Healthcare BPO Market Study of Key Players, Profile and Dynamics By 2026

Healthcare BPO market in terms of revenue was estimated to be worth $296.4 billion in 2021 and is poised to reach $468.5 billion by 2026, growing at a CAGR of 9.6% from 2021 to 2026 according to a latest report published by MarketsandMarkets™. Growth in this market is primarily driven by the need to reduce rising healthcare costs and the implementation of the Patient Protection and Affordable Care Act (PPACA) are compelling payers and providers to outsource their business processes to low-cost countries in order to reduce their operational costs.

The major source geographies that primarily outsource most of their non-core activities to third parties include North America, Europe, and Rest of the World.

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Key Market Players

Some of the prominent players operating in the Healthcare BPO market are Accenture (Ireland), Cognizant (US), Tata Consultancy Services (India), Xerox Corporation (US), WNS (Holdings) Limited (India), NTT Data Corporation (Japan), IQVIA (US), Mphasis (India), Genpact (US), Wipro (India), Infosys BPM (India), Firstsource Solutions (India), IBM Corporation (US), HCL Technologies (India), Sutherland Global (US), GeBBS Healthcare Solutions (US), Lonza (Switzerland), Omega Healthcare (India), R1 RCM (US), Invensis Technologies (India), UnitedHealth Group (US), Sykes Enterprises (US), Parexel International (US), Access Healthcare (US), and Akurate Management Solutions (US), among others

Healthcare BPO Market Dynamics

Drivers: pressure to reduce the rising healthcare costs

Cost savings are an important consideration in outsourcing, as by doing so, companies can reduce costs on resource management, labor, and space. There is pressure on the margins of healthcare payers due to the rise of health insurance exchanges (online marketplaces to obtain health insurance from competing providers) in the US. This enables consumers to obtain coverage from competing private healthcare providers and is likely to accelerate the adoption of outsourcing to rationalise costs.

Restraints: Hidden outsourcing costs

Improper planning and financial allocation for outsourcing activities often lead to negative impacts on cost savings and the business value that can be derived from outsourcing. Companies that plan their finances while outsourcing their business processes fail to take into account unforeseen costs, such as those incurred while evaluating and selecting a vendor, managing offshore contracts, transitioning their processes, and enhancing security and severance pay for employees.

Opportunities: Growing adoption of artificial intelligence-based tools for drug discovery

Artificial intelligence and machine learning, in particular, make the drug discovery process more efficient and substantially improve success rates at the early stages of drug development. This will help healthcare BPO service providers bring about major breakthroughs, as artificial intelligence also plays an important role in the discovery of drugs for chronic diseases such as cancer. Owing to its capabilities, AI significantly reduces the time taken to bring a cancer-fighting drug to market, which will lead to significant growth in the healthcare BPO market.

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Challenges: Data security concerns

In healthcare, approximately one-third of data breaches result in medical identity theft, mainly due to a lack of internal control over patient information, a lack of top-level management support, outdated policies and procedures or non-adherence to existing ones, and inadequate personnel training. This makes patient confidentiality a major challenge in the healthcare industry. As per the National Center for Biotechnology Information (NCBI), in 2018, the number of data breaches reported was 2,216 from 65 countries. Out of these, the healthcare industry faced 536 breaches (the highest number of breaches among all industries).

North America, as a source geography, holds the largest share of the healthcare BPO market.

North America held the largest share of this market, accounting for 49.0%, followed by Europe (30.6%) and the rest of the world (20.3%). Pharmaceutical companies in the region, particularly in the United States, are facing significant price pressures as a result of the Medicare Prescription Drug Coverage (Part D), which covers all Medicare beneficiaries for prescription drugs. Additionally, the patent expiration of several blockbuster drugs is expected to affect the revenue of large pharmaceutical companies in the US and Canada. Taking these factors into consideration, a number of pharmaceutical companies are focusing on cost reduction through outsourcing, subsequently driving market growth in North America.

Recent Developments

  • UnitedHealth Group Inc. has acquired InstaMed, a healthcare payments platform, for an undisclosed sum.
  • Cigna Corp. has acquired ScriptDrop, a medication delivery and adherence platform, for an undisclosed sum.
  • Optum Inc. has acquired Change Healthcare, a healthcare technology company, for $13 billion.
  • Anthem Inc. has acquired Evolent Health, a population health management company, for $4.7 billion.
  • Humana Inc. has acquired Genoa Healthcare, a behavioral health pharmacy services provider, for $1 billion.
  • Aetna Inc. has acquired Healthagen, a population health management company, for an undisclosed sum.
  • Cerner Corp. has acquired NantHealth, a healthcare technology company, for an undisclosed sum.
  • Allscripts Healthcare Solutions Inc. has acquired McKesson Corporation’s US Hospital and Health Systems business for an undisclosed sum.
  • Cognizant Technology Solutions Corp. has acquired TriZetto, a healthcare information technology provider, for $2.7 billion.
  • HCL Technologies Ltd. has acquired Medix, a healthcare BPO provider, for $85 million.

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