According to the Market Statsville Group (MSG), the global healthcare BPO market size is expected to grow from USD 281.9 billion in 2021 to USD 627.6 billion by 2030, at a CAGR of 9.3% from 2022 to 2030. Healthcare organizations use business process outsourcing (BPO) to choose and delegate particular business-related processes to third-party providers. It assists in processing claims, analyzing patient data and enrollment, strategic planning and managing accounts, business acquisition, and billings. This, in turn, helps healthcare organizations eliminate mistakes and illegal data access, improve productivity, and provide excellent services to patients while lowering operating expenses. Healthcare BPO is classified according to its many service categories, such as front-end and back-end.
The healthcare BPO market’s growth is attributed to the huge expansion of the healthcare industry and the rising incidence of different cardiovascular illnesses, particularly among the growing senior population. As a result, the number of hospital admissions worldwide is increasing. Furthermore, increased consumer knowledge about the availability of various health insurance plans and telehealth services is helping market growth.
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Other growth-inducing elements include fast technology improvements and integrating cloud-based BPO solutions in hospitals and clinics to establish cost-effective global service delivery models. Furthermore, government bodies of various nations have undertaken numerous favorable initiatives to adopt the BPO strategy for verifying insurance plans, filling, claiming, examining codding errors, and ensuring data security due to the increasing data breaches contributing to market growth. Other factors, such as the widespread use of electronic health records (EHR) and electronic medical records (EMR) for capturing patient health information and major cooperation among key companies, contribute to the market’s favorable outlook.
COVID–19 Impact on the Global Healthcare BPO Market
The COVID-19 pandemic has significantly impacted the global economy, putting further pressure on healthcare institutions to create a well-coordinated and well-connected environment with other hospital units. As a result, healthcare companies are increasingly outsourcing non-essential functions such as claims administration and revenue cycle management, enhancing patient outcomes by focusing on the organization’s core strengths. COVID-19 has had a complex and multifaceted influence on the healthcare BPO business. However, the business has been lucky enough to operate digitally, allowing BPO firms to continue operating with few employee health and safety hazards.
As a result, the COVID-19 pandemic is predicted to catalyze the fast change of traditional BPOs. Furthermore, the COVID-19 pandemic has increased R&D demand in the bio/pharmaceutical outsourcing business. This surge in demand, along with other pandemic-related effects, has forced several CROs to alter their emphasis and adjust their operations. Implementing digital innovations, technologies, and platforms have enabled the majority of healthcare BPO service providers to maintain efficiency and accuracy even during times of crisis.
Global Healthcare BPO Market Dynamics
Drivers: Increased pressure to reduce growing healthcare costs
Cost savings are key in outsourcing since it allows businesses to save money on resource management, labor, and space. Healthcare payer margins are under pressure due to the expansion of health insurance exchanges (online marketplaces for purchasing health insurance from competitive providers) in the United States. Customers can now receive coverage from many private healthcare competitors, which is anticipated to speed up the usage of outsourcing to cut expenses.
Structural changes, including the push toward paying for value, a greater emphasis on care management, and increasing cost-sharing with customers, are getting stronger as healthcare becomes a larger portion of the total economy, slowing the rapid expansion in healthcare spending. However, medical prices have been stable over the previous five years, ranging between 6% and 7%, and this is projected to raise healthcare expenditure. Rising healthcare expenses are consequently predicted to drive offshore outsourcing and, as a result, the global healthcare BPO industry.
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Restraints: High Hidden outsourcing costs
Cost reductions and the potential business value of outsourcing are negatively impacted by improper outsourcing strategy and financial allocation. Companies that plan their finances while outsourcing their business operations fail to account for unanticipated expenditures, such as those incurred while analyzing and selecting a vendor, administering offshore contracts, transitioning procedures, and improving employee security and severance compensation.
Concerns regarding the value for money these nations might offer have been raised due to rising labor costs in emerging economies. Furthermore, providers’ customized services and solutions will likely cost 15–30% more than regular services. When a customer exits a contract early, costs rise, and both the buyer and the supplier are exposed to the lawsuit, raising legal costs. Clients avoid outsourcing when the projected cost savings are not realized. This might stifle expansion in the healthcare BPO business.
Opportunities: Vastly increased application of artificial intelligence-based drug discovery tools
Artificial intelligence and machine learning, in particular, boost drug discovery efficiency and success rates during the early phases of drug development. This will assist healthcare BPO providers in making significant discoveries, as artificial intelligence is especially vital in discovering medications for chronic diseases like cancer. AI’s skills drastically cut the time required to bring cancer-fighting medicine to market, resulting in considerable growth in the healthcare BPO services market.
Several pharmaceutical firms are increasingly concentrating on collaborating with existing and developing AI-driven enterprises to utilize AI-based solutions’ power to accelerate their drug development initiatives. The growing number of pharmaceuticals created will influence the CRO services industry, thereby, a growing number of clinical trials and research on them. Such advantages have pushed several pharmaceutical and biotechnology businesses to use AI for drug development.
Scope of the Global Healthcare BPO Market
The study categorizes the healthcare BPO market based on provider service, payer service and life science service at the regional and global levels.
By Provider Service Outlook (Sales, USD Billion, 2017–2030)
- Revenue Cycle Management
- Patient Enrollment
- Patient Care
- Medical Transcription
- Medical Imaging
- Device Monitoring
By Payer Service Outlook (Sales, USD Billion, 2017–2030)
- Claims Management
- Claims Adjudication Services
- Claims Settlement Services
- Information Management Services
- Claims Repricing
- Claims Investigation Services
- Claims Indexing Services
- Fraud Detection & Management
- Product Development & Business Acquisition (PDBA)
- Member Management
- Provider Management
- Care Management
- Integrated Front-End Services and Back-office Operations
- Billing and accounts management services
- HR Services
By Life Science Service Outlook (Sales, USD Billion, 2017–2030)
- Vegetable Oils
- Non-Clinical Services
- Supply Chain Management & Logistics
- Sales and Marketing Services
- Performance Reporting
- Other Non-Clinical Services
By Region Outlook (Sales, USD Billion, 2017–2030)
- North America
- The Netherlands
- Czech Republic
- Rest of Europe
- Asia Pacific
- South Korea
- Australia & New Zealand
- Rest of Asia Pacific
- South America
- Rest of South America
- The Middle East & Africa
- Saudi Arabia
- South Africa
- Northern Africa
- Rest of MEA
Revenue cycle management segment accounts for the highest CAGR during the forecast period by Provider Service
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Based on provider service, the market is bifurcated into revenue cycle management, patient enrollment, and patient care. During the forecast period revenue cycle, the management segment is expected to grow at the highest CAGR. Revenue cycle management (RCM) market growth is attributable to increased government measures to improve RCM solution adoption, increased revenue loss owing to billing mistakes, and increased usage of EHR/EMR. Most hospitals rely on third-party suppliers for denial management services due to the lack of technical expertise and time to manage the reimbursement process. The most prevalent billing issues are failure to verify insurance, filing an incomplete claim, coding mistakes, lack of detail, and missing filing deadlines.
Most providers are currently tackling the issue by collaborating with third-party medical billing specialists who are experts in total revenue cycle management. Thus, it is concluded that specialist revenue cycle management service providers can help hospitals avoid revenue loss due to billing mistakes. Hence, drive the market under consideration throughout the forecast period.
North America is projected to account for the largest market share, by Region
Based on the regions, the global healthcare BPO market has been segmented across North America, Asia–Pacific, Europe, South America, and the Middle East & Africa. North America will dominate the global healthcare BPO market in 2021. Pharmaceutical businesses, particularly in the United States, are under considerable pricing pressures due to the Medicare Prescription Medication Coverage (Part D), which provides prescription drug coverage to all Medicare beneficiaries. Furthermore, it is anticipated that the income of important pharmaceutical businesses in the United States and Canada will be impacted by the patent expirations of several popular pharmaceutical products. Given these worries, many pharmaceutical companies are concentrating on outsourcing cost reduction, propelling market growth in North America.
However, Asia-Pacific is estimated to hold the highest CAGR in the global healthcare BPO market during the forecast period. The expanding population and energy consumption will contribute to market expansion. Asia Pacific area has a strong agricultural base in China and India, which will aid in meeting the need for healthcare BPO.
Key Market Players in the Global Healthcare BPO Market
The global healthcare BPO market is highly competitive, with key industry players adopting strategies such as product development, partnerships, acquisitions, agreements, and expansion to strengthen their market positions. Most market companies focus on expanding operations across regions, augmenting their capabilities, and building strong partner relations.
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Major players in the global healthcare BPO market are:
- Tata Consultancy Services
- Xerox Corporation
- WNS (Holdings) Limited
- NTT Data Corporation
- Infosys BPM
- Firstsource Solutions
- IBM Corporation
- HCL Technologies
- Sutherland Global
- GeBBS Healthcare Solutions
- Omega Healthcare
- R1 RCM
- Invensis Technologies
- UnitedHealth Group
- Sykes Enterprises
- Parexel International
- Access Healthcare
- Akurate Management Solutions (US)