U.S. Healthcare BPO Market Thriving Amidst Rising Healthcare Costs



Outsourced healthcare management has become a growing trend in the global healthcare industry. It comes across as a strategic solution for the healthcare professionals to manage their office functions. Outsourced management also helps in different financial, administrative and IT services. The U.S. healthcare BPO market is in a dynamic phase. Immense potential for growth in this industry is paired with technological advancements and positive acceptance from different clinical and non-clinical end users. All these positive influences are driving the American market, which is a great sign for the existing companies as well as new entrants.

Healthcare BPO Market Segmentation

Healthcare industry in United States of America is struggling with growing costs of healthcare, which is a universal issue. Governments from different parts of the world are taking various steps to control the rising costs, which is helping the industry rise on its feet at a rapid rate. Control on these expenses is driving the alternative management markets including healthcare BPO. Apart from cost control initiatives, innovation and developments in terms of technology, application areas and regulatory charges are also driving the U.S. healthcare finance and BPO market.

Government initiatives including the significant American Recovery and Reinvestment Act of 2009 and Health Information Technology for Economic and Clinical Health Act (HITECH) have caused tremendous upward growth in the market. Markets transformation from the ICD-9 to ICD-10 coding system, expected to be implemented from 2014, is also expected to push the American market forward. One can study the current trends in the market with help of the vast segmentation. Basic segments in the market depend on the types of services and their applications in various clinical and non-clinical markets.

According to the types of services, the industry is segmented into three basic types, namely, provider, payer and pharmaceutical. These three segments are then divided into different sub-segments, which make it easy for the researchers to collect the desired data about each of these services. According to the experts, all these segments are expected to grow at a significant rate, which is a great sign for the American market for healthcare BPO. Following are the details of the segmentation in the U.S. market:

  • Payer: This segment is divided into claims processing, finance, accounts, HR services, member services and customer care.
  • Provider: This segment is divided into medical billing, coding, transcription, finance and accounts.
  • Pharmaceutical: This segment is divided into contract research organization, CMO and non-clinical services.

According to the researchers, who have studied the American market from 2013 to 2018, U.S. healthcare BPO market is expected to become worth $141.7 billion by the end of 2018. The payer segment is anticipated to be worth $11.1 billion, while the provider sector will become worth $6.8 billion. Pharmaceutical segment is estimated to dominate all the segments with an estimated worth of $65.6 billion.