North America Healthcare BPO Market

North America BPO Market Size (2023 to 2028)

The size of the North American healthcare business process outsourcing (BPO) market was estimated at USD 123.12 Billion in 2023 and is poised to be worth USD 189.27 Billion by 2028, growing at a CAGR of 8.98% during the forecast period.

The growing need to reduce healthcare costs is one of the key factors driving the North American healthcare BPO market growth. Healthcare BPO offers effective solutions that alleviate the burden on healthcare management and result in cost savings for both the healthcare sector and patients. BPO enables improved business expansion while maintaining operational efficiency by outsourcing non-clinical activities and leveraging comprehensive data gathering. It plays a crucial role in mitigating significant errors in healthcare management by ensuring secure access to patient records, medical information and sensitive data. BPO facilitates convenience in health insurance processes and streamlines regulatory compliance and fosters cost-effective treatment options.

The growth of the North American healthcare BPO market is further propelled by the rising prevalence of chronic diseases and an expanding patient population. An alarming statistic reveals that nearly half of Americans are affected by at least one chronic disease. Factors such as lifestyle modifications, heightened alcohol and tobacco consumption, as well as hormonal changes contribute to the increased incidence of chronic conditions among the population. Through BPO services, healthcare organizations can allocate their focus towards patient care, thereby affording them valuable additional time. This, in turn, facilitates the delivery of high-quality healthcare services. Furthermore, by alleviating the burden on healthcare providers and workers, BPO enables enhanced work productivity without compromising performance due to excessive stress.

The growing adoption of advanced technologies, specifically artificial intelligence and machine learning contributes to the growth of the North American healthcare BPO market. BPO organizations within the healthcare sector are actively incorporating these cutting-edge technologies and software solutions to enhance operational efficiency and service capabilities. This strategic implementation of advanced technologies is aimed at streamlining processes and delivering faster and more effective services. Additionally, the rising research and development activities, strong support from the North American governments, the expanding presence of pharmaceutical companies, and an increasing number of product approvals further promote the growth of the North American healthcare BPO market.

The hidden costs associated with outsourcing business processes majorly hamper the growth of the North American healthcare BPO market. These costs arise from various factors such as the scarcity of skilled professionals, inadequate infrastructure facilities and a lack of awareness about BPO services. Moreover, ensuring data security and privacy poses a considerable challenge, particularly given the sensitive nature of healthcare data. The efficient management of data and the acquisition of relevant information from the healthcare sector for decision-making purposes present a substantial task for BPO services.

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

By Provider Service:

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

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

By Pharmaceutical Service:

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

By Country:

• The United States
• Canada
• Mexico
• Rest of North America

Regionally, the North American healthcare BPO market accounted for much of the overall healthcare BPO market. The region is a growing market for the payer, provider, and pharmaceutical services to support regional market expansion. However, well-established healthcare infrastructure influences the market growth in the region, and the presence of a high-income population and trained professionals are accelerating the market growth. In the regional market, the United States healthcare BPO market dominated in 2022. The U.S. healthcare payer market has been greatly wedged by introducing the PPAC Act, which has expanded insurance access to more than 35 million U.S. citizens. The market growth is attributed to the rising geriatric population; the increasing number of patients with chronic diseases in the country is contributing to the regional market growth. Increasing expenditure by the healthcare IT industry can be attributed to the most significant market growth in the United States. When compared to other countries, the United States has the most prominent healthcare costs. The nation spent $3.3 trillion on healthcare over the years. In the United States, healthcare rates have risen dramatically in recent years. It used to be 5% GDP in 1960, but it had now been increased to 18% in 2016. According to the CMS, this development will continue and exceed $5.7 trillion by 2027.

The Canadian healthcare BPO market is predicted to account for a considerable share of the North American market during the forecast period. The Canadian government provides comprehensive healthcare packages to its citizens and offers generous benefits and access to affordable treatment. Initiatives have been taken to introduce personal premium health cards to enable individuals to avail themselves of cost-effective healthcare services. Healthcare BPO plays a pivotal role in managing the intricate details and facilitating the approval process for these affordable treatment options. The efficient functioning of healthcare BPO services contributes significantly to the overall healthcare landscape in Canada to ensure streamlined operations and improved access to quality healthcare for its citizens.

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.