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Healthcare Provider Network Management Market by Component (Services, Internal, Outsourcing Services, Software), Delivery (On premise and Cloud), End User (Payer, Private, Public Health Insurers), Region (North America, Europe) - Global Forecasts to 2025

Published: January 2021

No. of Pages: 122

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“The growing focus on improving the quality of care through the effective use of payer reporting requirements, the need to curtail escalating healthcare costs are set to drive the healthcare provider network management market.”

The healthcare provider network management market is projected to reach USD 5.8 billion by 2025 from USD 2.9 billion in 2020, at a CAGR of 14.9%. The growth of this market is driven by the implementation of stringent federal mandates in the US, the growing focus on improving the quality of care through the effective use of payer reporting requirements, the need to curtail escalating healthcare costs, and the in-house shortage of skilled personnel.

Payers will play a critical role throughout the crisis to ensure patients get the care they need at the appropriate cost. While many payer organizations find it difficult to run smoothly, companies that opted for provider network management infrastructure are functioning well. Furthermore, the pandemic has also caused extensive concerns and increasing economic hardships for consumers, businesses, and communities. With the ongoing pressure on the supply and demand side, there is potential for further market disturbance. Organizations and individuals may be experiencing liquidity stress, including limited access to credit. The deployment of provider network management solutions is vital for healthcare insurance providers, as it helps to manage providers’ networks with greater efficiency, processes claims with greater accuracy, and reduces costs and errors while lowering the burden on providers. These solutions enable payers to handle clients’ risks in real-time.

“The services segment is expected to hold the largest market share during the forecast period.”

On the basis of component, the healthcare provider network management market is segmented into software and services. The services segment is expected to hold the largest share of the global healthcare provider network management market in 2020. This segment's large share can be attributed to the reduced costs of services in healthcare systems and improvements in claims auto adjudication rates, operational efficiencies, and provider relationships. The services segment is further categorized as internal and external services.

“The cloud-based delivery mode segment is expected to grow at the highest rate during the forecast period.”

Based on delivery mode, the healthcare provider network management market is segmented into the on-premise delivery mode and cloud-based delivery mode. The on-premise delivery mode segment accounted for the largest share of the global healthcare provider network management market in 2019. On the other hand, the cloud-based delivery mode segment is expected to register the highest CAGR during the forecast period. Comparatively, lower capital expenses and operational costs incurred, and better scalability, flexibility, and affordability are the major factors driving the cloud-based solutions market.

“The private payers to garner large market share during the forecast period.”

Based on end users, the healthcare provider network management services market is segmented into private payers and public payers. The private payers' segment is expected to hold the largest share of the global market in 2020. The large share of this end-user segment can be attributed to the rising competitiveness among private payers to enhance their capabilities and offerings.

“The Asia Pacific healthcare provider network management market is expected to grow at the highest rate during the forecast period.”

Geographically, the healthcare provider network management market is segmented into North America, Europe, Asia Pacific (APAC), and the Rest of the World. The Asia Pacific market is expected to grow at the highest rate during the forecast period. The high growth rate in APAC can be attributed to the evolution of the healthcare ecosystem, growing burden on the healthcare industry, and increasing government initiatives for HCIT adoption in the region.

Breakdown of supply-side primary interviews:

By Company Type: Tier 1 – 40%, Tier 2 – 30%, and Tier 3 – 30%
By Designation: C-level – 27%, Director-level – 18%, and Others – 55%
By Region: North America - 50%, Europe – 27%, APAC – 15%, and RoW – 8%

Some of the major players in the market include Cognizant (US), Ayasdi, Inc. (US), Change Healthcare (US), Optum, Inc. (US), Genpact Limited (US), Infosys BPM Ltd. (India), Atos Syntel, Inc. (France), Mphasis, Ltd. (India), SKYGEN USA (US), Evolent Health, Inc. (US), OSP Labs (US), HGS Ltd. (India), Virtusa Corp. (US), EXL (US), among others.

Research Coverage

This report studies the healthcare provider network management market based on component, delivery mode, end user and region. The report also studies factors (such as drivers, restraints, opportunities, and challenges) affecting market growth. It analyzes the opportunities and challenges in the market and provides details of the competitive landscape for market leaders. Furthermore, the report analyzes micro markets with respect to their individual growth trends and forecasts the revenue of the market segments with respect to four main regions and respective countries.

Key Benefits of Buying the Report

This report focuses on various levels of analysis—industry trends, market share of top players, and company profiles, which together form basic views and analyze the competitive landscape, emerging segments of the healthcare provider network management market, and high-growth regions and their drivers, restraints, challenges, and opportunities. The report will help both established firms as well as new entrants/smaller firms to gauge the pulse of the market and garner greater market shares.

Table Of Contents

1 Introduction
1.1 Objectives Of The Study
1.2 Market Definition
1.3 Market Scope
1.3.1 Markets Covered
1.3.2 Years Considered For The Study
1.4 Currency
1.5 Limitations
1.5.1 Scope-Related Limitations
1.5.2 Methodology-Related Limitations
1.6 Market Stakeholders
1.7 Summary Of Changes

2 Research Methodology
2.1 Research Data
2.2 Research Methodology Steps
Figure 1 Research Methodology: Healthcare Provider Network Management Market
Figure 2 Research Design
2.2.1 Secondary Data
2.2.1.1 Secondary Sources
2.2.2 Primary Data
Figure 3 Breakdown Of Primary Interviews: By Company Type, Designation, And Region
2.2.2.1 Key Data From Primary Sources
2.3 Market Size Estimation
2.3.1 Bottom-Up Approach
2.3.1.1 Approach One: Revenue Mapping-Based Estimation
Figure 4 Estimation Of The Healthcare Provider Network Management Market: Revenue Mapping-Based Estimation
2.3.1.2 Approach Two: Buyer Adoption-Based Approach
Figure 5 Market Size Estimation: Buyer Adoption-Based
Figure 6 Research Methodology: Hypothesis Building
Figure 7 Revenue-Based Market Size Estimation: Healthcare Provider Network Management Market
2.3.2 Top-Down Approach
Figure 8 Penetration Rate-Based Market Estimation
2.4 Market Data Estimation And Triangulation
Figure 9 Data Triangulation Methodology
2.5 Assumptions For The Study
2.5.1 Covid-19-Specific Assumptions
2.6 Risk Assessment
Table 1 Limitations And Associated Risks

3 Executive Summary
Figure 10 Healthcare Provider Network Management Market, By Component, 2020 Vs. 2025 (Usd Million)
Figure 11 Healthcare Provider Network Management Market, By Delivery Mode, 2020 Vs. 2025 (Usd Million)
Figure 12 Healthcare Provider Network Management Services Market, By End User, 2020 Vs. 2025 (Usd Million)
Figure 13 Geographical Snapshot Of The Healthcare Provider Network Management Market

4 Premium Insights
4.1 Healthcare Provider Network Management: Market Overview
Figure 14 The Asia Pacific Region Is Projected To Witness The Highest Growth During The Forecast Period
4.2 North America Healthcare Provider Network Management Market, By Component & Country (2019)
Figure 15 The Us Accounted For The Largest Share Of The North American Healthcare Provider Network Management Market In 2019
4.3 Healthcare Provider Network Management Market, By Delivery Mode (2020-2025)
Figure 16 On-Premise Delivery Mode Segment To Dominate The Healthcare Provider Network Management Market During The Forecast Period
4.4 Geographical Snapshot Of The Healthcare Provider Network Management Market
Figure 17 Asia Pacific Market To Register The Highest Growth Rate During The Forecast Period

5 Market Overview
5.1 Introduction
5.2 Market Dynamics
Figure 18 Healthcare Provider Network Management Market: Drivers, Restraints, Opportunities, And Challenges
5.2.1 Drivers
5.2.1.1 Implementation Of Stringent Federal Mandates In The Us
5.2.1.2 Growing Focus On Improving The Quality Of Care Through The Effective Use Of Payer Reporting Requirements
5.2.1.3 Need To Curtail Escalating Healthcare Costs
5.2.1.4 In-House Shortage Of Skilled Personnel
5.2.2 Restraints
5.2.2.1 It Infrastructural Constraints In Developing Countries
5.2.2.2 Unforeseen Costs Associated With Outsourcing Services
5.2.3 Opportunities
5.2.3.1 Advanced Data Analytics
5.2.4 Challenges
5.2.4.1 Reluctance Of Users To Migrate From Legacy Systems
5.3 Covid-19 Impact
5.4 Value Chain Analysis
Figure 19 Healthcare Provider Network Management Market: Value Chain
5.5 Ecosystem
Figure 20 Healthcare Provider Network Management Market: Ecosystem

6 Healthcare Provider Network Management Market, By Component
6.1 Introduction
Table 2 Global Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
6.2 Provider Network Management Services
6.2.1 The Services Segment Is Expected To Dominate The Global Market During The Forecast Period
Table 3 Global Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 4 Global Healthcare Provider Network Management Services Market, By Region, 2018-2025 (Usd Million)
Table 5 North America: Healthcare Provider Network Management Services Market, By Country, 2018-2025 (Usd Million)
Table 6 Europe: Healthcare Provider Network Management Services Market, By Country, 2018-2025 (Usd Million)
6.3 Provider Network Management Software
6.3.1 Rising Healthcare Costs Is The Key Driver For The Adoption Of Provider Network Management Software
Table 7 Global Healthcare Provider Network Management Software Market, By Region, 2018-2025 (Usd Million)
Table 8 North America: Healthcare Provider Network Management Software Market, By Country, 2018-2025 (Usd Million)
Table 9 Europe: Healthcare Provider Network Management Software Market, By Country, 2018-2025 (Usd Million)

7 Healthcare Provider Network Management Market, By Delivery Mode
7.1 Introduction
Table 10 Global Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
7.2 On-Premise Delivery Mode
7.2.1 The On-Premise Delivery Mode Segment Accounted For The Largest Share Of The Market In 2019
Table 11 Healthcare Provider Network Management Market For On-Premise Delivery Mode, By Region, 2018-2025 (Usd Million)
Table 12 North America: Healthcare Provider Network Management Market For On-Premise Delivery Mode, By Country, 2018-2025 (Usd Million)
Table 13 Europe: Healthcare Provider Network Management Market For On-Premise Delivery Mode, By Country, 2018-2025 (Usd Million)
7.3 Cloud-Based Delivery Mode
7.3.1 The Cloud-Based Delivery Mode Segment Is Expected To Register The Highest Cagr During The Forecast Period
Table 14 Healthcare Provider Network Management Market For Cloud-Based Delivery Mode, By Region, 2018-2025 (Usd Million)
Table 15 North America: Healthcare Provider Network Management Market For Cloud-Based Delivery Mode, By Country, 2018-2025 (Usd Million)
Table 16 Europe: Healthcare Provider Network Management Market For Cloud-Based Delivery Mode, By Country, 2018-2025 (Usd Million)

8 Healthcare Provider Network Management Services Market, By End User
8.1 Introduction
Table 17 Global Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
8.2 Private Payers
8.2.1 The Private Payers' Segment Is Expected To Dominate The Global Market During The Forecast Period
Table 18 Healthcare Provider Network Management Services Market For Private Payers, By Region, 2018-2025 (Usd Million)
8.3 Public Payers
8.3.1 Increasing Government Initiatives To Improve Healthcare Coverage Is Driving The Growth Of This Segment
Table 19 Healthcare Provider Network Management Services Market For Public Payers, By Region, 2018-2025 (Usd Million)

9 Healthcare Provider Network Management Market, By Region
9.1 Introduction
Table 20 Healthcare Provider Network Management Market, By Region, 2018-2025 (Usd Million)
9.2 North America
Figure 21 North America To Grow At A Cagr Of 14.0% During The Forecast Period
Table 21 North America: Healthcare Provider Network Management Market, By Country, 2018-2025 (Usd Million)
Table 22 North America: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 23 North America: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 24 North America: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 25 North America: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.2.1 Us
9.2.1.1 Increase In Health Insurance Coverage
9.2.1.2 Rising Need To Curtail Escalating Healthcare Costs
Table 26 Us: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 27 Us: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 28 Us: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 29 Us: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.2.2 Canada
9.2.2.1 Strong Government Focus On Healthcare It Solutions
9.2.2.2 The Rising Need To Improve The Quality Of Healthcare In Canada
Table 30 Canada: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 31 Canada: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 32 Canada: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 33 Canada: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.3 Europe
Figure 22 Europe: Healthcare Provider Network Management Market Overview
Table 34 Europe: Healthcare Provider Network Management Market, By Country, 2018-2025 (Usd Million)
Table 35 Europe: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 36 Europe: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 37 Europe: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 38 Europe: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.3.1 Germany
9.3.1.1 Government Initiatives To Modernize The Healthcare System In Germany Drives The Market Growth
Table 39 Germany: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 40 Germany: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 41 Germany: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 42 Germany: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.3.2 Uk
9.3.2.1 Uk Is Projected To Grow With The Highest Cagr During The Forecast Period
Table 43 Uk: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 44 Uk: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 45 Uk: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 46 Uk: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.3.3 France
9.3.3.1 Digital Insurance Startups In France To Support Market Growth For Hpnm Solutions
Table 47 France: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 48 France: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 49 France: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 50 France: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.3.4 Rest Of Europe
Table 51 Roe: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 52 Roe: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 53 Roe: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 54 Roe: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.4 Asia Pacific
Table 55 Apac: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 56 Apac: Healthcare Provider Network Management Services Market, By Type, 2018-2025 (Usd Million)
Table 57 Apac: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 58 Apac: Healthcare Provider Network Management Services Market, By End User, 2018-2025 (Usd Million)
9.5 Rest Of The World
Table 59 Row: Healthcare Provider Network Management Market, By Component, 2018-2025 (Usd Million)
Table 60 Row: Healthcare Provider Network Management Market, By Delivery Mode, 2018-2025 (Usd Million)
Table 61 Row: Healthcare Provider Network Management Services Market Size, By End User, 2018-2025 (Usd Million)

10 Competitive Landscape
10.1 Overview
Figure 23 Key Players Adopted Organic And Inorganic Growth Strategies Between 2017 And 2020
Figure 24 Market Evolution Framework
10.2 Competitive Scenario
10.2.1 Acquisitions
10.2.2 Agreements, Partnerships, And Collaborations
10.2.3 Product And Service Launches
10.2.4 Expansions

11 Company Evaluation Matrix And Company Profiles
11.1 Company Evaluation Matrix: Definitions And Methodology
11.1.1 Stars
11.1.2 Emerging Leaders
11.1.3 Pervasive Players
11.1.4 Participants
Figure 25 Mnm Vendor Dive Comparison Matrix: Healthcare Provider Network Management Market
11.2 Company Profiles
(Business Overview, Products Offered, Recent Developments, Mnm View)*
11.2.1 Cognizant
Figure 26 Cognizant: Company Snapshot (2019)
11.2.2 Change Healthcare
Figure 27 Change Healthcare: Company Snapshot
11.2.3 Optum, Inc. (A Part Of Unitedhealth Group)
Figure 28 Unitedhealth Group: Company Snapshot
11.2.4 Ayasdi, Inc.
11.2.5 Genpact Limited
Figure 29 Genpact Limited: Company Snapshot
11.2.6 Infosys Bpm, Ltd.
Figure 30 Infosys: Company Snapshot
11.2.7 Atos Syntel Inc. (A Subsidiary Of Atos Se)
Figure 31 Atos Se: Company Snapshot (2019)
11.2.8 Mphasis Limited
Figure 32 Mphasis Limited: Company Snapshot
11.2.9 Skygen Usa, Llc.
11.2.10 Evolent Health, Inc.
Figure 33 Evolent Health: Company Snapshot (2019)
11.2.11 Osp Labs
11.2.12 Hgs Ltd.
Figure 34 Hgs Ltd.: Company Snapshot (2019)
11.2.13 Virtusa Corp.
Figure 35 Virtusa Corp.: Company Snapshot (2020)
11.2.14 Exl
Figure 36 Exl: Company Snapshot (2019)
11.2.15 Vee Technologies
11.2.16 Symplr
11.2.17 Appian
11.2.18 Virsys12, Llc. (A Salesforce Company)
11.2.19 Inovalon
11.2.20 Wipro Limited

*Business Overview, Products Offered, Recent Developments, Mnm View Might Not Be Captured In Case Of Unlisted Companies.

12 Appendix
12.1 Discussion Guide
12.2 Knowledge Store: Marketsandmarkets’ Subscription Portal
12.3 Available Customizations
12.4 Related Reports
12.5 Author Details

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