Table of Content
1 INTRODUCTION
1.1 OBJECTIVES OF THE STUDY
1.2 MARKET DEFINITION
1.3 OVERVIEW OF GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET
1.4 CURRENCY AND PRICING
1.5 LIMITATION
1.6 MARKETS COVERED
2 MARKET SEGMENTATION
2.1 KEY TAKEAWAYS
2.2 ARRIVING AT THE GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET SIZE
2.2.1 VENDOR POSITIONING GRID
2.2.2 TECHNOLOGY LIFE LINE CURVE
2.2.3 TRIPOD DATA VALIDATION MODEL
2.2.4 MARKET GUIDE
2.2.5 MULTIVARIATE MODELLING
2.2.6 TOP TO BOTTOM ANALYSIS
2.2.7 CHALLENGE MATRIX
2.2.8 APPLICATION COVERAGE GRID
2.2.9 STANDARDS OF MEASUREMENT
2.2.10 VENDOR SHARE ANALYSIS
2.2.11 DATA POINTS FROM KEY PRIMARY INTERVIEWS
2.2.12 DATA POINTS FROM KEY SECONDARY DATABASES
2.3 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET: RESEARCH SNAPSHOT
2.4 ASSUMPTIONS
3 MARKET OVERVIEW
3.1 DRIVERS
3.2 RESTRAINTS
3.3 OPPORTUNITIES
3.4 CHALLENGES
4 EXECUTIVE SUMMARY
5 PREMIUM INSIGHTS
5.1 PESTEL ANALYSIS
5.2 PORTER’S FIVE FORCES MODEL
6 INDUSTRY INSIGHTS
6.1 KEY PRICING STRATEGIES
6.2 DATA-DRIVEN DECISION MAKING
6.3 ADOPTION OF OUTSOURCING
6.4 INTERVIEWS WITH SPECIALIST
6.5 OTHER KOL SNAPSHOTS
6.6 PAYER VALUE CHAIN ANALYSIS
7 MERGERS AND ACQUISITION
7.1 LICENSING
7.2 COMMERCIALIZATION AGREEMENTS
8 REGULATORY FRAMEWORK
8.1 REGULATORY PROCESS
8.2 REGULATORY APPROVAL PATHWAYS
8.3 LICENSING AND REGISTRATION
9 MARKET ACCESS
9.1 10-YEAR MARKET FORECAST
9.2 TECHNOLOGICAL ENABLEMENT
9.3 EXPANDING HEALTH INSURANCE COVERAGE
9.4 FOCUS ON CUSTOMER ENGAGEMENT
9.5 NAVIGATING REIMBURSEMENT MODELS
10 MARKET OVERVIEW
10.1 DRIVERS
10.2 RESTRAINTS
10.3 OPPORTUNITIES
10.4 CHALLENGES
11 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY SERVICE TYPE
11.1 OVERVIEW
11.2 BUSINESS PROCESS OUTSOURCING
11.2.1 CLAIMS PROCESSING
11.2.2 CUSTOMER SERVICE
11.2.3 ENROLLMENT & BILLING SERVICES
11.2.4 PROVIDER MANAGEMENT
11.2.5 MEDICAL CODING & BILLING
11.2.6 OTHER ADMINISTRATIVE SERVICES
11.3 KPO (KNOWLEDGE PROCESS OUTSOURCING)
11.3.1 DATA ANALYTICS & ACTUARIAL SERVICES
11.3.2 COMPLIANCE & RISK MANAGEMENT
11.3.3 FRAUD DETECTION & PREVENTION
11.3.4 HEALTHCARE CONSULTING & MARKET RESEARCH
11.3.5 HEALTH PLAN DESIGN & CONSULTING
11.3.6 PREDICTIVE MODELING
11.4 ITO (INFORMATION TECHNOLOGY OUTSOURCING)
11.4.1 IT INFRASTRUCTURE MANAGEMENT
11.4.2 APPLICATION MANAGEMENT SERVICES
11.4.3 CYBERSECURITY & DATA PRIVACY
11.4.4 CLOUD SERVICES & HOSTING
11.4.5 SYSTEM INTEGRATION & IMPLEMENTATION
11.4.6 DATA WAREHOUSING & BUSINESS INTELLIGENCE
12 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY APPLICATION
12.1 OVERVIEW
12.2 CLAIMS MANAGEMENT
12.3 PROVIDER NETWORK MANAGEMENT
12.4 CUSTOMER RELATIONSHIP MANAGEMENT
12.5 BILLING & ACCOUNTS MANAGEMENT
12.6 COMPLIANCE MANAGEMENT
12.7 FRAUD DETECTION & PREVENTION
12.8 DATA ANALYTICS & HEALTH INFORMATICS
13 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY DEPLOYMENT MODE
13.1 OVERVIEW
13.2 ON-PREMISE
13.3 CLOUD-BASED
14 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY END USER
14.1 OVERVIEW
14.2 PRIVATE PAYERS
14.2.1 INSURANCE COMPANIES
14.2.2 HEALTH MAINTENANCE ORGANIZATIONS (HMOS)
14.2.3 PREFERRED PROVIDER ORGANIZATIONS (PPOS)
14.3 PUBLIC PAYERS
14.3.1 GOVERNMENT HEALTH INSURANCE PROGRAMS
14.3.2 MEDICARE & MEDICAID
15 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY CONTRACT TYPE
15.1 OVERVIEW
15.2 LONG-TERM CONTRACTS
15.3 SHORT-TERM CONTRACTS
16 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY SIZE OF ORGANIZATION (PAYER)
16.1 OVERVIEW
16.2 LARGE ENTERPRISES
16.3 SMALL & MEDIUM ENTERPRISES (SMES)
17 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , SWOT AND DBMR ANALYSIS
18 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , COMPANY LANDSCAPE
18.1 COMPANY SHARE ANALYSIS: GLOBAL
18.2 COMPANY SHARE ANALYSIS: NORTH AMERICA
18.3 COMPANY SHARE ANALYSIS: EUROPE
18.4 COMPANY SHARE ANALYSIS: ASIA-PACIFIC
18.5 MERGERS & ACQUISITIONS
18.6 NEW PRODUCT DEVELOPMENT & APPROVALS
18.7 EXPANSIONS
18.8 REGULATORY CHANGES
18.9 PARTNERSHIP AND OTHER STRATEGIC DEVELOPMENTS
19 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , BY REGION
GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , (ALL SEGMENTATION PROVIDED ABOVE IS REPRESENTED IN THIS CHAPTER BY COUNTRY)
19.1 NORTH AMERICA
19.1.1 U.S.
19.1.2 CANADA
19.1.3 MEXICO
19.2 EUROPE
19.2.1 GERMANY
19.2.2 U.K.
19.2.3 ITALY
19.2.4 FRANCE
19.2.5 SPAIN
19.2.6 RUSSIA
19.2.7 SWITZERLAND
19.2.8 TURKEY
19.2.9 BELGIUM
19.2.10 NETHERLANDS
19.2.11 DENMARK
19.2.12 SWEDEN
19.2.13 POLAND
19.2.14 NORWAY
19.2.15 FINLAND
19.2.16 REST OF EUROPE
19.3 ASIA-PACIFIC
19.3.1 JAPAN
19.3.2 CHINA
19.3.3 SOUTH KOREA
19.3.4 INDIA
19.3.5 SINGAPORE
19.3.6 THAILAND
19.3.7 INDONESIA
19.3.8 MALAYSIA
19.3.9 PHILIPPINES
19.3.10 AUSTRALIA
19.3.11 NEW ZEALAND
19.3.12 VIETNAM
19.3.13 TAIWAN
19.3.14 REST OF ASIA-PACIFIC
19.4 SOUTH AMERICA
19.4.1 BRAZIL
19.4.2 ARGENTINA
19.4.3 REST OF SOUTH AMERICA
19.5 MIDDLE EAST AND AFRICA
19.5.1 SOUTH AFRICA
19.5.2 EGYPT
19.5.3 BAHRAIN
19.5.4 UNITED ARAB EMIRATES
19.5.5 KUWAIT
19.5.6 OMAN
19.5.7 QATAR
19.5.8 SAUDI ARABIA
19.5.9 REST OF MEA
19.6 KEY PRIMARY INSIGHTS: BY MAJOR COUNTRIES
20 GLOBAL HEALTHCARE PAYER SOLUTIONS MARKET , COMPANY PROFILE
20.1 COGNIZANT
20.1.1 COMPANY OVERVIEW
20.1.2 REVENUE ANALYSIS
20.1.3 GEOGRAPHIC PRESENCE
20.1.4 PRODUCT PORTFOLIO
20.1.5 RECENT DEVELOPMENTS
20.2 ACCENTURE
20.2.1 COMPANY OVERVIEW
20.2.2 REVENUE ANALYSIS
20.2.3 GEOGRAPHIC PRESENCE
20.2.4 PRODUCT PORTFOLIO
20.2.5 RECENT DEVELOPMENTS
20.3 XEROX (CONDUENT)
20.3.1 COMPANY OVERVIEW
20.3.2 REVENUE ANALYSIS
20.3.3 GEOGRAPHIC PRESENCE
20.3.4 PRODUCT PORTFOLIO
20.3.5 RECENT DEVELOPMENTS
20.4 TATA CONSULTANCY SERVICES (TCS)
20.4.1 COMPANY OVERVIEW
20.4.2 REVENUE ANALYSIS
20.4.3 GEOGRAPHIC PRESENCE
20.4.4 PRODUCT PORTFOLIO
20.4.5 RECENT DEVELOPMENTS
20.5 WIPRO
20.5.1 COMPANY OVERVIEW
20.5.2 REVENUE ANALYSIS
20.5.3 GEOGRAPHIC PRESENCE
20.5.4 PRODUCT PORTFOLIO
20.5.5 RECENT DEVELOPMENTS
20.6 INFOSYS
20.6.1 COMPANY OVERVIEW
20.6.2 REVENUE ANALYSIS
20.6.3 GEOGRAPHIC PRESENCE
20.6.4 PRODUCT PORTFOLIO
20.6.5 RECENT DEVELOPMENTS
20.7 UNITEDHEALTH GROUP (OPTUM)
20.7.1 COMPANY OVERVIEW
20.7.2 REVENUE ANALYSIS
20.7.3 GEOGRAPHIC PRESENCE
20.7.4 PRODUCT PORTFOLIO
20.7.5 RECENT DEVELOPMENTS
20.8 HCL TECHNOLOGIES
20.8.1 COMPANY OVERVIEW
20.8.2 REVENUE ANALYSIS
20.8.3 GEOGRAPHIC PRESENCE
20.8.4 PRODUCT PORTFOLIO
20.8.5 RECENT DEVELOPMENTS
20.9 EXL SERVICE HOLDINGS, INC.
20.9.1 COMPANY OVERVIEW
20.9.2 REVENUE ANALYSIS
20.9.3 GEOGRAPHIC PRESENCE
20.9.4 PRODUCT PORTFOLIO
20.9.5 RECENT DEVELOPMENTS
20.1 IBM CORPORATION
20.10.1 COMPANY OVERVIEW
20.10.2 REVENUE ANALYSIS
20.10.3 GEOGRAPHIC PRESENCE
20.10.4 PRODUCT PORTFOLIO
20.10.5 RECENT DEVELOPMENTS
20.11 GENPACT
20.11.1 COMPANY OVERVIEW
20.11.2 REVENUE ANALYSIS
20.11.3 GEOGRAPHIC PRESENCE
20.11.4 PRODUCT PORTFOLIO
20.11.5 RECENT DEVELOPMENTS
20.12 NTT DATA CORPORATION
20.12.1 COMPANY OVERVIEW
20.12.2 REVENUE ANALYSIS
20.12.3 GEOGRAPHIC PRESENCE
20.12.4 PRODUCT PORTFOLIO
20.12.5 RECENT DEVELOPMENTS
20.13 MPHASIS
20.13.1 COMPANY OVERVIEW
20.13.2 REVENUE ANALYSIS
20.13.3 GEOGRAPHIC PRESENCE
20.13.4 PRODUCT PORTFOLIO
20.13.5 RECENT DEVELOPMENTS
20.14 CAPGEMINI
20.14.1 COMPANY OVERVIEW
20.14.2 REVENUE ANALYSIS
20.14.3 GEOGRAPHIC PRESENCE
20.14.4 PRODUCT PORTFOLIO
20.14.5 RECENT DEVELOPMENTS
20.15 WNS GLOBAL SERVICES
20.15.1 COMPANY OVERVIEW
20.15.2 REVENUE ANALYSIS
20.15.3 GEOGRAPHIC PRESENCE
20.15.4 PRODUCT PORTFOLIO
20.15.5 RECENT DEVELOPMENTS
20.16 HGS (HINDUJA GLOBAL SOLUTIONS)
20.16.1 COMPANY OVERVIEW
20.16.2 REVENUE ANALYSIS
20.16.3 GEOGRAPHIC PRESENCE
20.16.4 PRODUCT PORTFOLIO
20.16.5 RECENT DEVELOPMENTS
20.17 SUTHERLAND GLOBAL SERVICES
20.17.1 COMPANY OVERVIEW
20.17.2 REVENUE ANALYSIS
20.17.3 GEOGRAPHIC PRESENCE
20.17.4 PRODUCT PORTFOLIO
20.17.5 RECENT DEVELOPMENTS
20.18 SUTHERLAND GLOBAL SERVICES
20.18.1 COMPANY OVERVIEW
20.18.2 REVENUE ANALYSIS
20.18.3 GEOGRAPHIC PRESENCE
20.18.4 PRODUCT PORTFOLIO
20.18.5 RECENT DEVELOPMENTS
20.19 HEXAWARE TECHNOLOGIES
20.19.1 COMPANY OVERVIEW
20.19.2 REVENUE ANALYSIS
20.19.3 GEOGRAPHIC PRESENCE
20.19.4 PRODUCT PORTFOLIO
20.19.5 RECENT DEVELOPMENTS
20.2 CONCENTRIX
20.20.1 COMPANY OVERVIEW
20.20.2 REVENUE ANALYSIS
20.20.3 GEOGRAPHIC PRESENCE
20.20.4 PRODUCT PORTFOLIO
20.20.5 RECENT DEVELOPMENTS
20.21 ALORICA
20.21.1 COMPANY OVERVIEW
20.21.2 REVENUE ANALYSIS
20.21.3 GEOGRAPHIC PRESENCE
20.21.4 PRODUCT PORTFOLIO
20.21.5 RECENT DEVELOPMENTS
20.22 FIRSTSOURCE SOLUTIONS
20.22.1 COMPANY OVERVIEW
20.22.2 REVENUE ANALYSIS
20.22.3 GEOGRAPHIC PRESENCE
20.22.4 PRODUCT PORTFOLIO
20.22.5 RECENT DEVELOPMENTS
20.23 DXC TECHNOLOGY
20.23.1 COMPANY OVERVIEW
20.23.2 REVENUE ANALYSIS
20.23.3 GEOGRAPHIC PRESENCE
20.23.4 PRODUCT PORTFOLIO
20.23.5 RECENT DEVELOPMENTS
21 RELATED REPORTS
22 CONCLUSION
23 QUESTIONNAIRE
24 ABOUT DATA BRIDGE MARKET RESEARCH
