North America Healthcare BPO Market

North America BPO Market Size (2024 to 2029)

The North American healthcare business process outsourcing (BPO) market is estimated to grow at a CAGR of 8.98% from 2024 to 2029 and the regional market size is predicted to be valued at USD 206.2 billion by 2029 from USD 134.1 billion in 2024.

The factors driving the BPO market in North America are the rising medical bills and claims and technological advancements in healthcare IT.

Billing and processing medical claims are challenging tasks that require an experienced person. Outsourcing your billing to a specialized company makes it easier to manage pre-authorization, handle patient insurance eligibility, and increase efficiency. Furthermore, these companies can effectively handle medical coding data security and streamline the entire process.

The rapid adoption of digital technologies and the development of new business models and processes are boosting the share of the North American healthcare BPO market. In August 2023, GE Healthcare signed an agreement with Genpact to handle its leasing and lending operations of medical equipment with the help of modern digital technology and business processes as a service model.

The increasing adoption of modern technologies is providing more opportunities for the key players in the market. The effectiveness of drug discovery and success rates in the development process can be improved significantly by artificial intelligence and machine learning. Therefore, faster discovery of drugs for chronic diseases will elevate the demand for healthcare BPO services in the region.

The development of FHIR Healthcare Interoperability Standards, which use HITRUST, NIST, SOC2, and HIPAA for better and more efficient healthcare data exchange between stakeholders. It also reduces the risk of data breaches, cyberattacks, ransomware attacks, etc.

The hidden cost of outsourcing and ineffective data security and privacy measures are restricting the North American healthcare BPO market growth. Increasing cyberattacks against revenue cycle management companies as they have both financial and patient data. Difficulty in maintaining the required data security level as per HIPAA regulation is impeding the market share. The biggest challenge for the North American healthcare BPO market is rising data breaches and ransomware attacks in the region. The average cost of a healthcare data breach in 2021 was more than nine million dollars. The focus is on implementing robust processes and controls, restricting data access, and utilizing advanced technologies to prevent data breaches. Furthermore, there is a growing popularity of mobile applications without clear authorization and authentication protocols. All these issues are further restricting the market growth rate.

This research report on the North American Healthcare BPO Market has been segmented and sub-segmented into the following categories.

North America BPO Market Analysis By Provider Service

• Medical Billing
• Medical Coding
• Medical Transcription
• Finance & Accounts

The medical billing segment is expected to be the largest segment under this category. The advantages of RCM adoption are anticipated to accelerate the segment growth during the projection period.

North America BPO Market Analysis By Payer Service

• Claims Management
• Integrated Front-end Services and Back-office Operations
• Member Management
• Provider Management
• Billing and Accounts Management
• Analytics and Fraud Management
• HR Services

The claim management segment is anticipated to grow at a faster growth rate during the forecast period. The aging population, an increase in chronic illnesses, and an increase in healthcare claims activity are all projected to drive the segment's growth.

North America BPO Market Analysis By Pharmaceutical Service

• Research and Development

• Manufacturing

• Non-clinical Services
  • Sales and Marketing services
  • Supply Chain Management
  • Other Non-Clinical Applications

The non-clinical services segment is estimated to be the leading segment during the forecast period due to the high emphasis on supply chain management and improving inventory management.

North America BPO Market Analysis By Country

• The United States

• Canada

• Mexico
• Rest of North America

The United States Healthcare BPO Market is the biggest in the region. There has been increasing demand for superior patient care and patient follow-up and treatment costs. The improvement of administrative processes and operational efficiency will take the market forward in the coming years.

The Canadian healthcare BPO Market is expected to grow further during the forecast period. Appropriate measures are required to reduce health inequalities, update healthcare infrastructure, address staff shortages, etc., in Canadian healthcare. Therefore, BPO companies have the opportunity to improve healthcare BPO services and expand their market share.

KEY DEVELOPMENTS

In February 2023, The Florida-based healthcare IT company Availity sold its India-based patient access outsourcing business unit to AGS Health. This will add new technology to the AGS AI platform and improve its capacity and efficiency while also easing patient access processes. It will also increase the first-pass reimbursement rate.

KEY MARKET PLAYERS

The most promising companies in the North American Healthcare BPO Market are Infosys BPO Ltd, Cognizant Technology Solutions Corporation, Genpact Limited, Tata Consultancy Services Ltd., Accenture PLC, and Xerox Corporation.