Healthcare Provider Network Management Market Forecasts to 2030 - Global Analysis By Component (Software, Hardware and Services), Mode Of Delivery (On-Premise Solutions and Cloud-Based Solutions), Technology, Application, End User and By Geography

According to Stratistics MRC, the Global Healthcare Provider Network Management Market is accounted for $4.72 billion in 2023 and is expected to reach $14.12 billion by 2030 growing at a CAGR of 16.9% during the forecast period. Healthcare provider network management involves the organization and oversight of healthcare providers within a network to ensure quality care delivery and efficient operations. The goal is to establish a robust network of healthcare professionals and facilities that can meet the needs of patients while controlling costs. Effective management involves collaboration with insurers, providers, and patients to optimize care outcomes, streamline administrative processes, and maintain regulatory compliance. This ensures patients have access to high-quality care within a well-coordinated healthcare system.

According to the Medical Expenditure Panel Survey, the share of uninsured adults aged 18 to 64 years, in the US, for the entire calendar year declined by 18.8% in 2013 and 13.0% by 2018.

Market Dynamics:

Driver:

Growing demand for quality healthcare

The growing demand for quality healthcare necessitates efficient management of provider networks to ensure access to high-caliber healthcare professionals and facilities. Providers seek robust network management solutions to enhance care coordination, streamline operations, and improve patient outcomes. Additionally, as healthcare systems globally shift towards value-based care models, the emphasis on quality necessitates effective network management strategies to optimize resource utilization and enhance the overall patient experience. Consequently, the demand for provider network management solutions continues to rise to meet these evolving healthcare needs.

Restraint:

Data security concerns

Data security concerns in healthcare provider network management relate to the protection of sensitive patient information from unauthorized access, breaches, and misuse. These concerns stem from the potential consequences of data breaches, including privacy violations, financial losses, and damage to reputation. Consequently, healthcare organizations may hesitate to adopt network management solutions due to fears of data vulnerability. This hesitation hampers the market growth.

Opportunity:

Expansion of healthcare infrastructure

The expansion of healthcare infrastructure, particularly in emerging markets, creates opportunities for the development and optimization of robust healthcare networks. As new facilities, clinics, and hospitals are established, there is an increasing need to efficiently manage provider networks to ensure seamless coordination, accessibility, and quality of care. Moreover, the demand for network management solutions intensifies as healthcare infrastructure development emphasizes the importance of coordinated care delivery and the integration of diverse healthcare services.

Threat:

Interoperability issues

Interoperability issues in healthcare provider network management arise from the lack of standardized data formats and communication protocols among different systems. This fragmentation impedes seamless exchange of patient information, leading to inefficiencies, errors, and compromised patient care. Consequently, healthcare providers struggle with data integration, coordination, and decision-making processes, hindering the optimization of resources and patient outcomes.

Covid-19 Impact

The covid-19 pandemic has significantly impacted the healthcare provider network management market. With the strain on healthcare systems worldwide, there has been an increased focus on efficient management of provider networks to ensure optimal patient care and resource allocation. Telehealth solutions have surged in popularity, leading to a greater demand for network management technologies capable of supporting remote care delivery. Additionally, the pandemic has highlighted the importance of data analytics and interoperability in managing provider networks effectively amidst rapidly changing healthcare landscapes, driving further innovation in the sector.

The software segment is expected to be the largest during the forecast period

The software segment is estimated to have a lucrative growth, due to its diverse array of solutions tailored to streamline operations, enhance patient care, and ensure regulatory compliance. They facilitate efficient data management, patient scheduling, billing, and clinical decision support. Additionally, specialized software addresses credentialing, provider directory management, and network analytics, enabling healthcare organizations to optimize resource allocation, improve care coordination, and adapt to evolving industry trends while maintaining high standards of patient care and regulatory compliance.

The provider performance management segment is expected to have the highest CAGR during the forecast period

The provider performance management segment is anticipated to witness the highest CAGR growth during the forecast period. It involves the evaluation and optimization of healthcare providers' performance to enhance quality of care and operational efficiency. This encompasses various metrics such as patient outcomes, adherence to clinical guidelines, patient satisfaction, and cost-effectiveness. By fostering accountability, continuous quality improvement, and alignment with organizational goals, it contributes to the delivery of high-quality, patient-centered care within healthcare provider networks while promoting provider satisfaction and engagement.

Region with largest share:

Asia Pacific is projected to hold the largest market share during the forecast period owing to increasing healthcare expenditure, the growing prevalence of chronic diseases, and advancements in healthcare IT infrastructure. Countries like China, India, Japan, and Australia are key players in this market, with a focus on improving healthcare infrastructure, implementing digital solutions for network management, and enhancing patient outcomes. The market is driven by the need for efficient management of healthcare providers, networks, and resources to ensure better access and delivery of healthcare services across the region.

Region with highest CAGR:

North America is projected to have the highest CAGR over the forecast period, owing to increasing healthcare spending, technological advancements, and the emphasis on improving patient outcomes. With the United States being the largest market in the region, there is a strong focus on optimizing healthcare networks, enhancing provider-payer collaborations, and implementing value-based care models. Additionally, the growing demand for integrated healthcare delivery systems and the need for efficient management of healthcare resources contribute to the expansion of the market in North America.

Key players in the market

Some of the key players profiled in the Healthcare Provider Network Management Market include Cerner Corporation, Optum Healthcare company, McKesson Corporation, IBM Watson Health, Allscripts Healthcare Solutions, Athenahealth Inc., Change Healthcare, Conifer Health Solutions, EPIC Systems Corporation, GE Healthcare, HMS Holdings Corporation, NextGen Healthcare, Quest Diagnostics, Genpact Limited, Veeva Systems, Infosys BPM Limited, Mphasis Limited and Innovaccer.

Key Developments:

In June 2023, Quest Analytics, the leader in provider network management solutions and services, launched the Provider Claims Insights. This new offering adds provider performance measures within the Quest Enterprise Services (QES) platform to help health plans improve provider selection and overall network performance.

In May 2023, IBM unveiled IBM Hybrid Cloud Mesh, a SaaS offering that is designed to enable enterprises to bring management to their hybrid multicloud infrastructure. Driven by "Application-Centric Connectivity", IBM Hybrid Cloud Mesh is engineered to automate the process, management and observability of application connectivity in and between public and private clouds to help modern enterprises operate their infrastructure across hybrid multicloud and heterogeneous environments.

Components Covered:

• Software
• Hardware
• Services

Mode Of Deliveries Covered:

• On-Premise Solutions
• Cloud-Based Solutions

Technologies Covered:

• Blockchain
• Artificial Intelligence (AI)
• Machine Learning (ML)
• Other Technologies

Applications Covered:

• Network Development & Contract Management
• Provider Credentialing
• Provider Enrollment
• Provider Directory Management
• Provider Performance Management
• Provider Payment Management
• Other Applications

End Users Covered:

• Healthcare Providers
• Healthcare Payers
• Government Healthcare Agencies
• Accountable Care Organizations (ACOs)
• Other End Users

Regions Covered:

• North America
  • US
  • Canada
  • Mexico
• Europe
  • Germany
  • UK
  • Italy
  • France
  • Spain
  • Rest of Europe
• Asia Pacific
  • Japan
  • China
  • India
  • Australia
  • New Zealand
  • South Korea
  • Rest of Asia Pacific
• South America
  • Argentina
  • Brazil
  • Chile
  • Rest of South America
• Middle East & Africa
  • Saudi Arabia
  • UAE
  • Qatar
  • South Africa
  • Rest of Middle East & Africa

What our report offers:

• Market share assessments for the regional and country-level segments
• Strategic recommendations for the new entrants
• Covers Market data for the years 2021, 2022, 2023, 2026, and 2030
• Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and recommendations)
• Strategic recommendations in key business segments based on the market estimations
• Competitive landscaping mapping the key common trends
• Company profiling with detailed strategies, financials, and recent developments
• Supply chain trends mapping the latest technological advancements

Free Customization Offerings:

All the customers of this report will be entitled to receive one of the following free customization options:

• Company Profiling
  • Comprehensive profiling of additional market players (up to 3)
  • SWOT Analysis of key players (up to 3)
• Regional Segmentation
  • Market estimations, Forecasts and CAGR of any prominent country as per the client's interest (Note: Depends on feasibility check)
• Competitive Benchmarking
  • Benchmarking of key players based on product portfolio, geographical presence, and strategic alliances