Logistics
5.3.3.2 Sales and Marketing Services
5.3.3.3 Other Non-clinical Services
6. COMPETITIVE LANDSCAPE
6.1 Company Profiles
6.1.1 Accenture PLC
6.1.2 Capgemini
6.1.3 Cognizant
6.1.4 GeBBs Healthcare Solutions
6.1.5 Genpact Limited
6.1.6 IBM Corporation
6.1.7 IQVIA
6.1.8 Parexel International
6.1.9 Sutherland Healthcare Solutions
6.1.10 UnitedHealth Group Incorporated
- *List Not Exhaustive
7. MARKET OPPORTUNITIES AND FUTURE TRENDS
US Healthcare BPO Industry Segmentation
The healthcare BPO (business process outsourcing) refers to a process in which the healthcare providers select the most suited third-party vendor for specific business processes. It allows hospitals and medical professionals to spend their energy and valuable time on patient care.
The United States healthcare BPO market is segmented by payer service (human resource management, claims management, customer relationship management (CRM), operational/administrative management, care management, provider management, other payer services), provider service (patient enrollment and strategic planning, patient care service, revenue cycle management), and pharmaceutical service (research and development, manufacturing, non-clinical service). The report offers the value (USD) for the above segments.
| By Payer Service | |
| Human Resource Management | |
| Claims Management | |
| Customer Relationship Management (CRM) | |
| Operational/Administrative Management | |
| Care Management | |
| Provider Management | |
| Other Payer Services |
| By Provider Service | |
| Patient Enrollment and Strategic Planning | |
| Patient Care Service | |
| Revenue Cycle Management |
| By Pharmaceutical Service | |||||
| Research and Development | |||||
| Manufacturing | |||||
|
US Healthcare BPO Market Research FAQs
How big is the US Healthcare BPO Market?
The US Healthcare BPO Market size is expected to reach USD 133 billion in 2024 and grow at a CAGR of 8.11% to reach USD 231 billion by 2029.
What is the current US Healthcare BPO Market size?
In 2024, the US Healthcare BPO Market size is expected to reach USD 133 billion.
Who are the key players in US Healthcare BPO Market?
Accenture PLC, Genpact Limited, Parexel International, Cognizant and IBM Corporation are the major companies operating in the US Healthcare BPO Market.
What years does this US Healthcare BPO Market cover, and what was the market size in 2023?
In 2023, the US Healthcare BPO Market size was estimated at USD 122.21 billion. The report covers the US Healthcare BPO Market historical market size for years: 2019, 2020, 2021, 2022 and 2023. The report also forecasts the US Healthcare BPO Market size for years: 2024, 2025, 2026, 2027, 2028 and 2029.
US Healthcare BPO Industry Report
Statistics for the 2024 US Healthcare BPO market share, size and revenue growth rate, created by Mordor Intelligence™ Industry Reports. US Healthcare BPO analysis includes a market forecast outlook to 2029 and historical overview. Get a sample of this industry analysis as a free report PDF download.
