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Pulished Date July, 2021
ID: 11860
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Global Healthcare Reimbursement Market Size, Share, Trends, COVID-19 Impact & Growth Analysis Report – Segmented By Claims, Payer, Service Provider & Region (North America, Europe, Asia-Pacific, Latin America, Middle East and Africa)- Industry Forecast (2021 to 2026)

Pulished: July, 2021
ID: 11860
Pages: 190

Global Healthcare Reimbursement Market Size (2021 to 2026)

The global healthcare reimbursement market size is estimated to be worth USD 33.94 billion by 2026 from USD 15.72 billion in 2021, growing at a CAGR of 16.64% during the forecast period.

Healthcare reimbursement is the process by which private health insurers or government agencies pay for the services of healthcare providers. Healthcare reimbursement plans are sometimes referred to as healthcare reimbursement arrangements to distinguish them from traditional employer-sponsored health insurance plans.

COVID-19 introduces new reimbursement challenges in the healthcare industry, such as billing and coding, patient financial accountability, and this trend will continue to be a threat to healthcare organizations in 2021. The trend toward digitalization and payment automation was driven by new processes triggered by a significant decrease in face-to-face interaction and a rapid increase in telehealth check-ups. Having the right technologies and best practices in place will significantly aid in ensuring both billing compliance and reimbursement maximization in the future.

MARKET DRIVERS:

People are becoming more aware of the importance of health insurance policies and healthcare coverages, which is expected to drive the global healthcare reimbursement market.

A health insurance policy is a contract between an insurance company and a policyholder in which the insurer pays for the life insured's medical expenses. This policy applies to services reported using the 1500 Health Insurance Claim Form (a/k/a CMS-1500) or its electronic equivalent or successor form. This policy applies to all products, all network and non-network physicians, and other qualified health care professionals, including, but not limited to, non-network authorized and percent of charge contract physicians and other qualified health care professionals.

Growing costs of the federal and state governments' operation of the Medicare and Medicaid programs are expected to accelerate the growth rate of the global healthcare reimbursement market during the forecast period.

Medicaid has grown to become the primary source of medical and health-related services in the United States for low-income and resource-constrained Americans. In 2019, Medicaid accounted for 16% of total healthcare spending in the United States. The federal and state governments both play a role in the program's success. Medicaid spending increased in recent years as the percentage of people on Medicaid increased. The Medicare program cost the United States approximately $800 billion in 2019.

Growing primary healthcare across the world is predicted to promote the global healthcare reimbursement market growth.

According to WHO & PHC, nearly 930 million people worldwide are at risk of falling into poverty due to out-of-pocket health spending of 10% or more of their household budget. Achieving the PHC targets will necessitate an additional investment of between $200 and 370 billion USD per year for a more comprehensive package of health services. By 2030, expanding primary health care (PHC) interventions in low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years. PHC is the most inclusive, equitable, cost-effective, and efficient method of improving people's physical and mental health, as well as their social well-being.

Additionally, advancements in EMR technology for monitoring patient responsiveness, rising digital technology advancements in healthcare, growing initiatives from the public and private sector, and rising healthcare costs are expected to favor the global healthcare reimbursement market. Growing geriatric population worldwide, increasing prevalence of chronic diseases, and rising investments from the governments are further estimated to boost the market growth during the forecast period.

MARKET RESTRAINTS:

Deterioration in the quality of care available to patients in need of high-cost treatments, as well as the administrative burden that clinicians frequently face. The high number of incidents involving fraudulent activities for state and government-led health programs are expected to limit the global healthcare reimbursement market growth. Complications exist in the market as a core feature of a complex framework. The risk of patient data breaches or HIPAA violations increases is further expected to limit the market growth.

Impact of COVID-19 on the global healthcare reimbursement market:

Hospitals and healthcare systems have seen a significant drop in profits and income since the onset of COVID-19. It has been over a year since the COVID-19 pandemic began. While we won't know the full impact on our overall health, economy, and society for many years, we know a lot about how it will affect healthcare systems. Medicare now reimburses hospitals, physicians, pharmacies, and others for administering the COVID-19 vaccine. Healthcare systems responded heroically. Millions of patients were tested, treated, and cured as a result of their efforts. It went from not having a standard test for COVID-19 to testing over 2 million people in a single day. Unfortunately, many providers and patients postponed or skipped elective procedures and wellness visits. The number of appointments available was limited due to safety protocols, and many people were afraid to go to the doctor.

Evidence of the far-reaching impact of PHC investment grows all the time, especially in times of crisis, such as the COVID-19 pandemic. Another significant change was the replacement of in-person visits with telemedicine visits. While rules and policies were simplified or even suspended, documentation and reimbursement remained difficult. The new coding and documentation guidelines added to the pandemic-related denials. As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers cannot charge patients any fees for vaccine administration. In the long term, the financial impact of COVID-19-related healthcare spending is not expected to have a significant impact on overall healthcare spending. The health care systems are expected to work collaboratively to hammer out physician compensation agreements to prepare for future situations similar to COVID-19.

REPORT COVERAGE:

REPORT METRIC

DETAILS

Market Size Available

2020 to 2026

Base Year

2020

Forecast Period

2021 to 2026

Segments Covered

By Claims, Payer, Service Provider & Region

Various Analyses Covered

Global, Regional & Country Level Analysis, Segment-Level Analysis, Drivers, Restraints, Opportunities, Challenges, PESTLE Analysis, Porter’s Five Forces Analysis, Competitive Landscape, Analyst Overview on Investment Opportunities

Regions Covered

North America, Europe, Asia Pacific, Latin America, Middle East & Africa

 

This research report on the global healthcare reimbursement market has been segmented and sub-segmented based on the claims, payer, service provider & region.

Healthcare Reimbursement Market – By Claims:

  • Underpaid
  • Full Paid

Healthcare Reimbursement Market – By Payer:

  • Private Payers
  • Public Payers

Healthcare Reimbursement Market – By Service Provider:

  • Physician Office
  • Hospitals
  • Diagnostic Laboratories
  • Others

Healthcare Reimbursement Market – By Region:

  • North America
  • Europe
  • Asia-Pacific
  • Latin America
  • The Middle East and Africa

KEY MARKET PARTICIPANTS:

Companies such as CVS Health, UnitedHealth Group, Nippon Life Insurance, Allianz, WellCare Health Plans, Aviva Life Insurance Company India Ltd., AgileHealthInsurance, Aetna, Blue Cross Blue Shield Association, Aetna Inc., and Reliance BNP Paribas are currently playing a leading role in the global healthcare reimbursement market.

  1. Introduction                                                          
    1. Market Definition                                               
    2. Scope of the report                                            
    3. Study Assumptions
    4. Base Currency, Base Year and Forecast Periods
  2. Research Methodology
    1. Analysis Design
    2. Research Phases
      1. Secondary Research
      2. Primary Research
      3. Data Modelling
      4. Expert Validation
    3. Study Timeline
  3. Report Overview
    1. Executive Summary
    2. Key Inferences
  4. Market Dynamics
    1. Impact Analysis
      1. Drivers
      2. Restraints
      3. Opportunities
    2. Regulatory Environment
    3. Technology Timeline & Recent Trends
  5. Competitor Benchmarking Analysis
    1. Key Player Benchmarking
      1. Market share analysis
      2. Products/Service
      3. Regional Presence
    2. Mergers & Acquisition Landscape
    3. Joint Ventures & Collaborations
  6. Market Segmentation
    1. Healthcare Reimbursement Market, By Claims
      1. Underpaid
      2. Full Paid
      3. Market Size Estimations & Forecasts (2021-2026)
      4. Y-o-Y Growth Rate Analysis
      5. Market Attractiveness Index
    2. Healthcare Reimbursement Market, By Payer
      1. Private Payers
      2. Public Payers
      3. Market Size Estimations & Forecasts (2021-2026)
      4. Y-o-Y Growth Rate Analysis
      5. Market Attractiveness Index
    3. Healthcare Reimbursement Market, By End User
      1. Physician Office
      2. Hospitals
      3. Diagnostic Laboratories
      4. Others
      5. Market Size Estimations & Forecasts (2021-2026)
      6. Y-o-Y Growth Rate Analysis
      7. Market Attractiveness Index
  7. Geographical Landscape
    1. Global Healthcare Reimbursement Market, by Region
    2. North America - Market Analysis (2021 to 2026)
      1. By Country
        1. USA
        2. Canada
    3. Europe                                                   
      1. By Country
        1. UK
        2. France
        3. Germany
        4. Spain
        5. Italy
        6. Rest of Europe
    4. Asia Pacific                                             
      1. By Country
        1. China                  
        2. India
        3. Japan                  
        4. South Korea
        5. Southeast Asia
        6. Australia & NZ
        7. Rest of Asia- Pacific
    5. Latin America
      1. By Country
        1. Brazil
        2. Argentina
        3. Mexico                
        4. Rest of Latin America
    6. The Middle East and Africa
      1. By Country
        1. Middle East
        2. Africa
  8. Key Player Analysis
    1. CVS Health
      1. Business Description
      2. Products/Service
      3. Financials                             
      4. SWOT Analysis
      5. Recent Developments
      6. Analyst Overview
    2. UnitedHealth Group
    3. Nippon Life Insurance
    4. Allianz
    5. WellCare Health Plans
    6. Aviva Life Insurance Company India Ltd.
    7. AgileHealthInsurance
    8. Aetna
    9. Blue Cross Blue Shield Association
    10. Aetna Inc.
    11. Nippon Life Insurance Company Limited
    12. Reliance BNP Paribas
  9. Market Outlook & Investment Opportunities
  10. Appendix                                               
    1. List of Tables
    2. List of Figures
  • Global and country-level analysis and forecasts of the study market; providing Insights on the major countries/regions in which this industry is blooming and to also identify the regions that are still untapped.
  • Segment-level analysis in terms of claims, payer and service provider along with market size forecasts and estimations to detect key areas of industry growth in detail.
  • Identification of key drivers, restraints, opportunities, and challenges (DROC) in the market and their impact on shifting market dynamics.
  • Study of the effect of exogenous and endogenous factors that affect the global market; which includes broadly demographic, economics, and political, among other macro-environmental factors presented in an extensive PESTLE Analysis.
  • Study the micro environment factors that determine the overall profitability of an Industry, using Porter’s five forces analysis for analysing the level of competition and business strategy development.
  • A comprehensive list of key market players along with their product portfolio, current strategic interests, key financial information, legal issues, SWOT analysis and analyst overview to study and sustain the market environment.
  • Competitive landscape analysis listing out the mergers, acquisitions, collaborations in the field along with new product launches, comparative financial studies and recent developments in the market by the major companies.
  • An executive summary, abridging the entire report in such a way that decision-making personnel can rapidly become acquainted with background information, concise analysis and main conclusions.
  • Expertly devised analyst overview along with Investment opportunities to provide both individuals and organizations a strong financial foothold in the market.
  1. Global Healthcare Reimbursement Market, By Region, From 2021 to 2026 (USD Billion)
  2. Global Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  3. Global Underpaid Market, By Region, From 2021 to 2026 (USD Billion)
  4. Global Full Paid Market, By Region, From 2021 to 2026 (USD Billion)
  5. Global Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  6. Global Private Payers Market, By Region, From 2021 to 2026 (USD Billion)
  7. Global Public Payers Market, By Region, From 2021 to 2026 (USD Billion)
  8. Global Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  9. Global Physician Office Market, By Region, From 2021 to 2026 (USD Billion)
  10. Global Hospitals Market, By Region, From 2021 to 2026 (USD Billion)
  11. Global Diagnostic Laboratories Market, By Region, From 2021 to 2026 (USD Billion)
  12. Global Others Market, By Region, From 2021 to 2026 (USD Billion)
  13. North America Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  14. North America Underpaid Market, By Region, From 2021 to 2026 (USD Billion)
  15. North America Full Paid Market, By Region, From 2021 to 2026 (USD Billion)
  16. North America Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  17. North America Private Payers Market, By Region, From 2021 to 2026 (USD Billion)
  18. North America Public Payers Market, By Region, From 2021 to 2026 (USD Billion)
  19. North America Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  20. North America Physician Office Market, By Region, From 2021 to 2026 (USD Billion)
  21. North America Hospitals Market, By Region, From 2021 to 2026 (USD Billion)
  22. North America Diagnostic Laboratories Market, By Region, From 2021 to 2026 (USD Billion)
  23. North America Others Market, By Region, From 2021 to 2026 (USD Billion)
  24. United States Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  25. United States Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  26. United States Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  27. Canada Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  28. Canada Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  29. Canada Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  30. Europe Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  31. Europe Underpaid Market, By Region, From 2021 to 2026 (USD Billion)
  32. Europe Full Paid Market, By Region, From 2021 to 2026 (USD Billion)
  33. Europe Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  34. Europe Private Payers Market, By Region, From 2021 to 2026 (USD Billion)
  35. Europe Public Payers Market, By Region, From 2021 to 2026 (USD Billion)
  36. Europe Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  37. Europe Physician Office Market, By Region, From 2021 to 2026 (USD Billion)
  38. Europe Hospitals Market, By Region, From 2021 to 2026 (USD Billion)
  39. Europe Diagnostic Laboratories Market, By Region, From 2021 to 2026 (USD Billion)
  40. Europe Others Market, By Region, From 2021 to 2026 (USD Billion)
  41. U.K. Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  42. U.K. Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  43. U.K. Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  44. Germany Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  45. Germany Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  46. Germany Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  47. France Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  48. France Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  49. France Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  50. Italy Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  51. Italy Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  52. Italy Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  53. Spain Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  54. Spain Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  55. Spain Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  56. Asia Pacific Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  57. Asia Pacific Underpaid Market, By Region, From 2021 to 2026 (USD Billion)
  58. Asia Pacific Full Paid Market, By Region, From 2021 to 2026 (USD Billion)
  59. Asia Pacific Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  60. Asia Pacific Private Payers Market, By Region, From 2021 to 2026 (USD Billion)
  61. Asia Pacific Public Payers Market, By Region, From 2021 to 2026 (USD Billion)
  62. Asia Pacific Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  63. Asia Pacific Physician Office Market, By Region, From 2021 to 2026 (USD Billion)
  64. Asia Pacific Hospitals Market, By Region, From 2021 to 2026 (USD Billion)
  65. Asia Pacific Diagnostic Laboratories Market, By Region, From 2021 to 2026 (USD Billion)
  66. Asia Pacific Others Market, By Region, From 2021 to 2026 (USD Billion)
  67. Japan Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  68. Japan Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  69. Japan Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  70. China Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  71. China Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  72. China Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  73. India Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  74. India Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  75. India Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  76. Australia Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  77. Australia Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  78. Australia Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  79. South Korea Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  80. South Korea Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  81. South Korea Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  82. Latin America Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  83. Latin America Underpaid Market, By Region, From 2021 to 2026 (USD Billion)
  84. Latin America Full Paid Market, By Region, From 2021 to 2026 (USD Billion)
  85. Latin America Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  86. Latin America Private Payers Market, By Region, From 2021 to 2026 (USD Billion)
  87. Latin America Public Payers Market, By Region, From 2021 to 2026 (USD Billion)
  88. Latin America Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  89. Latin America Physician Office Market, By Region, From 2021 to 2026 (USD Billion)
  90. Latin America Hospitals Market, By Region, From 2021 to 2026 (USD Billion)
  91. Latin America Diagnostic Laboratories Market, By Region, From 2021 to 2026 (USD Billion)
  92. Latin America Others Market, By Region, From 2021 to 2026 (USD Billion)
  93. Brazil Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  94. Brazil Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  95. Brazil Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  96. Argentina Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  97. Argentina Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  98. Argentina Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  99. Mexico Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  100. Mexico Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  101. Mexico Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  102. Rest of Latin America Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  103. Rest of Latin America Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  104. Rest of Latin America Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  105. Middle East and Africa Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  106. Middle East and Africa Underpaid Market, By Region, From 2021 to 2026 (USD Billion)
  107. Middle East and Africa Full Paid Market, By Region, From 2021 to 2026 (USD Billion)
  108. Middle East and Africa Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  109. Middle East and Africa Private Payers Market, By Region, From 2021 to 2026 (USD Billion)
  110. Middle East and Africa Public Payers Market, By Region, From 2021 to 2026 (USD Billion)
  111. Middle East and Africa Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  112. Middle East and Africa Physician Office Market, By Region, From 2021 to 2026 (USD Billion)
  113. Middle East and Africa Hospitals Market, By Region, From 2021 to 2026 (USD Billion)
  114. Middle East and Africa Diagnostic Laboratories Market, By Region, From 2021 to 2026 (USD Billion)
  115. Middle East and Africa Others Market, By Region, From 2021 to 2026 (USD Billion)
  116. Middle East Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  117. Middle East Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  118. Middle East Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)
  119. Africa Healthcare Reimbursement Market, By Claims, From 2021 to 2026 (USD Billion)
  120. Africa Healthcare Reimbursement Market, By Payer, From 2021 to 2026 (USD Billion)
  121. Africa Healthcare Reimbursement Market, By End User, From 2021 to 2026 (USD Billion)

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