Key drivers attributing to the growth are ObamaCare, shift to ICD-10
coding system, growing geriatric population, increasing disease burden
and penetration of insurance coverage in emerging economies.
In 2013, as per estimates published by the America's Health Insurance
Plans (AHIP), which is the national trade association representing the
health insurance industry, one-sixth of the U.S. economy or nearly USD
2.7 trillion is dedicated to healthcare spending and the number is
expected to increase year on year.
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However, the healthcare system is not able to reap the benefits of
such expenditure due to process inefficiencies and use of redundant
systems. The estimated loss due to such inefficiencies is nearly 800
billion or approximately 20 to 30 percent of the overall expenditure.
Increasing healthcare expenditure is a major concern for the U.S. and
all the other major economies. In order to reduce the economic burden
and provide universal access to healthcare, governments are encouraging
outsourcing of payer services to onshore or offshore locations.
The shift from ICD-9 coding system to ICD-10 coding has created huge
work load for the payers to upgrade their systems, train their staff and
has significantly increased the financial burden. The ICD-9 code system
had 13,000 codes, where as the ICD-10 code system has nearly 68,000
codes.
This shift from the legacy system to the latest system has
significantly increased the need for medical coding, accounting, HR, and
other technical professionals, thereby is expected to positively
reinforce the healthcare payer BPO outsourcing market growth in the next
seven years.
Further key findings from the study suggest:
In 2014, claims processing services accounted for the maximum share
of approximately 55%. Key reasons attributed are growth in new member
enrolments due to ObamaCare, increase in disease burden. For instance,
as per data published by ObamaCare and CMS, in 2013 nearly 8 million
people enrolled through the marketplace and nearly 11.7 million people
were enrolled in 2015.
However, Asia Pacific is expected to be the fastest growing market
over the forecast period owing to high economic development in the
region, favorable government initiatives and growth in insurance
penetration across urban and rural centers.
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For instance, the Indian government's initiatives such as Pradhan
Mantri Suraksha Bima Yojana and Pradhan Mantri Jeevan Jyoti Bima Yojana,
are expected to benefit millions of people seeking life insurance and
personal accident coverage and as consequence is expected to contribute
to the healthcare payer BPO market expansion over the forecast period.
Some key players operating in the market include, Xerox Corporation,
Genpact Limited, Wipro Limited, Capgemini, Hinduja Global Solutions, HCL
Technologies Ltd, Cognizant Technology Solutions, EXLService Holdings
Inc., and Accenture. These players dominate the market owing to their
strong product and service delivery portfolio, and presence of large
customer base in the U.S and European markets.
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