Market Analysis
published on Jul 31, 2024
Report Overview:
NelsonHall’s Healthcare Payer Operations Transformation market analysis consists of 81 pages.
Who is this Report for:
NelsonHall’s Healthcare Payer Operations Transformation report is a comprehensive market assessment report designed for:
- Sourcing managers investigating sourcing developments within the Healthcare Payer Operations Transformation market
- Vendor marketing, sales, and business managers developing strategies to target Healthcare Payer Operations Transformation opportunities
- Financial analysts and investors specializing in the Healthcare Payer Operations Transformation services sector.
Scope of this Report:
The report analyzes the worldwide market for Healthcare Payer Operations Transformation and addresses the following questions:
- What is the market size and projected growth for the Healthcare Payer Operations Transformation by geography?
- What is the profile of activity in the Healthcare Payer Operations Transformation services market?
- What are the top drivers for adoption of Healthcare Payer Operations Transformation services?
- What are the benefits currently achieved by Healthcare Payer Operations Transformation users?
- What factors are inhibiting user adoption of Healthcare Payer Operations Transformation services?
- What pricing mechanisms are typically used within Healthcare Payer Operations Transformation services and how is this changing?
- Who are the leading Healthcare Payer Operations Transformation vendors globally and by geography?
- What combination of services is typically provided within Healthcare Payer Operations Transformation contracts and what new services are being added?
- What is the current pattern of delivery location used for Healthcare Payer Operations Transformation services and how is this changing?
- What services are delivered from onshore and which from offshore?
- What are the challenges and success factors within Healthcare Payer Operations Transformation services?
Key Findings & Highlights:
The report focuses on strategies for 2024 and beyond. Recent trends underscore a notable reliance on Healthcare Payer Operations Transformation BPS services, particularly in claims management/administration, member engagement, services and enrollment, care management and wellness services, and provider management/administration. There is also an anticipated surge in demand for BPS services in emerging areas such as member engagement, care management and provider administration. Tomorrow’s consumers are increasingly seeking hyper-personalization across the entire Healthcare payer value chain.
These evolving expectations prompt vendors to invest significantly in advanced technologies like generative AI, seamlessly integrating them into their BPS offerings. Concurrently, carriers are investigating/undertaken newer technologies such as generative AI, NLP/ML/DL, BPaaS, Analytics, and Cloud integration across the healthcare value chain and are in various stages of deployment from proof of concept to extensive roll-out and scaling.
Regarding operational delivery, offshore centers are expected to remain stable, with an increase in the demand for onshore and nearshore delivery centers. Due to regulatory requirements, vendors will witness demand increase for onshore capabilities and a growing trend in various pricing mechanisms (e.g., PMPM, outcome-based pricing, and transaction or per-unit pricing).