Technology Solutions In The U.S. Healthcare Payer Market Size, Share & Trends Analysis Report By Application, By Solution Type (Standalone, Integrated), By Payer Type (Government, Commercial), And Segment Forecasts, 2024 - 2030

Table of Contents

Chapter 1 Methodology And Scope

• 1.1 Market Segmentation & Scope
  • 1.1.1 Estimates & Forecast Timeline
• 1.2 Research Methodology
• 1.3 Information Procurement
  • 1.3.1 Purchased Database:
  • 1.3.2 GVR's Internal Database
  • 1.3.3 Secondary Sources
  • 1.3.4 Primary Research:
  • 1.3.5 Details Of Primary Research
• 1.4 Information Or Data Analysis
  • 1.4.1 Data Analysis Models
• 1.5 Market Formulation & Validation
• 1.6 Model Details
  • 1.6.1 Commodity Flow Analysis
  • 1.6.2 Segment Level Market Estimation
• 1.7 List Of Secondary Sources
• 1.8 Objectives
  • 1.8.1 Objective 1:
  • 1.8.2 Objective 2:

Chapter 2 Executive Summary

• 2.1 Market Outlook
• 2.2 Market Snapshot
• 2.3 Segmentation Snapshot
• 2.4 Segmentation Snapshot
• 2.5 Competitive Landscape Snapshot

Chapter 3 Technology Solutions In The U.S. Healthcare Payers Market Variables, Trends & Scope

• 3.1 Market Lineage Outlook
  • 3.1.1 Ancillary Market Analysis
• 3.2 Healthcare It Trends/dynamics In U.S. Healthcare Payers Market
  • 3.2.1 Market Driver Analysis
    • 3.2.1.1 Market Leaders
    • 3.2.1.1.1 Modernization Of Enrollment And Billing Processes
    • 3.2.1.1.2 Growing Acquisitions By Market Leaders
    • 3.2.1.2 Emerging Players/startups
    • 3.2.1.2.1 Growing Interest Of Investors And Venture Capitalists
    • 3.2.1.2.2 Revolutionization Of Healthcare Using Innovative Technologies
  • 3.2.2 Market Restraint Analysis
    • 3.2.2.1 Market Leaders
    • 3.2.2.1.1 Demand-supply Gap Of Tech Experts
    • 3.2.2.2 Emerging Players/startups
    • 3.2.2.2.1 Growing Instances Of Data Breaches
  • 3.2.3 Market Challenges Analysis
    • 3.2.3.1 Market Leaders
    • 3.2.3.1.1 Inflation And Rising Cost Of Care
    • 3.2.3.2 Emerging Players/startups
    • 3.2.3.2.1 Increased Competition
  • 3.2.4 Market Opportunity Analysis
    • 3.2.4.1 Market Leaders
    • 3.2.4.1.1 Growing Demand For Innovative Technologies
    • 3.2.4.2 Emerging Players/startups
    • 3.2.4.2.1 Enhanced Communication And Engagement
• 3.3 Industry Analysis Tools: Porter's Analysis
• 3.4 Industry Analysis - Pest
• 3.5 U.S. Healthcare Payers Market Technology Timeline
  • 3.5.1 Secondary Survey Insights Related To Changes In Technology Investments By Healthcare Payers
    • 3.5.1.1 Survey No.1
    • 3.5.1.2 Survey No.2
  • 3.5.2 Emerging Trends
    • 3.5.2.1 Digital Technology Analysis
    • 3.5.2.2 Modernization
    • 3.5.2.2.1 Cloud-based Solutions Analysis
    • 3.5.2.3 Ai-enabled Technology Analysis
• 3.6 Impact Of Covid-19 Pandemic

Chapter 4 U.S. Healthcare Payer Market

Chapter 5 Technology Solutions In The U.S. Healthcare Payers Market: Application Estimates & Trend Analysis

• 5.1 Segment Dashboard
• 5.2 Application Movement Analysis, USD Million, 2023 & 2030
  • 5.2.1 Enrollment And Member Management
    • 5.2.1.1 Enrollment And Member Management Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.2 Provider Management
    • 5.2.2.1 Provider Management Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.3 Claims Management
    • 5.2.3.1 Claims Management Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.4 Value-based Payments
    • 5.2.4.1 Value-based Payments Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.5 Revenue Management And Billing
    • 5.2.5.1 Revenue Management And Billing Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.6 Analytics
    • 5.2.6.1 Analytics Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.7 Personalize /crm
    • 5.2.7.1 Personalize /crm Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.8 Clinical Decision Support
    • 5.2.8.1 Clinical Decision Support Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.9 Data Management And Authorization
    • 5.2.9.1 Data Management And Authorization Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 5.2.10 Others
    • 5.2.10.1 Others Market Estimates And Forecasts, 2018 - 2030 (USD Million)

Chapter 6 Technology Solutions In The U.S. Healthcare Payers Market: Solution Type Estimates & Trend Analysis

• 6.1 Segment Dashboard
• 6.2 Technology Solutions In The U.S. Healthcare Payers Market: Solution Type Movement Analysis, USD Million, 2023 & 2030
  • 6.2.1 Standalone
    • 6.2.1.1 Standalone Market Estimates And Forecasts, 2018 - 2030 (USD Million)
  • 6.2.2 Integrated
    • 6.2.2.1 Integrated Market Estimates And Forecasts, 2018 - 2030 (USD Million)

Chapter 7 Country Estimates, Technology Solutions In The U.S. Healthcare Payers Market, By Application And Solution Type

• 7.1 U.S.
  • 7.1.1 Competitive Scenario
  • 7.1.2 Regulatory Framework
    • 7.1.2.1 Technology Solutions In The U.S. Healthcare Payer Market Estimates And Forecasts, 2018 - 2030 (USD Million)

Chapter 8 Market Player Analysis

• 8.1 Recent Developments & Impact Analysis By Key Market Participants
  • 8.1.1 Cognizant (Trizetto Business Line)
  • 8.1.2 Zeomega
  • 8.1.3 Pegasystems, Inc.
  • 8.1.4 Hyland Software, Inc.
  • 8.1.5 Medecision
  • 8.1.6 Medhok, Inc. (Mhk)
• 8.2 Company/competition Categorization (Key Innovators, Market Leaders, Emerging Players)
• 8.3 Estimated Dominant Company Market Position Analysis, 2023
• 8.4 Top Technology Solution Providers For Healthcare Payers
• 8.5 Competitive Factors And Strategies Implementation
  • 8.5.1 By Technology Solutions Providers In The U.S. Healthcare Payers Market
  • 8.5.2 Other Related Streams In The U.S. Healthcare Payers Market
• 8.6 Healthcare Payer's Digital Transformation Initiatives
  • 8.6.1 Key Focus Areas For Healthcare Payers
    • 8.6.1.1 Advanced Analytics
    • 8.6.1.2 Member Engagement
    • 8.6.1.3 Cybersecurity:
    • 8.6.1.4 Telehealth:
    • 8.6.1.5 Value-based Care:
    • 8.6.1.6 Population Health Management:
  • 8.6.2 Digital Healthcare Payer's Transformation Use Cases
    • 8.6.2.1 Accelerating Claims Processing
    • 8.6.2.1.1 Gleematic A.i: Cognitive Automation For Claims Processing
    • 8.6.2.2 Enhancing Customer Care
    • 8.6.2.2.1 Virtusa Corp.: 98% Boost In Customer Satisfaction Realized By Top Payer
    • 8.6.2.3 Accelerating New Member Enrollment
    • 8.6.2.3.1 Innova Solutions: Enrollment Management Solution For Leading U.S. Health Insurance Company
    • 8.6.2.4 Enabling Remote Workforce
    • 8.6.2.4.1 Productive Edge: Revolutionizing Primary Care: A Regional Payer's Innovative Virtual Solution For Patient Needs
    • 8.6.2.5 Enhancing Interoperability
    • 8.6.2.5.1 Hyland Software, Inc.: A Complex Regional Health System And Plan Provider Achieves Interoperability And Significant Roi
    • 8.6.2.6 Other Applications
    • 8.6.2.6.1 Hyland Software, Inc.: New York Health Plan Enhances Efficiency And Security By Automating Appeals And Grievances Processes
• 8.7 Analyst Recommendations For Healthcare Payers Regarding Technology Solutions
  • 8.7.1 Potential Growth And Penetration Areas

Chapter 9 Technology Solutions In The U.S. Healthcare Payers Market: Competitive Analysis

• 9.1 Strategic Initiatives
• 9.2 Top 5 Consulting Service Lines
  • 9.2.1 Ey
    • 9.2.1.1 Strategic Alliances
  • 9.2.2 Deloitte
    • 9.2.2.1 Strategic Alliances
  • 9.2.3 KPMG
    • 9.2.3.1 Strategic Alliances
  • 9.2.4 Pwc (Pricewaterhousecoopers)
    • 9.2.4.1 Strategic Alliances
  • 9.2.5 Ntt Data
    • 9.2.5.1 Strategic Alliances
• 9.3 Top 5 Indian Advisory Companies
  • 9.3.1 Infosys
    • 9.3.1.1 Strategic Alliances
  • 9.3.2 Tcs
    • 9.3.2.1 Strategic Alliances
  • 9.3.3 Wipro
    • 9.3.3.1 Strategic Alliances
  • 9.3.4 Cognizant
    • 9.3.4.1 Strategic Alliances
  • 9.3.5 Optum
    • 9.3.5.1 Strategic Alliances

Chapter 10 Technology Solutions in the U.S. Healthcare Payers Market: Market Player Landscape

• 10.1 Major Market Player Landscape
  • 10.1.1 HEALTHEDGE
    • 10.1.1.1 Company Overview
    • 10.1.1.2 Partners:
    • 10.1.1.3 Go-To-Market Strategies
  • 10.1.2 ORACLE
    • 10.1.2.1 Company OverVIew
    • 10.1.2.2 Oracle Enterprise Service Bus (ESB)
    • 10.1.2.3 Partners: Accenture, PwC, Cognizant, Deloitte, KPMG, TCS, Infosys, Wipro, EY
    • 10.1.2.4 Go-To-Market Strategies
  • 10.1.3 ORACLE EBS (E-BUSINESS SUITE)
  • 10.1.4 COGNIZANT
    • 10.1.4.1 Company OverVIew
    • 10.1.4.2 Facts of Cognizant digital healthcare payer Solutions
    • 10.1.4.3 Partnership
    • 10.1.4.4 Go-To-Market Strategies
• 10.2 Company Profiles
  • 10.2.1. COGNIZANT (TRIZETTO BUSINESS LINE)
    • 10.2.1.1. Participant's Overview
    • 10.2.1.2. Financial Performance
    • 10.2.1.3. Product Benchmarking
    • 10.2.1.4. Recent Developments
  • 10.2.2. ZEOMEGA
    • 10.2.2.1. Participant's Overview
    • 10.2.2.2. Financial Performance
    • 10.2.2.3. Product Benchmarking
    • 10.2.2.4. Recent Developments
  • 10.2.3. Oracle
    • 10.2.3.1. Participant's Overview
    • 10.2.3.2. Financial Performance
    • 10.2.3.3. Product Benchmarking
    • 10.2.3.4. Recent Developments
  • 10.2.4. HealthEdge Software Inc.
    • 10.2.4.1. Participant's Overview
    • 10.2.4.2. Financial Performance
    • 10.2.4.3. Product Benchmarking
    • 10.2.4.4. Recent Developments
  • 10.2.5. Pegasystems Inc.
    • 10.2.5.1. Participant's Overview
    • 10.2.5.2. Financial Performance
    • 10.2.5.3. Product Benchmarking
    • 10.2.5.4. Recent Developments
  • 10.2.6. Hyland Software Inc.
    • 10.2.6.1. Participant's Overview
    • 10.2.6.2. Financial Performance
    • 10.2.6.3. Product Benchmarking
    • 10.2.6.4. Recent Developments
  • 10.2.7. Zyter (Zyter| TrueCare)
    • 10.2.7.1. Participant's Overview
    • 10.2.7.2. Financial Performance
    • 10.2.7.3. Product Benchmarking
    • 10.2.7.4. Recent Developments
  • 10.2.8. Medecision
    • 10.2.8.1. Participant's Overview
    • 10.2.8.2. Financial Performance
    • 10.2.8.3. Product Benchmarking
    • 10.2.8.4. Recent Developments
  • 10.2.9. OSP
    • 10.2.9.1. Participant's Overview
    • 10.2.9.2. Financial Performance
    • 10.2.9.3. Product Benchmarking
    • 10.2.9.4. Recent Developments
  • 10.2.10. Open Text Corporation
    • 10.2.10.1. Participant's Overview
    • 10.2.10.2. Financial Performance
    • 10.2.10.3. Product Benchmarking
    • 10.2.10.4. Recent Developments
  • 10.2.11. MedHOK, Inc. (MHK)
    • 10.2.11.1. Participant's Overview
    • 10.2.11.2. Financial Performance
    • 10.2.11.3. Product Benchmarking
    • 10.2.11.4. Recent Developments

List of Tables

• Table 1 List of Abbreviation
• Table 2 Technology solutions in the U.S. healthcare payer market, by application, 2018 - 2030 (USD Million)
• Table 3 Technology solutions in the U.S. healthcare payer market, by solution type, 2018 - 2030 (USD Million)
• Table 4 Technology solutions in the U.S. healthcare payer market, by payer type, 2018 - 2030 (USD Million)

List of Figures

• Fig. 1 Technology solutions in the U.S. healthcare payers market segmentation
• Fig. 2 Market research process
• Fig. 3 Data triangulation techniques
• Fig. 4 Primary research pattern
• Fig. 5 Market research approaches
• Fig. 6 Value-chain-based sizing & forecasting
• Fig. 7 QFD modeling for market share assessment
• Fig. 8 Market formulation & validation
• Fig. 9 Technology Solutions in the healthcare payers market - Commodity flow analysis
• Fig. 10 Market Snapshot
• Fig. 11 Segment Snapshot
• Fig. 12 Segment Snapshot
• Fig. 13 Competitive Landscape Snapshot
• Fig. 14 Technology Solutions in the U.S. Healthcare Payers Market: PORTER's Analysis
• Fig. 15 Technology Solutions in the U.S. Healthcare Payers Market: PEST Analysis
• Fig. 16 Technology Solutions in the U.S. Healthcare Payers Market: Changes in Technology Investments (Percentage of Insurance Respondents)
• Fig. 17 Technology Solutions in the U.S. Healthcare Payers Market: Secondary Survey Insights
• Fig. 18 Technology Solutions in the U.S. Healthcare Payers Market: Secondary Survey Insights
• Fig. 19 Technology Solutions in the U.S. Healthcare Payers Market: Secondary Survey Insights
• Fig. 20 Technology Solutions in the U.S. Healthcare Payers Market: Secondary Survey Insights
• Fig. 21 Technology Solutions in the U.S. Healthcare Payers Market: Post COVID-19 Impact
• Fig. 22 Technology Solutions in the U.S. Healthcare Payers Market: Post COVID-19 Impact
• Fig. 23 Technology Solutions in the U.S. Healthcare Payers Market: COVID-19 Impact
• Fig. 24 Technology solutions in the U.S. healthcare payers market, application outlook key takeaways (USD Million)
• Fig. 25 Application movement analysis (USD Million), 2023 & 2030
• Fig. 26 Enrollment and member management market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 27 Provider management market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 28 Claims management market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 29 Value-based payments market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 30 Revenue management and billing market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 31 Analytics market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 32 Personalize /CRM market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 33 Clinical decision support market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 34 Data management and authorization market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 35 Others market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 36 Technology solutions in the U.S. healthcare payers market, solution type outlook key takeaways (USD Million)
• Fig. 37 Technology solutions in the U.S. healthcare payers market: Solution type movement analysis (USD Million), 2023 & 2030
• Fig. 38 Standalone market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 39 Integrated market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 40 U.S. key country dynamics
• Fig. 41 U.S. key country dynamics
• Fig. 42 Technology solutions in the U.S. healthcare payer market estimates and forecasts, 2018 - 2030 (USD Million)
• Fig. 43 Company/competition categorization
• Fig. 44 Strategic Initiatives by Key Players (%)
• Fig. 45 Company Overview: EY
• Fig. 46 Company Overview: Deloitte
• Fig. 47 Company Overview: KPMG
• Fig. 48 Company Overview: PwC
• Fig. 49 Company Overview: NTT Data
• Fig. 50 Company Overview: Infosys
• Fig. 51 Company Overview: TCS
• Fig. 52 Company Overview: WIPRO
• Fig. 53 Company Overview: Cognizant
• Fig. 54 Company Overview: Optum
• Fig. 55 Company Overview: Exela Technologies
• Fig. 56 Company Overview: EXL
• Fig. 57 Company Overview
• Fig. 58 Company Overview: MPhasis
• Fig. 59 Company Overview: Firstsource
• Fig. 60 Company Overview: HealthEdge
• Fig. 61 Company Overview: HealthEdge (Part 2)
• Fig. 62 Company Overview: Oracle
• Fig. 63 Company Overview: Cognizant