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1652653

세계의 헬스케어 EDI 시장(-2029년) : 변속기(부가가치 네트워크, point-to-point), 소프트웨어, 공급(조달, 재고), 서비스, 최종사용자(병원, ASC, 보험자), 지역별

Healthcare EDI Market by Transmission (Value added Network, Point-to-Point), Software, Supply (Procurement, Inventory), Service, End User (Hospital, ASC, Payer), Region - Global Forecast to 2029

발행일: | 리서치사: MarketsandMarkets | 페이지 정보: 영문 368 Pages | 배송안내 : 즉시배송

    
    
    




※ 본 상품은 영문 자료로 한글과 영문 목차에 불일치하는 내용이 있을 경우 영문을 우선합니다. 정확한 검토를 위해 영문 목차를 참고해주시기 바랍니다.

세계 헬스케어 EDI 시장 규모는 2024년 44억 7,000만 달러에서 2024년부터 2029년까지 9.7%의 연평균 복합 성장률(CAGR)로 2029년에는 71억 1,000만 달러 규모에 이를 것으로 예상됩니다.

의료 기록 및 환자 데이터의 급속한 디지털화, 규제 준수 요건, 청구서 제출량 증가, 의료 보험업계 수요 증가, EDI 도입에 따른 비용 절감 등이 시장 성장의 배경이 되고 있습니다. WEDI(Workgroup for Electronic Data Interchange)는 EDI를 도입함으로써 미국 의료보험제도와 보험회사는 1달러, 의사는 1.49달러, 병원은 0.86달러, 기타 관계자들은 0.83달러를 절감할 수 있을 것으로 추산하고 있습니다. 또한 CAQH Index 2023에 따르면, 2023년 미국의 의료보험 청구 건수는 8% 증가한 95억 건에 달할 것으로 추산됩니다. 한편, 기존 의료 IT 시스템과의 통합, 데이터 프라이버시, 보안의 제약이 이 시장에서 큰 과제로 대두되고 있습니다.

조사 범위
조사 대상 연도 2022-2029년
기준 연도 2023년
예측 기간 2024-2029년
단위 달러
부문별 컴포넌트, 변속기 유형, 최종사용자별
대상 지역 북미, 유럽, 아시아태평양, 라틴아메리카, 중동 및 아프리카

"포인트 투 포인트 EDI 부문이 2023년 가장 큰 점유율을 차지"

Direct EDI라고도 불리는 포인트 투 포인트 EDI는 관련 파트너간에 단일 교환 회선을 설정하고 파트너가 서로 개별적으로 통신해야 합니다. 의료 산업에서 포인트 투 포인트 EDI는 의료 기관이 FTP 또는 EDIINT(EDI over the Internet) 소프트웨어를 사용하여 청산소 또는 보험사와 직접 연결하는 데 사용되며, 이를 통해 사용자는 데이터에 대한 더 큰 제어 및 보안을 제공합니다. 데이터에 대한 통제와 보안을 강화할 수 있습니다. 중개 비용 절감, 데이터 보안, 규제 표준 준수 등이 시장 성장을 가속하는 주요 요인 중 일부입니다.

"거래 유형별로는 청구서 결제 부문이 예측 기간 동안 가장 빠른 성장세를 기록할 것으로 전망"

CAQH Index 2023에 따르면, 청구 결제의 EDI는 일반적으로 보험사와 공급자 간의 결제 교환을 자동화하고, 보험사가 부가가치 네트워크(VAN)를 통해 보험사에서 공급자에게 직접 전자적으로 결제를 전송하는 것을 포함하며, CAQH Index 2023에 따르면, 청구 결제의 완전 전자화를 통해 의료 산업은 연간 5억 2 2,400만 달러의 비용을 절감할 수 있을 것으로 예상됩니다. 신속한 청구 처리에 대한 요구 증가, 의료 보험사의 전자 청구 결제 프로세스 채택 증가, 보상 모델의 복잡성 증가는 시장 성장을 가속하는 주요 요인 중 일부입니다.

"아시아태평양은 예측 기간 동안 가장 높은 CAGR을 나타낼 것으로 예상"

이 지역의 성장은 의료 인프라의 성장, 의료 산업의 현대화 및 디지털화를 위한 정부의 이니셔티브, 의료 보험 산업의 성장에 기인합니다. 일본과 중국 등의 국가들은 실시간 공중보건 데이터 공유의 중요성, 의료보험의 급속한 확산, 국경 간 의료 서비스 확대, 첨단 기술 도입, 의료 데이터 표준화에 대한 규제 의무화(특히 중국과 일본), 비용 효율적인 솔루션 개발에 주력하고 있으며, 이는 아시아태평양의 성장을 견인하고 있습니다. 시장 성장을 견인하고 있습니다. 또한, 의료 관광의 확대, 의료비 증가, 의료보험 보급률 증가, 정부 지원 확대 등도 시장 성장을 가속하는 요인으로 작용하고 있습니다.

세계 헬스케어 EDI 시장을 조사했으며, 시장 개요, 시장 성장에 영향을 미치는 각종 영향요인 분석, 기술 및 특허 동향, 규제 환경, 사례연구, 시장 규모 추이 및 예측, 각 부문별/지역별/주요 국가별 상세 분석, 경쟁 구도, 주요 기업 프로파일 등의 정보를 정리하여 전해드립니다.

목차

제1장 서론

제2장 조사 방법

제3장 주요 요약

제4장 프리미엄 인사이트

제5장 시장 개요

  • 시장 역학
    • 성장 촉진요인
    • 성장 억제요인
    • 기회
    • 과제
  • 고객 사업에 영향을 미치는 동향/파괴적 변화
  • 헬스케어 EDI 표준
  • 업계 동향
  • 공급망 분석
  • 생태계 분석
  • 기술 분석
  • Porter의 Five Forces 분석
  • 주요 이해관계자와 구입 기준
  • 가격 분석
  • 규제 상황
  • 주요 컨퍼런스 및 이벤트
  • 사례 연구 분석
  • 특허 분석
  • 최종사용자 분석
  • 투자와 자금조달 시나리오
  • 헬스케어 EDI 비즈니스 모델 분석

제6장 헬스케어 EDI 시장 : 컴포넌트별

  • 서비스
    • 매니지드 서비스
    • 전문 서비스
  • 소프트웨어
    • 도입 모델별
    • 트랜잭션 유형별

제7장 헬스케어 EDI 시장 : 변속기 유형별

  • VALUE-ADDED NETWORK (VAN) EDI
  • POINT-TO-POINT EDI
  • MULTI-CHANNEL EDI

제8장 헬스케어 EDI 시장 : 최종사용자별

  • 의료 제공자
    • 병원 및 클리닉
    • 외래수술센터(ASC)
    • 기타
  • 보험 가입자
    • 민간 보험 가입자
    • 공적 보험 가입자
  • 의료기기 기업
  • 제약 기업 및 바이오테크놀러지 기업
  • 약국

제9장 헬스케어 EDI 시장 : 지역별

  • 북미
    • 거시경제 전망
    • 미국
    • 캐나다
  • 유럽
    • 거시경제 전망
    • 독일
    • 영국
    • 프랑스
    • 이탈리아
    • 스페인
    • 기타
  • 아시아태평양
    • 거시경제 전망
    • 일본
    • 중국
    • 인도
    • 기타
  • 라틴아메리카
    • 거시경제 전망
    • 브라질
    • 멕시코
    • 기타
  • 중동 및 아프리카
    • 거시경제 전망
    • GCC 국가
    • 기타

제10장 경쟁 구도

  • 주요 시장 진출기업의 전략/강점
  • 매출 분석
  • 시장 점유율 분석
  • 기업 평가 매트릭스 : 주요 기업
  • 기업 평가 매트릭스 : 스타트업/중소기업
  • 기업 평가와 재무 지표
  • 브랜드/제품 비교
  • 경쟁 시나리오

제11장 기업 개요

  • 주요 기업
    • MCKESSON CORPORATION
    • UNITEDHEALTH GROUP
    • COGNIZANT
    • IBM
    • VERADIGM LLC
    • ATHENAHEALTH, INC.
    • BOOMI, LP
    • EXPERIAN INFORMATION SOLUTIONS, INC.
    • SSI GROUP LLC
    • QUADAX, INC.
    • WAYSTAR
    • AVAILITY, LLC
    • COMARCH SA
    • AXWAY
    • PLEXIS HEALTHCARE SYSTEMS
    • TRUE COMMERCE, INC.
    • INOVALON
    • 123 EDI
    • NTT DATA GROUP CORPORATION
    • CIRIUS GROUP, INC.
    • EPICOR SOFTWARE CORPORATION
  • 기타 기업
    • OSP LABS
    • NALASHAA
    • WNS
    • PILOTFISH, INC.
    • CLEO

제12장 부록

LSH 25.02.28

The global Healthcare EDI market is projected to reach USD 7.11 billion by 2029 from USD 4.47 billion in 2024, at a CAGR of 9.7 % from 2024 to 2029. The market's growth is fuelled by the rapid digitization of healthcare records and patient data, regulatory compliance requirements, the growing volume of claims submissions, growing demand from the healthcare insurance industry, and cost reductions associated with EDI implementation. The Workgroup for Electronic Data Interchange (WEDI) estimated that EDI implementation could save USD 1 per claim for health plans and insurers, USD 1.49 for physicians, USD 0.86 for hospitals, and USD 0.83 for other parties in the US. Furthermore, according to the CAQH Index 2023, the estimated volume of claim submissions for the medical industry rose by 8% to 9.5 billion in the US in 2023. However, integration with existing healthcare IT systems, data privacy, and security constraints pose a significant challenge within this market.

Scope of the Report
Years Considered for the Study2022-2029
Base Year2023
Forecast Period2024-2029
Units ConsideredMillion/Billion (USD)
SegmentsBy Component, Transmission Type, and End-user
Regions coveredNorth America, Europe, Asia Pacific, Latin America, and Middle East Africa.

"Point-to-point EDI held the largest market share in the healthcare EDI market in 2023."

The healthcare EDI market is segmented based on transmission type into Value Added Network (VAN) EDI and point-to-point EDI. The point-to-point EDI segment held the largest market share in 2023. Point-to-point EDI, also known as direct EDI, establishes a single line of exchange between the involved partners, requiring them to communicate with each other individually. In the healthcare industry, point-to-point EDI is used by healthcare organizations to connect with clearinghouses or payers directly using an FTP or EDIINT (EDI over the Internet) software, thereby providing users greater control and security over their data. Reduction in intermediary costs, data security, and compliance with regulatory standards are some of the significant factors propelling market growth. However, interoperability issues and setup complexities are some of the factors restraining the market growth.

"By transaction type, the claims payment segment is expected to register the fastest growth over the forecast period."

By transaction type, the healthcare EDI market is divided into claims submission, claims status, eligibility verification, claims payment, referral certification & authorization, payment remittance, and other EDI transactions. The claims payment segment is projected to be the fastest-growing segment over the forecast year. EDI in claims payment typically involves the automation of payment exchange between payers and providers, wherein the payment is sent directly and electronically from payers to providers through a value-added network (VAN). According to the CAQH Index 2023, fully electronic claim payment could lead to a potential cost savings opportunity of USD 524 million annually for the medical industry. The increasing demand for quick claim adjudication, the rising adoption of electronic claims payment processes by healthcare payers, and the growing complexity of reimbursement models are some of the major factors driving the market growth.

"Asia Pacific is estimated to register the highest CAGR over the forecast period."

The Healthcare EDI market is segmented segments, namely, North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. The healthcare EDI market in Asia Pacific is projected to register at the highest CAGR rate during the forecast period. The growth of this region is due to growth in healthcare infrastructure, government initiatives to modernize and digitalize the healthcare industry, and growth in the health insurance industry. Countries such as Japan and China are focusing on developing cost-effective solutions emphasizing the importance of real-time public health data sharing, rapid growth in healthcare insurance coverage, growth in cross-border healthcare services, adopting advanced technologies, and regulatory mandates for healthcare data standardization (especially in China and Japan) which bolster the Asia Pacific market growth. For instance, the implementation of the Healthy China 2030 Plan is driving the country's health insurance system and subsequent HCIT adoption. China expects to achieve health equity by 2030. Moreover, growing medical tourism, rising healthcare expenditure, increased health insurance penetration, and growing government support are other factors augmenting the market growth.

Breakdown of supply-side primary interviews by company type, designation, and region:

  • By Company Type: Tier 1 (40%), Tier 2 (35%), and Tier 3 (25%)
  • By Designation: Managers (40%), Directors (35%), and Others (25%)
  • By Region: North America (40%), Europe (30%), Asia Pacific (20%), Latin America (5%) and Middle East Africa (5%)

List of Companies Profiled in the Report

    • McKESSON CORPORATION (US)
    • UnitedHealth Group Incorporated (US)
    • IBM (US)
    • Cognizant (US)
    • Boomi (US)
    • True Commerce, Inc. (US)
    • athenahealth (US)
    • Axway (US)
    • Experian Information Solutions, Inc. (US)
    • Veradigm LLC (US)
    • The SSI Group, LLC (US)
    • NTT DATA Group Corporation (Japan)
    • Comarch SA. (Poland)
    • Availity, LLC. (US)
    • Quadax, Inc. (US)
    • Waystar. (US)
    • PLEXIS Healthcare Systems (US)
    • Inovalon. (US)
    • 123 EDI (US)
    • Cirius Group, Inc. (US)
    • Epicor Software Corporation (US)
    • OSP Labs (US)
    • Nalashaa. (US)
    • WNS (US)
    • PilotFish, Inc. (US)
    • Cleo (US)

Research Coverage

This research report categorizes the Healthcare EDI market by component (services [managed services and professional services], and software), transmission type (VAN EDI, and point-to-point EDI), end user (Healthcare providers, healthcare payers, medical device companies, pharmaceutical and biotechnology companies, and pharmacies), and region. The scope of the report covers detailed information regarding the major factors, such as drivers, restraints, challenges, and opportunities, influencing the growth of the healthcare EDI market. A thorough analysis of the key industry players has been done to provide insights into their business overview, offerings, and key strategies such as acquisitions, collaborations, agreements, mergers, product launches & updates, partnerships, expansions, and other recent developments associated with the healthcare EDI market. Competitive analysis of upcoming startups in the healthcare EDI market ecosystem is covered in this report.

Reasons to Buy the Report

The report will help market leaders/new entrants in this market with information on the closest approximations of the revenue numbers for the overall healthcare EDI market and the subsegments. This report will help stakeholders understand the competitive landscape and gain more insights to better position their businesses and plan suitable go-to-market strategies. The report also helps stakeholders understand the market pulse and provides information on key market drivers, restraints, challenges, and opportunities.

The report provides insights on the following pointers:

  • Analysis of key drivers (supportive regulations for transaction processes, growing necessity to reduce healthcare costs, reduction in costs and improved operational efficiency with healthcare EDI software, rising demand for streamlined claims management, API integration accelerating claims management), restraints (ensuring data security is a major concern for both patients and EDI Users, elevated costs associated with implementing EDI software), opportunities (rising trend in outsourcing EDI services, adoption of ICD-11 standards, utilizing real-time data exchange, telehealth and remote monitoring expansion), and challenges (integration of diverse healthcare IT solutions across the industry, needs and limitations of end users, interoperability issues in legacy systems, complexities in transactions and healthcare network) influencing the growth of the healthcare EDI market
  • Product Development/Innovation: Detailed insights on upcoming technologies, research & development activities, and new product & service launches in the healthcare EDI market
  • Market Development: Comprehensive information about lucrative markets - the report analyses the healthcare EDI market across varied regions.
  • Market Diversification: Exhaustive information about new products & services, untapped geographies, recent developments, and investments in the healthcare EDI market
  • Competitive Assessment: In-depth assessment of market shares, growth strategies, and service offerings of leading players such as McKESSON CORPORATION (US), UnitedHealth Group Incorporated (US), Cognizant (US), IBM (US), Veradigm LLC (US), athenahealth (US), Axway (US), Boomi (US), and True Commerce, Inc. (US), etc. among others in healthcare EDI market.

TABLE OF CONTENTS

1 INTRODUCTION

  • 1.1 STUDY OBJECTIVES
  • 1.2 MARKET DEFINITION
  • 1.3 MARKET SCOPE
    • 1.3.1 MARKETS COVERED
    • 1.3.2 INCLUSIONS & EXCLUSIONS
    • 1.3.3 YEARS CONSIDERED
    • 1.3.4 CURRENCY CONSIDERED
  • 1.4 MARKET STAKEHOLDERS
  • 1.5 SUMMARY OF CHANGES

2 RESEARCH METHODOLOGY

  • 2.1 RESEARCH DATA
    • 2.1.1 SECONDARY DATA
      • 2.1.1.1 Key data from secondary sources
    • 2.1.2 PRIMARY DATA
      • 2.1.2.1 Primary sources
      • 2.1.2.2 Key industry insights
      • 2.1.2.3 Breakdown of primary interviews (supply side): By company type, designation, and region
  • 2.2 MARKET SIZE ESTIMATION
  • 2.3 MARKET BREAKDOWN AND DATA TRIANGULATION
  • 2.4 MARKET SHARE ESTIMATION
  • 2.5 STUDY ASSUMPTIONS
  • 2.6 LIMITATIONS
    • 2.6.1 METHODOLOGY-RELATED LIMITATIONS
    • 2.6.2 SCOPE-RELATED LIMITATIONS
  • 2.7 RISK ASSESSMENT

3 EXECUTIVE SUMMARY

4 PREMIUM INSIGHTS

  • 4.1 HEALTHCARE EDI MARKET OVERVIEW
  • 4.2 HEALTHCARE EDI MARKET: REGIONAL MIX
  • 4.3 NORTH AMERICA: HEALTHCARE EDI MARKET, BY END USER AND COUNTRY
  • 4.4 HEALTHCARE EDI MARKET: GEOGRAPHIC SNAPSHOT

5 MARKET OVERVIEW

  • 5.1 INTRODUCTION
  • 5.2 MARKET DYNAMICS
    • 5.2.1 DRIVERS
      • 5.2.1.1 Supportive regulations for transaction processes
      • 5.2.1.2 Growing requirement to curb healthcare costs
      • 5.2.1.3 Healthcare EDI software provides low costs and improved operational efficiency
      • 5.2.1.4 Increasing demand for streamlined claims management
      • 5.2.1.5 Acceleration of claims management with API integration
    • 5.2.2 RESTRAINTS
      • 5.2.2.1 Concerns associated with data security
      • 5.2.2.2 High software implementation costs
    • 5.2.3 OPPORTUNITIES
      • 5.2.3.1 Rising trend of outsourcing EDI services
      • 5.2.3.2 Adoption of ICD-11 guidelines
      • 5.2.3.3 Benefits of real-time data exchange
      • 5.2.3.4 Expansion of telehealth and remote monitoring capabilities
    • 5.2.4 CHALLENGES
      • 5.2.4.1 Integration of healthcare IT solutions
      • 5.2.4.2 End-user limitations & requirements
      • 5.2.4.3 Interoperability issues in legacy systems
      • 5.2.4.4 Complexities associated with transactions
  • 5.3 TRENDS/DISRUPTIONS IMPACTING CUSTOMERS' BUSINESSES
  • 5.4 HEALTHCARE EDI STANDARDS
    • 5.4.1 ANSI X12
    • 5.4.2 EDIFACT
    • 5.4.3 OTHER STANDARDS
  • 5.5 INDUSTRY TRENDS
    • 5.5.1 ADOPTION OF INTEROPERABILITY STANDARDS
    • 5.5.2 GROWTH OF VALUE-BASED CARE MODELS
    • 5.5.3 INCREASING EMPHASIS ON DATA SECURITY & PRIVACY
    • 5.5.4 GROWING FOCUS ON INTEGRATION PLATFORM AS A SERVICE (IPAAS)
    • 5.5.5 INCREASING USE OF EDI IN SUPPLY CHAIN & DISTRIBUTION INDUSTRY
  • 5.6 SUPPLY CHAIN ANALYSIS
  • 5.7 ECOSYSTEM ANALYSIS
  • 5.8 TECHNOLOGY ANALYSIS
    • 5.8.1 KEY TECHNOLOGIES
      • 5.8.1.1 REST APIS
      • 5.8.1.2 Real-time data exchange
      • 5.8.1.3 JSON or XML Conversion
      • 5.8.1.4 EDI as a service (EDIAAS)
    • 5.8.2 COMPLEMENTARY TECHNOLOGIES
      • 5.8.2.1 Health information exchange
      • 5.8.2.2 Electronic health records (EHRs)
      • 5.8.2.3 Healthcare middleware solutions
    • 5.8.3 ADJACENT TECHNOLOGIES
      • 5.8.3.1 AI and ML
      • 5.8.3.2 Blockchain technology
  • 5.9 PORTER'S FIVE FORCES ANALYSIS
    • 5.9.1 INTENSITY OF COMPETITIVE RIVALRY
    • 5.9.2 BARGAINING POWER OF SUPPLIERS
    • 5.9.3 BARGAINING POWER OF BUYERS
    • 5.9.4 THREAT OF SUBSTITUTES
    • 5.9.5 THREAT OF NEW ENTRANTS
  • 5.10 KEY STAKEHOLDERS & BUYING CRITERIA
    • 5.10.1 KEY STAKEHOLDERS IN BUYING PROCESS
    • 5.10.2 BUYING CRITERIA
  • 5.11 PRICING ANALYSIS
    • 5.11.1 AVERAGE SELLING PRICE TREND, BY REGION (QUALITATIVE)
    • 5.11.2 INDICATIVE PRICING ANALYSIS, BY SOFTWARE
  • 5.12 REGULATORY LANDSCAPE
    • 5.12.1 REGULATORY SCENARIO
      • 5.12.1.1 North America
        • 5.12.1.1.1 US
        • 5.12.1.1.2 Canada
      • 5.12.1.2 Europe
      • 5.12.1.3 Asia Pacific
        • 5.12.1.3.1 China
        • 5.12.1.3.2 Japan
        • 5.12.1.3.3 India
      • 5.12.1.4 Middle East & Africa
      • 5.12.1.5 Latin America
    • 5.12.2 REGULATORY BODIES, GOVERNMENT AGENCIES, AND OTHER ORGANIZATIONS
  • 5.13 KEY CONFERENCES & EVENTS, 2025-2026
  • 5.14 CASE STUDY ANALYSIS
    • 5.14.1 TRANSFORMING CLAIMS MANAGEMENT WITH OPTUM CLAIMS MANAGER
      • 5.14.1.1 Use case 1: Optum claims manager enhances revenue management & compliance for North Carolina
    • 5.14.2 VIBRA HEALTHCARE'S SUCCESS WITH WAYSTAR
      • 5.14.2.1 Use case 2: Streamlining billing and enhancing cost reduction with Waystar
    • 5.14.3 ENHANCING PHARMACY CLAIMS EFFICIENCY WITH RELAYRX
      • 5.14.3.1 Use case 3: Streamlining pharmacy reimbursements and improving patient outcomes
  • 5.15 PATENT ANALYSIS
    • 5.15.1 PATENT PUBLICATION TRENDS FOR HEALTHCARE EDI
    • 5.15.2 INSIGHTS: JURISDICTION AND TOP APPLICANT ANALYSIS
  • 5.16 END-USER ANALYSIS
    • 5.16.1 UNMET NEEDS FOR END USERS IN HEALTHCARE EDI MARKET
    • 5.16.2 END-USER EXPECTATIONS
  • 5.17 INVESTMENT & FUNDING SCENARIO
  • 5.18 HEALTHCARE EDI BUSINESS MODEL ANALYSIS
    • 5.18.1 TOP USE CASES & MARKET POTENTIAL
      • 5.18.1.1 Key use cases
    • 5.18.2 CASE STUDIES OF AI/GENERATIVE AI IMPLEMENTATION
      • 5.18.2.1 Case study 1: Simplification of prior authorization with Availity AuthAI
      • 5.18.2.2 Case study 2: Automating claims management with implementation of AI
      • 5.18.2.3 Case study 3: Enhancement of supply chain with AI-powered solution
    • 5.18.3 IMPACT OF AI/GEN AI ON INTERCONNECTED & ADJACENT ECOSYSTEMS
      • 5.18.3.1 Electronic health records market
      • 5.18.3.2 Medical billing market
      • 5.18.3.3 Healthcare revenue cycle management market
      • 5.18.3.4 Health information exchange market
    • 5.18.4 USER READINESS AND IMPACT ASSESSMENT
      • 5.18.4.1 User readiness
        • 5.18.4.1.1 Healthcare providers
        • 5.18.4.1.2 Healthcare payers
      • 5.18.4.2 Impact assessment
        • 5.18.4.2.1 User A: Healthcare providers
          • 5.18.4.2.1.1 Implementation
          • 5.18.4.2.1.2 Impact
        • 5.18.4.2.2 User B: Academic research institutes
          • 5.18.4.2.2.1 Implementation
          • 5.18.4.2.2.2 Impact

6 HEALTHCARE EDI MARKET, BY COMPONENT

  • 6.1 INTRODUCTION
  • 6.2 SERVICES
    • 6.2.1 MANAGED SERVICES
      • 6.2.1.1 Claims management services
        • 6.2.1.1.1 Rising complexities associated with healthcare billing and regulatory requirements to boost demand
      • 6.2.1.2 Supply management services
        • 6.2.1.2.1 Growing focus on automation and real-time data integration to drive market
    • 6.2.2 PROFESSIONAL SERVICES
      • 6.2.2.1 Implementation services
        • 6.2.2.1.1 Increasing demand for interoperability & integration of cloud systems to fuel market
      • 6.2.2.2 Maintenance & support services
        • 6.2.2.2.1 Requirement of software updates and real-time support to boost demand
      • 6.2.2.3 Other services
  • 6.3 SOFTWARE
    • 6.3.1 SOFTWARE, BY DEPLOYMENT MODEL
      • 6.3.1.1 On-premise EDI model
        • 6.3.1.1.1 Enhanced control over data security to support market growth
      • 6.3.1.2 Web/Cloud-based EDI model
        • 6.3.1.2.1 High uptake of SaaS models to propel market
    • 6.3.2 SOFTWARE, BY TRANSACTION TYPE
      • 6.3.2.1 Claims management software
        • 6.3.2.1.1 Claims submission
          • 6.3.2.1.1.1 Growing need for improved claims accuracy and low administration costs to drive market
        • 6.3.2.1.2 Claims status
          • 6.3.2.1.2.1 Growing demand for claims checks with minimal manual intervention to fuel uptake
        • 6.3.2.1.3 Eligibility verification
          • 6.3.2.1.3.1 Growing focus on real-time patient insurance validation to boost market
        • 6.3.2.1.4 Claims payment
          • 6.3.2.1.4.1 Need for streamlined reimbursement processes to fuel uptake
        • 6.3.2.1.5 Referral certification & authorization
          • 6.3.2.1.5.1 Growing requirement for healthcare investments to drive market
        • 6.3.2.1.6 Payment remittance
          • 6.3.2.1.6.1 Growing focus on streamlining payment facilities to drive market
        • 6.3.2.1.7 Other EDI claims transactions
      • 6.3.2.2 Supply management software
        • 6.3.2.2.1 Procurement management
          • 6.3.2.2.1.1 Rising demand for supply chain efficiencies to fuel uptake
        • 6.3.2.2.2 Inventory management
          • 6.3.2.2.2.1 Growing requirement for real-time inventory tracking to drive market
        • 6.3.2.2.3 Order management
          • 6.3.2.2.3.1 Rising volume of medical supplies & pharmaceuticals to support market growth

7 HEALTHCARE EDI MARKET, BY TRANSMISSION TYPE

  • 7.1 INTRODUCTION
  • 7.2 VALUE-ADDED NETWORK (VAN) EDI
    • 7.2.1 INCREASING DEMAND FOR CLEARINGHOUSE SERVICES TO DRIVE MARKET
  • 7.3 POINT-TO-POINT EDI
    • 7.3.1 UTILIZATION BY LARGE ORGANIZATIONS FOR VOLUME TRANSACTIONS TO BOOST DEMAND
  • 7.4 MULTI-CHANNEL EDI
    • 7.4.1 GRADUAL SHIFT TOWARDS API-BASED EXCHANGE FOR ENHANCED INTEROPERABILITY TO PROPEL MARKET

8 HEALTHCARE EDI MARKET, BY END USER

  • 8.1 INTRODUCTION
  • 8.2 HEALTHCARE PROVIDERS
    • 8.2.1 HOSPITALS & CLINICS
      • 8.2.1.1 Mitigation of denial claims loss to boost demand
    • 8.2.2 AMBULATORY SURGERY CENTERS
      • 8.2.2.1 Rising trend toward outpatient care facilities to drive market
    • 8.2.3 OTHER HEALTHCARE PROVIDERS
  • 8.3 HEALTHCARE PAYERS
    • 8.3.1 PRIVATE PAYERS
      • 8.3.1.1 Fraud prevention and improvements in traceability to fuel uptake
    • 8.3.2 PUBLIC PAYERS
      • 8.3.2.1 Mandatory EDI compliance for healthcare data processing to propel market
  • 8.4 MEDICAL DEVICE COMPANIES
    • 8.4.1 TECHNOLOGICAL INNOVATION AND SEAMLESS DEVICE PROCUREMENT REQUIREMENTS TO DRIVE MARKET
  • 8.5 PHARMACEUTICAL & BIOTECHNOLOGY COMPANIES
    • 8.5.1 AUTOMATION OF SUPPLY CHAIN PROCESSES TO BOOST DEMAND
  • 8.6 PHARMACIES
    • 8.6.1 RETAIL PHARMACY EXPANSION TO SUPPORT MARKET GROWTH

9 HEALTHCARE EDI MARKET, BY REGION

  • 9.1 INTRODUCTION
  • 9.2 NORTH AMERICA
    • 9.2.1 MACROECONOMIC OUTLOOK FOR NORTH AMERICA
    • 9.2.2 US
      • 9.2.2.1 Increasing investments in rural healthcare to encourage growth
    • 9.2.3 CANADA
      • 9.2.3.1 Rising investments in preventive and social care to facilitate growth
  • 9.3 EUROPE
    • 9.3.1 MACROECONOMIC OUTLOOK FOR EUROPE
    • 9.3.2 GERMANY
      • 9.3.2.1 Favorable government initiatives to promote growth
    • 9.3.3 UK
      • 9.3.3.1 Growing digitization of healthcare infrastructure to drive market
    • 9.3.4 FRANCE
      • 9.3.4.1 Growing modernization efforts in healthcare to boost market
    • 9.3.5 ITALY
      • 9.3.5.1 Increasing focus on optimizing healthcare resources to accelerate growth
    • 9.3.6 SPAIN
      • 9.3.6.1 Universal public healthcare system to sustain growth
    • 9.3.7 REST OF EUROPE
  • 9.4 ASIA PACIFIC
    • 9.4.1 MACROECONOMIC OUTLOOK FOR ASIA PACIFIC
    • 9.4.2 JAPAN
      • 9.4.2.1 Innovations in digital health solutions to propel market
    • 9.4.3 CHINA
      • 9.4.3.1 High uptake of digitization and policy-driven expansion of health services to drive market
    • 9.4.4 INDIA
      • 9.4.4.1 Growing adoption of EHR solutions to fuel uptake
    • 9.4.5 REST OF ASIA PACIFIC
  • 9.5 LATIN AMERICA
    • 9.5.1 MACROECONOMIC OUTLOOK FOR LATIN AMERICA
    • 9.5.2 BRAZIL
      • 9.5.2.1 Improvements in hospital management systems to drive market
    • 9.5.3 MEXICO
      • 9.5.3.1 Budgetary cuts and shortage of healthcare professionals to restrain market
    • 9.5.4 REST OF LATIN AMERICA
  • 9.6 MIDDLE EAST & AFRICA
    • 9.6.1 MACROECONOMIC OUTLOOK FOR MIDDLE EAST & AFRICA
    • 9.6.2 GCC COUNTRIES
      • 9.6.2.1 Rising healthcare investments for supply management to fuel uptake
    • 9.6.3 REST OF MIDDLE EAST & AFRICA

10 COMPETITIVE LANDSCAPE

  • 10.1 INTRODUCTION
  • 10.2 KEY PLAYER STRATEGY/RIGHT TO WIN
    • 10.2.1 OVERVIEW OF STRATEGIES ADOPTED BY PLAYERS IN HEALTHCARE EDI MARKET
  • 10.3 REVENUE ANALYSIS, 2019-2023
  • 10.4 MARKET SHARE ANALYSIS, 2023
    • 10.4.1 SOFTWARE PROVIDERS
      • 10.4.1.1 Ranking of key market players
    • 10.4.2 SERVICE PROVIDERS
      • 10.4.2.1 Ranking of key market players
  • 10.5 COMPANY EVALUATION MATRIX: KEY PLAYERS, 2023
    • 10.5.1 STARS
    • 10.5.2 EMERGING LEADERS
    • 10.5.3 PERVASIVE PLAYERS
    • 10.5.4 PARTICIPANTS
    • 10.5.5 COMPANY FOOTPRINT: KEY PLAYERS, 2023
      • 10.5.5.1 Company footprint
      • 10.5.5.2 Component footprint
      • 10.5.5.3 Transmission type footprint
      • 10.5.5.4 End-user footprint
      • 10.5.5.5 Region footprint
  • 10.6 COMPANY EVALUATION MATRIX: STARTUPS/SMES, 2023
    • 10.6.1 PROGRESSIVE COMPANIES
    • 10.6.2 RESPONSIVE COMPANIES
    • 10.6.3 DYNAMIC COMPANIES
    • 10.6.4 STARTING BLOCKS
    • 10.6.5 COMPETITIVE BENCHMARKING: STARTUPS/SMES, 2023
  • 10.7 COMPANY VALUATION & FINANCIAL METRICS
    • 10.7.1 FINANCIAL METRICS
    • 10.7.2 COMPANY VALUATION
  • 10.8 BRAND/PRODUCT COMPARISON
  • 10.9 COMPETITIVE SCENARIO
    • 10.9.1 PRODUCT/SERVICE LAUNCHES & ENHANCEMENTS
    • 10.9.2 DEALS
    • 10.9.3 OTHER DEVELOPMENTS

11 COMPANY PROFILES

  • 11.1 KEY PLAYERS
    • 11.1.1 MCKESSON CORPORATION
      • 11.1.1.1 Business overview
      • 11.1.1.2 Products/Services offered
        • 11.1.1.2.1 Deals
        • 11.1.1.2.2 Other developments
      • 11.1.1.3 MnM view
        • 11.1.1.3.1 Key strengths
        • 11.1.1.3.2 Strategic choices
        • 11.1.1.3.3 Weaknesses & competitive threats
    • 11.1.2 UNITEDHEALTH GROUP
      • 11.1.2.1 Business overview
      • 11.1.2.2 Products/Services offered
      • 11.1.2.3 Recent developments
        • 11.1.2.3.1 Deals
        • 11.1.2.3.2 Other developments
      • 11.1.2.4 MnM view
        • 11.1.2.4.1 Key strengths
        • 11.1.2.4.2 Strategic choices
        • 11.1.2.4.3 Weaknesses & competitive threats
    • 11.1.3 COGNIZANT
      • 11.1.3.1 Business overview
      • 11.1.3.2 Products/Services offered
      • 11.1.3.3 Recent developments
        • 11.1.3.3.1 Deals
        • 11.1.3.3.2 Other developments
      • 11.1.3.4 MnM view
        • 11.1.3.4.1 Key strengths
        • 11.1.3.4.2 Strategic choices
        • 11.1.3.4.3 Weaknesses & competitive threats
    • 11.1.4 IBM
      • 11.1.4.1 Business overview
      • 11.1.4.2 Products/Services offered
      • 11.1.4.3 Recent developments
        • 11.1.4.3.1 Product launches
        • 11.1.4.3.2 Deals
      • 11.1.4.4 MnM view
        • 11.1.4.4.1 Key strengths
        • 11.1.4.4.2 Strategic choices
        • 11.1.4.4.3 Weaknesses & competitive threats
    • 11.1.5 VERADIGM LLC
      • 11.1.5.1 Business overview
      • 11.1.5.2 Products/Services offered
      • 11.1.5.3 Recent developments
        • 11.1.5.3.1 Product launches
        • 11.1.5.3.2 Deals
        • 11.1.5.3.3 Other developments
    • 11.1.6 ATHENAHEALTH, INC.
      • 11.1.6.1 Business overview
      • 11.1.6.2 Products/Services offered
    • 11.1.7 BOOMI, LP
      • 11.1.7.1 Business overview
      • 11.1.7.2 Products/Services offered
      • 11.1.7.3 Recent developments
        • 11.1.7.3.1 Product enhancements
        • 11.1.7.3.2 Deals
    • 11.1.8 EXPERIAN INFORMATION SOLUTIONS, INC.
      • 11.1.8.1 Business overview
      • 11.1.8.2 Products/Services offered
      • 11.1.8.3 Recent developments
        • 11.1.8.3.1 Product launches
        • 11.1.8.3.2 Deals
        • 11.1.8.3.3 Other developments
    • 11.1.9 SSI GROUP LLC
      • 11.1.9.1 Business overview
      • 11.1.9.2 Products/Services offered
        • 11.1.9.2.1 Product launches
    • 11.1.10 QUADAX, INC.
      • 11.1.10.1 Business overview
      • 11.1.10.2 Products/Services offered
      • 11.1.10.3 Recent developments
        • 11.1.10.3.1 Deals
        • 11.1.10.3.2 Other developments
    • 11.1.11 WAYSTAR
      • 11.1.11.1 Business overview
      • 11.1.11.2 Products/Services offered
      • 11.1.11.3 Recent developments
        • 11.1.11.3.1 Product launches
        • 11.1.11.3.2 Deals
        • 11.1.11.3.3 Other developments
    • 11.1.12 AVAILITY, LLC
      • 11.1.12.1 Business overview
      • 11.1.12.2 Products/Services offered
      • 11.1.12.3 Recent developments
        • 11.1.12.3.1 Product launches
        • 11.1.12.3.2 Deals
        • 11.1.12.3.3 Other developments
    • 11.1.13 COMARCH SA
      • 11.1.13.1 Business overview
      • 11.1.13.2 Products/Services offered
      • 11.1.13.3 Recent developments
        • 11.1.13.3.1 Deals
        • 11.1.13.3.2 Other developments
    • 11.1.14 AXWAY
      • 11.1.14.1 Business overview
      • 11.1.14.2 Products/Services offered
      • 11.1.14.3 Recent developments
        • 11.1.14.3.1 Deals
    • 11.1.15 PLEXIS HEALTHCARE SYSTEMS
      • 11.1.15.1 Business overview
      • 11.1.15.2 Products/Services offered
      • 11.1.15.3 Recent developments
        • 11.1.15.3.1 Other developments
    • 11.1.16 TRUE COMMERCE, INC.
      • 11.1.16.1 Business overview
      • 11.1.16.2 Products/Services offered
      • 11.1.16.3 Recent developments
        • 11.1.16.3.1 Deals
        • 11.1.16.3.2 Expansions
        • 11.1.16.3.3 Other developments
    • 11.1.17 INOVALON
      • 11.1.17.1 Business overview
      • 11.1.17.2 Products/Services offered
      • 11.1.17.3 Recent developments
        • 11.1.17.3.1 Product enhancements
        • 11.1.17.3.2 Deals
        • 11.1.17.3.3 Other developments
    • 11.1.18 123 EDI
      • 11.1.18.1 Business overview
      • 11.1.18.2 Products/Services offered
    • 11.1.19 NTT DATA GROUP CORPORATION
      • 11.1.19.1 Business overview
      • 11.1.19.2 Products/Services offered
      • 11.1.19.3 Recent developments
        • 11.1.19.3.1 Deals
    • 11.1.20 CIRIUS GROUP, INC.
      • 11.1.20.1 Business overview
      • 11.1.20.2 Products/Services offered
    • 11.1.21 EPICOR SOFTWARE CORPORATION
      • 11.1.21.1 Business overview
      • 11.1.21.2 Products/Services offered
      • 11.1.21.3 Recent developments
        • 11.1.21.3.1 Deals
  • 11.2 OTHER PLAYERS
    • 11.2.1 OSP LABS
    • 11.2.2 NALASHAA
    • 11.2.3 WNS
    • 11.2.4 PILOTFISH, INC.
    • 11.2.5 CLEO

12 APPENDIX

  • 12.1 DISCUSSION GUIDE
  • 12.2 KNOWLEDGESTORE: MARKETSANDMARKETS' SUBSCRIPTION PORTAL
  • 12.3 CUSTOMIZATION OPTIONS
  • 12.4 RELATED REPORTS
  • 12.5 AUTHOR DETAILS
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