Dublin, Aug. 16, 2024 (GLOBE NEWSWIRE) -- The "U.S. Healthcare Payers Core Administrative Processing Solutions Market Size, Share & Trends Analysis Report by Type (Software, Services), Deployment (On-premise, Cloud-based), and Segment Forecasts, 2024-2030" report has been added to ResearchAndMarkets.com's offering.
The U.S. healthcare payers core administrative processing solutions market size is expected to reach USD 2.88 billion by 2030 and is growing at a CAGR of 7.8% from 2024 to 2030
The market's growth is attributed to the increasing need for operational optimization. Healthcare payers are adopting technology to enhance administrative workflows, reduce expenses, and boost operational efficiency. Moreover, the market expansion is also driven by the growing need for regulatory compliance in light of strict healthcare regulations, including Medicare Access. 
Investor and venture capitalist interest in the healthcare payer sector is increasing, driven by technology startups focusing on innovative solutions. This surge in investment is attributed to various factors, including digital transformation, the adoption of value-based care models, the application of data analytics, and a shift toward consumer-centric care.
These elements underscore the healthcare industry's vast potential for innovation and growth. For instance, in August 2023, VBA, a prominent provider of cloud-based software for healthcare payers, completed a majority growth equity transaction valued at USD 156 million with Spectrum Equity, a notable growth equity firm. VBA's objective is to leverage this investment to develop technologically advanced solutions to meet the expanding needs of its customer base.
Furthermore, the healthcare industry is transforming, propelled by changing patient expectations, transitioning to value-based care, and a growing demand for accessible, personalized healthcare services. This evolution fosters a competitive landscape where startups introduce advanced technologies and solutions, aiming to advance the healthcare payer ecosystem in the country.
The onset of the COVID-19 pandemic made it critical to maintain business operations, effective member communication, and support. These elements continued to be significant as the situation evolved from an emerging issue to a worldwide emergency, necessitating widespread shutdowns for social distancing. To address these challenges, healthcare payers engaged with various stakeholders, including providers and government bodies. Strategies included forming partnerships, identifying members at elevated risk, and anticipating fluctuations in supply and demand.
Moreover, prominent players in the market are adopting strategic initiatives such as partnerships, new product launches, collaborations, acquisitions, and expansions to strengthen their market position and expand their customer base. For instance, in February 2022, HealthEdge entered a strategic partnership with CitiusTech to offer joint market implementation and consulting services focused on HealthEdge's solutions in care management, core administration, and payment integrity. This collaboration aims at supporting health plans transitioning to value-based care while seeking to optimize their operations.
U.S. Healthcare Payers Core Administrative Processing Solutions Market Report Highlights
- The market is segmented by type into software and services. Software held the largest market share, 57.56% in 2023. The increasing demand for advanced and integrated solutions to streamline administrative processes, reduce operational costs, and enhance efficiency is fueling the growth
- Based on deployment, cloud-based accounted for a significant market share of 55.42% in 2023, driven by the scalability of cloud-based solutions, which allows healthcare payers to adapt their administrative operations to changing needs efficiently
- Some of the notable companies in the market are HealthEdge Software, Inc., Optum, Cognizant, HealthAxis, Plexis Healthcare Systems, Mphasis, and SS&C Technologies among others.
Companies Featured
- HealthEdge Software, Inc.
- Optum
- Cognizant
- HealthAxis
- Plexis Healthcare Systems
- Mphasis
- SS&C Technologies
- Conduent
- RAM Technologies
- Evolent
- Invidasys
- Advantasure
- VBA solftware
- Advalent Corp
Key Attributes:
| Report Attribute | Details |
| No. of Pages | 120 |
| Forecast Period | 2023 - 2030 |
| Estimated Market Value (USD) in 2023 | $1.7 Billion |
| Forecasted Market Value (USD) by 2030 | $2.88 Billion |
| Compound Annual Growth Rate | 7.8% |
| Regions Covered | United States |
Key Topics Covered:
Chapter 1. Methodology and Scope
1.1. Market Segmentation and Scope
1.2. Market Definitions
1.3. Research Methodology
1.4. Information Procurement
1.5. Details of primary research
1.6. Market Formulation & Validation
1.7. Model Details
1.8. Research Scope and Assumptions
Chapter 2. Executive Summary
2.1. Market Outlook
2.2. Segment Outlook
2.2.1. Type Outlook
2.2.2. Deployment Outlook
2.3. Competitive Insights
Chapter 3. U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Market Variables, Trends, & Scope
3.1. Market Lineage Outlook
3.1.1. Parent Market Outlook
3.1.2. Related/Ancillary Market Outlook
3.2. Pricing Analysis Around the Medical Food Market
3.3. Industry Analysis
3.3.1. User Perspective Analysis
3.3.2. Key Deployments
3.4. Technology Outlook
3.5. Regulatory Framework
3.6. Market Dynamics
3.6.1. Market Drivers Analysis
3.6.2. Market Restraints Analysis
3.6.3. Industry Challenges and Opportunity Analysis
3.7. U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Market Analysis Tools
3.7.1. Porter's Analysis
3.7.2. PESTEL Analysis
3.8. Major Deals & Strategic Alliances Analysis in the U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Industry
3.9. Impact of COVID-19
3.10. Case Study
Chapter 4. U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Market: Type Estimates & Trend Analysis
4.1. Definition and Scope
4.2. Type Market Share Analysis, 2023 & 2030
4.3. Segment Dashboard
4.4. U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Market : By Type, 2018 to 2030
4.5. Software
4.5.1. Software Market Revenue Estimates and Forecasts, 2018-2030 (USD Billion)
4.5.2. Standalone
4.5.3. Integrated
4.6. Services
Chapter 5. U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Market: Deployment Estimates & Trend Analysis
5.1. Definition and Scope
5.2. Deployment Market Share Analysis, 2023 & 2030
5.3. Segment Dashboard
5.4. U.S. Healthcare Payers Core Administrative Processing Solutions (CAPS) Market: By Deployment, 2018 to 2030
5.5. On-premise
5.6. Cloud-based
Chapter 6. Competitive Landscape
6.1. Recent Developments & Impact Analysis by Key Market Participants
6.2. Company Categorization
6.3. Company Market Share Analysis
6.4. Company Heat Map Analysis
6.5. Strategy Mapping
6.5.1. Expansion
6.5.2. Mergers & Acquisition
6.5.3. Partnerships & Collaborations
6.5.4. New Type Launches
6.5.5. Research And Development
6.6. Company Profiles
6.6.1. Participant's Overview
6.6.2. Financial Performance
6.6.3. Type Benchmarking
6.6.4. Recent Developments
For more information about this report visit https://www.researchandmarkets.com/r/x02hvv
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