North America Healthcare Reimbursement Market Size, Share & Trends Analysis Report By Claim (Underpaid and Full Paid), By Service Provider, By Payer (Public Payers and Private Payers), By Country and Growth Forecast, 2024

List of Tables

The North America Healthcare Reimbursement Market would witness market growth of 17.2% CAGR during the forecast period (2024-2031).

The US market dominated the North America Healthcare Reimbursement Market by Country in 2023, and would continue to be a dominant market till 2031; thereby, achieving a market value of $29,447.1 Million by 2031. The Canada market is experiencing a CAGR of 19.6% during (2024 - 2031). Additionally, The Mexico market would exhibit a CAGR of 18.7% during (2024 - 2031).

The market plays a pivotal role in the global healthcare ecosystem. It encompasses a complex framework involving healthcare providers' compensation for services rendered to patients. This market comprises multiple stakeholders, including public and private health insurance providers, government agencies, healthcare providers, and patients. Rising healthcare costs, the increasing prevalence of chronic diseases, technological advancements, and expanding health insurance coverage have driven the growth and transformation of this market.

In addition, the healthcare reimbursement system ensures that healthcare providers receive payment for delivering medical services such as diagnostics, treatments, surgeries, and follow-up care. Efficient reimbursement models are critical for promoting access to high-quality care, reducing out-of-pocket expenses for patients, and sustaining healthcare providers' financial health. This market has witnessed significant changes with the growing focus on value-based care and innovations in digital health, telemedicine, and artificial intelligence (AI)-powered claims processing.

Cancer is the third leading cause of death in Mexico, with over 195,000 new cases recorded in 2020 and 90,222 deaths. The high prevalence of cancers such as breast, prostate, thyroid, colon, and cervical cancer is increasing healthcare expenditures and the need for efficient reimbursement systems to manage treatment costs. Cancer care often involves expensive diagnostics, surgeries, radiation, and chemotherapy, requiring streamlined reimbursement processes to minimize patient financial burdens. The growing number of cancer patients is driving demand for advanced oncology services, leading to an increase in reimbursement claims related to specialized cancer treatments. Therefore, the rising demand for home care services in Canada and the increasing prevalence of cancer in Mexico are significantly influencing the growth of the healthcare reimbursement market.

Based on Claim, the market is segmented into Underpaid and Full Paid. Based on Service Provider, the market is segmented into Hospitals, Diagnostic Laboratories, Physician Office, and Other Service Provider. Based on Payer, the market is segmented into Public Payers and Private Payers. Based on countries, the market is segmented into U.S., Mexico, Canada, and Rest of North America.

List of Key Companies Profiled

United HealthCare Services, Inc.
Allianz Care (Allianz Group)
CVS Health Corporation (ActiveHealth Management, Inc.)
Nippon Life Insurance Company Limited
The Cigna Group
Elevance Health, Inc.
Humana Inc.
Molina Healthcare, Inc.
Centene Corporation
MetLife, Inc.

North America Healthcare Reimbursement Market Report Segmentation

By Claim

Underpaid
Full Paid

By Service Provider

Hospitals
Diagnostic Laboratories
Physician Office
Other Service Provider

By Payer

Public Payers
Private Payers

By Country

US
Canada
Mexico
Rest of North America

Chapter 1. Market Scope & Methodology

1.1 Market Definition
1.2 Objectives
1.3 Market Scope
1.4 Segmentation
- 1.4.1 North America Healthcare Reimbursement Market, by Claim
- 1.4.2 North America Healthcare Reimbursement Market, by Service Provider
- 1.4.3 North America Healthcare Reimbursement Market, by Payer
- 1.4.4 North America Healthcare Reimbursement Market, by Country
1.5 Methodology for the research

Chapter 2. Market at a Glance

2.1 Key Highlights

Chapter 3. Market Overview

3.1 Introduction
- 3.1.1 Overview
  - 3.1.1.1 Market Composition and Scenario
3.2 Key Factors Impacting the Market
- 3.2.1 Market Drivers
- 3.2.2 Market Restraints
- 3.2.3 Market Opportunities
- 3.2.4 Market Challenges
3.3 Porter Five Forces Analysis

Chapter 4. North America Healthcare Reimbursement Market by Claim

4.1 North America Underpaid Market by Region
4.2 North America Full Paid Market by Region

Chapter 5. North America Healthcare Reimbursement Market by Service Provider

5.1 North America Hospitals Market by Country
5.2 North America Diagnostic Laboratories Market by Country
5.3 North America Physician Office Market by Country
5.4 North America Other Service Provider Market by Country

Chapter 6. North America Healthcare Reimbursement Market by Payer

6.1 North America Public Payers Market by Country
6.2 North America Private Payers Market by Country

Chapter 7. North America Healthcare Reimbursement Market by Country

7.1 US Healthcare Reimbursement Market
- 7.1.1 US Healthcare Reimbursement Market by Claim
- 7.1.2 US Healthcare Reimbursement Market by Service Provider
- 7.1.3 US Healthcare Reimbursement Market by Payer
7.2 Canada Healthcare Reimbursement Market
- 7.2.1 Canada Healthcare Reimbursement Market by Claim
- 7.2.2 Canada Healthcare Reimbursement Market by Service Provider
- 7.2.3 Canada Healthcare Reimbursement Market by Payer
7.3 Mexico Healthcare Reimbursement Market
- 7.3.1 Mexico Healthcare Reimbursement Market by Claim
- 7.3.2 Mexico Healthcare Reimbursement Market by Service Provider
- 7.3.3 Mexico Healthcare Reimbursement Market by Payer
7.4 Rest of North America Healthcare Reimbursement Market
- 7.4.1 Rest of North America Healthcare Reimbursement Market by Claim
- 7.4.2 Rest of North America Healthcare Reimbursement Market by Service Provider
- 7.4.3 Rest of North America Healthcare Reimbursement Market by Payer

Chapter 8. Company Profiles

8.1 United HealthCare Services, Inc.
- 8.1.1 Company Overview
8.2 CVS Health Corporation (ActiveHealth Management, Inc.)
- 8.2.1 Company Overview
- 8.2.2 Financial Analysis
- 8.2.3 Segmental and Regional Analysis
8.3 Allianz Care (Allianz Group)
- 8.3.1 Company Overview
- 8.3.2 Financial Analysis
8.4 Reliance Nippon Life Insurance Company Limited
- 8.4.1 Company Overview
8.5 The Cigna Group
- 8.5.1 Company Overview
- 8.5.2 Financial Analysis
- 8.5.3 Segmental Analysis
8.6 Elevance Health, Inc.
- 8.6.1 Company Overview
- 8.6.2 Financial Analysis
- 8.6.3 Segmental Analysis
8.7 Humana Inc.
- 8.7.1 Company Overview
8.8 Molina Healthcare, Inc.
- 8.8.1 Company Overview
8.9 Centene Corporation
- 8.9.1 Company Overview
8.10. MetLife, Inc.
- 8.10.1 Company Overview

LIST OF TABLES

TABLE 1 North America Healthcare Reimbursement Market, 2020 - 2023, USD Million
TABLE 2 North America Healthcare Reimbursement Market, 2024 - 2031, USD Million
TABLE 3 North America Healthcare Reimbursement Market by Claim, 2020 - 2023, USD Million
TABLE 4 North America Healthcare Reimbursement Market by Claim, 2024 - 2031, USD Million
TABLE 5 North America Underpaid Market by Region, 2020 - 2023, USD Million
TABLE 6 North America Underpaid Market by Region, 2024 - 2031, USD Million
TABLE 7 North America Full Paid Market by Region, 2020 - 2023, USD Million
TABLE 8 North America Full Paid Market by Region, 2024 - 2031, USD Million
TABLE 9 North America Healthcare Reimbursement Market by Service Provider, 2020 - 2023, USD Million
TABLE 10 North America Healthcare Reimbursement Market by Service Provider, 2024 - 2031, USD Million
TABLE 11 North America Hospitals Market by Country, 2020 - 2023, USD Million
TABLE 12 North America Hospitals Market by Country, 2024 - 2031, USD Million
TABLE 13 North America Diagnostic Laboratories Market by Country, 2020 - 2023, USD Million
TABLE 14 North America Diagnostic Laboratories Market by Country, 2024 - 2031, USD Million
TABLE 15 North America Physician Office Market by Country, 2020 - 2023, USD Million
TABLE 16 North America Physician Office Market by Country, 2024 - 2031, USD Million
TABLE 17 North America Other Service Provider Market by Country, 2020 - 2023, USD Million
TABLE 18 North America Other Service Provider Market by Country, 2024 - 2031, USD Million
TABLE 19 North America Healthcare Reimbursement Market by Payer, 2020 - 2023, USD Million
TABLE 20 North America Healthcare Reimbursement Market by Payer, 2024 - 2031, USD Million
TABLE 21 North America Public Payers Market by Country, 2020 - 2023, USD Million
TABLE 22 North America Public Payers Market by Country, 2024 - 2031, USD Million
TABLE 23 North America Private Payers Market by Country, 2020 - 2023, USD Million
TABLE 24 North America Private Payers Market by Country, 2024 - 2031, USD Million
TABLE 25 North America Healthcare Reimbursement Market by Country, 2020 - 2023, USD Million
TABLE 26 North America Healthcare Reimbursement Market by Country, 2024 - 2031, USD Million
TABLE 27 US Healthcare Reimbursement Market, 2020 - 2023, USD Million
TABLE 28 US Healthcare Reimbursement Market, 2024 - 2031, USD Million
TABLE 29 US Healthcare Reimbursement Market by Claim, 2020 - 2023, USD Million
TABLE 30 US Healthcare Reimbursement Market by Claim, 2024 - 2031, USD Million
TABLE 31 US Healthcare Reimbursement Market by Service Provider, 2020 - 2023, USD Million
TABLE 32 US Healthcare Reimbursement Market by Service Provider, 2024 - 2031, USD Million
TABLE 33 US Healthcare Reimbursement Market by Payer, 2020 - 2023, USD Million
TABLE 34 US Healthcare Reimbursement Market by Payer, 2024 - 2031, USD Million
TABLE 35 Canada Healthcare Reimbursement Market, 2020 - 2023, USD Million
TABLE 36 Canada Healthcare Reimbursement Market, 2024 - 2031, USD Million
TABLE 37 Canada Healthcare Reimbursement Market by Claim, 2020 - 2023, USD Million
TABLE 38 Canada Healthcare Reimbursement Market by Claim, 2024 - 2031, USD Million
TABLE 39 Canada Healthcare Reimbursement Market by Service Provider, 2020 - 2023, USD Million
TABLE 40 Canada Healthcare Reimbursement Market by Service Provider, 2024 - 2031, USD Million
TABLE 41 Canada Healthcare Reimbursement Market by Payer, 2020 - 2023, USD Million
TABLE 42 Canada Healthcare Reimbursement Market by Payer, 2024 - 2031, USD Million
TABLE 43 Mexico Healthcare Reimbursement Market, 2020 - 2023, USD Million
TABLE 44 Mexico Healthcare Reimbursement Market, 2024 - 2031, USD Million
TABLE 45 Mexico Healthcare Reimbursement Market by Claim, 2020 - 2023, USD Million
TABLE 46 Mexico Healthcare Reimbursement Market by Claim, 2024 - 2031, USD Million
TABLE 47 Mexico Healthcare Reimbursement Market by Service Provider, 2020 - 2023, USD Million
TABLE 48 Mexico Healthcare Reimbursement Market by Service Provider, 2024 - 2031, USD Million
TABLE 49 Mexico Healthcare Reimbursement Market by Payer, 2020 - 2023, USD Million
TABLE 50 Mexico Healthcare Reimbursement Market by Payer, 2024 - 2031, USD Million
TABLE 51 Rest of North America Healthcare Reimbursement Market, 2020 - 2023, USD Million
TABLE 52 Rest of North America Healthcare Reimbursement Market, 2024 - 2031, USD Million
TABLE 53 Rest of North America Healthcare Reimbursement Market by Claim, 2020 - 2023, USD Million
TABLE 54 Rest of North America Healthcare Reimbursement Market by Claim, 2024 - 2031, USD Million
TABLE 55 Rest of North America Healthcare Reimbursement Market by Service Provider, 2020 - 2023, USD Million
TABLE 56 Rest of North America Healthcare Reimbursement Market by Service Provider, 2024 - 2031, USD Million
TABLE 57 Rest of North America Healthcare Reimbursement Market by Payer, 2020 - 2023, USD Million
TABLE 58 Rest of North America Healthcare Reimbursement Market by Payer, 2024 - 2031, USD Million
TABLE 59 Key Information - United HealthCare Services, Inc.
TABLE 60 Key Information - CVS Health Corporation
TABLE 61 Key Information - Allianz Care
TABLE 62 Key Information - Reliance Nippon Life Insurance Company Limited
TABLE 63 Key Information - The Cigna Group
TABLE 64 Key Information - Elevance Health, Inc.
TABLE 65 Key Information - Humana Inc.
TABLE 66 Key Information - Molina Healthcare, Inc.
TABLE 67 Key Information - Centene Corporation
TABLE 68 Key Information - MetLife, Inc.

North America Healthcare Reimbursement Market Size, Share & Trends Analysis Report By Claim (Underpaid and Full Paid), By Service Provider, By Payer (Public Payers and Private Payers), By Country and Growth Forecast, 2024 - 2031

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