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Technology Solutions in U.S. Healthcare Payer Market Trends

Report ID: GMI9539
Published Date: May 2024
Report Format: PDF

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Technology Solutions in U.S. Healthcare Payer Market Trends

Healthcare payers are utilizing advanced healthcare analytics techniques such as predictive analytics, machine learning algorithms, and data visualization tools to extract valuable insights from the vast amounts of healthcare data available. These data-driven insights are enabling the healthcare payers to enhance patient outcomes and optimize costs by tailoring their strategies based on the unique needs and characteristics of each individual.
The widespread occurrence of fraudulent activities in claim management has become a pressing concern for healthcare payers. Vendors are increasingly preferring to integrate generative AI in their existing solutions to detect patterns in fraudulent activities. Such integrations have enabled the healthcare payers to analyze datasets and detect the subtle patterns that indicate and alarm for any fraudulent activities.
For instance, according to an article published by HealthEdge Software, Inc. in March 2024, healthcare payers are using core administration processing systems (CAPS) to improve auto adjudication rates and detect fraud. Such advanced integrations are expected to drive the adoption of technology solutions among healthcare payers in the U.S.

Authors: Mariam Faizullabhoy, Gauri Wani

Frequently Asked Questions (FAQ) :

Technology solutions in U.S. healthcare payer industry was valued at USD 7.6 billion in 2023 and is anticipated to showcase 7.2% CAGR from 2024 – 2032, due to the increasing need for streamlining operational workflow and reducing administrative expenses.

The integrated solution type segment is anticipated to grow at 7.5% CAGR up to 2032, due to the growing demand for user experience through offering personalized solutions.

The claims management application segment held 31.5% share in 2023 and is anticipated to grow at 7.4% CAGR up to 2032, led by rapid technological advancements, such as digital engagement, automation, AI and advanced analytics.

Cognizant Technology Solutions Corporation, HCL Technologies Limited, HealthEdge Software, Inc., Hyland Software, Inc., KMS Healthcare, Medecision, MedHOK, Inc., Open Text Corporation, Oracle Corporation, OSP, and Pegasystems Inc.