Healthcare Electronic Data Interchange Market Size, Share & Trends Analysis Report By Component (Services, Solutions), By Delivery Mode, By End-use (Healthcare Payers, Healthcare Providers, Others), By Region, And Segment Forecasts, 2022 - 2030

Report Overview

The global healthcare electronic data interchange market size was valued at USD 4.0 billion in 2021 and is estimated to grow at a compound annual growth rate (CAGR) of 9.6% from 2022 to 2030. Rising need to curb healthcare costs coupled with technological advancements in electronic data interchange (EDI) is expected to facilitate market growth. Additionally, a surge in the number of end-users coupled with increasing adoption of EDI is expected to support the market growth during the forecast period. Healthcare EDI helps in the automation of business processes from claims submission and payment, insurance eligibility checks, and data reporting. Claim submissions are considered to be the most common electronic transaction in health care as per the Maryland Healthcare Commission. EDI thus finds notable applications in this segment.

The electronic data interchange helps in keeping healthcare costs at an affordable level, improving the quality of healthcare delivery and its supporting process, and making accurate, fast, reliable, secure, and detailed information. The use of paper form can be cumbersome, incompetent, and costlier when it needs to distribute, retrieve, consolidate, and look for data. The electronic data interchange helps in minimizing these kinds of time-consuming processes and streamlines the claim management processes.

Technologically innovated electronic data interchange services/solutions such as web-based EDI have advanced to address issues regarding confidentiality, authentication, and data integrity. Developments in the American National Standards Institute (ANSI) X12 EDI formatting standard have made electronic data interchange useful for Business-to-Business (B2B) transactions. The emergence of Extensible Markup Language (XML) and web-based standards in electronic data interchange is pacing the growth of this industry.

Various methods or delivery modes are used to deliver electronic data interchange services/solutions such as web and cloud-based EDI, EDI Value Added Network (VAN), direct (point-to-point) EDI, mobile EDI, Applicability Statement version 2 (AS2), File Transfer Protocol over Virtual Private Network (FTP/VPN), Secure File Transfer Protocol (SFTP) or File Transfer Protocol Secure (FTPS).

Moreover, an increasing number of end-users are expected to propel the demand for electronic data interchange services/solutions over the market period. The end-users include payers, providers, pharmaceutical & medical device industries, and others. A surge in the number of hospitals in the UK., France, Germany, Benelux, and Denmark, which are adopting cost curtailing strategies through the use of electronic data interchange coupled with increased tie-ups with their vendors or suppliers. This is expected to support the growth of this space during the forecast period.

Pharmaceutical industries and medical device manufacturers are also adopting electronic data interchange services or solutions owing to growing competitiveness, pricing pressure, and lower profit margins, this is anticipated to assist in the growth of this vertical.

Component Insights

The components analyzed in this study include services and solutions. The services segment is expected to dominate the market owing to the rising rate of outsourcing electronic data interchange services by healthcare organizations and increasing demand for scalability and integrity of EDI solutions.

The solutions segment is expected to register favorable growth over the forecast period owing to the growing demand for electronic data interchange solutions such as e-invoicing, EDIFACT manifests, and others, as it reduces administrative costs, accelerates information processing, ensures data accuracy, eliminates certain business transactions, streamlines business procedures, and strengthens customer or vendor relations.

Delivery Mode Insights

The delivery modes analyzed in this study include EDI VAN, direct EDI, and mobile EDI. The web and cloud-based EDI segment is anticipated to spearhead the healthcare electronic data interchange (EDI) market owing to growing demand from small and medium-sized healthcare providers for its affordable solutions coupled with improved flexibility and scalability.

The mobile EDI segment is expected to register a comparatively higher CAGR over the forecast period. This is due to technological advancements in the healthcare industry and the increasing acceptance of mobile solutions among healthcare providers.

End-Use Insights

By end-use, the market is categorized into payers, providers, pharmaceutical & medical device industries, and others. The payers' segment is anticipated to register a comparatively higher market share during the forecast period. This is due to growing demand from insurance plans, and healthcare payer organizations for the evaluation of insurance claims before their payment settlement, prevention and detection of fraudulent claims, and disease risk assessment.

On the other hand, the providers' segment is expected to register a comparatively higher CAGR during the forecast period. This is attributed to the rising adoption of EDI for operational intelligence, performance management, and financial management by physicians and clinicians, hospitals, clinics, and medical assessment centers.

Regional Insights

North America held a dominant share in the market in 2021, owing to the higher adoption of Healthcare Information Technology (HCIT), and the presence of major market players such as McKesson Corporation, Optum, Inc.; The SSI Group, LLC; etc. Europe is also expected to hold a substantial market share during the forecast period due to the rising demand for electronic data interchange services/solutions among pharmaceutical companies and medical device manufacturers to tackle growing competitiveness, pricing pressure, and lower profit margins.

The presence of policy reforms, economic development, and the growing IT industry is expected to drive the market in the Asia Pacific region. Additionally, rising patient volume, increasing the need to manage a large volume of patient data, and implementation of HCIT programs in India, Japan, and Australia are expected to help the growth of this vertical.

Key Players & Market Share Insights

The market is competitive in nature. Leading companies are involved in deploying strategic initiatives, such as product launches/ development, regional expansion, and partnerships. Other growth strategies include mergers & acquisitions, and collaborations. For instance, in October 2019, Epicor Software Corporation acquired 1 EDI Source, Inc., specializing in business visibility software and electronic data interchange (EDI) solutions. This strengthened Epicor’s Business Services lineup and supported its objective to become the cloud vendor of choice in target markets. Some of the key players in the global healthcare electronic data interchange market include: 

• OSP

• McKesson Corporation

• NXGN Management, LLC

• Optum, Inc.

• SSI Group LLC

• Cleo

• Cerner Corporation

• 1 EDI Source (Epicor Software Corporation)

• Effective Data

• DataTrans Solutions

Healthcare Electronic Data Interchange Market Report Scope

Segments Covered in the Report

This report forecasts revenue growth at the regional & country level and provides an analysis of the latest trends and opportunities in each of the sub-segments from 2017 to 2030. For the purpose of this report, Grand View Research has segmented the healthcare electronic data interchange market on the basis of component, delivery mode, end-use, and region:

• Component Outlook (Revenue, USD Million, 2017 - 2030)

  • Services

  • Solutions

• Delivery Mode Outlook (Revenue, USD Million, 2017 - 2030)

  • Web and Cloud-based EDI

  • EDI Value Added Network (VAN)

  • Direct (Point-to-Point) EDI

  • Mobile EDI

• End-Use Outlook (Revenue, USD Million, 2017 - 2030)

  • Healthcare Payers

  • Healthcare Providers

  • Pharmaceutical & Medical Device Industries

  • Others

• Regional Outlook (Revenue, USD Million, 2017 - 2030)

  • North America

    • U.S.

    • Canada

  • Europe

    • Germany

    • U.K.

    • France

    • Italy

    • Spain

  • Asia Pacific

    • China

    • India

    • Japan

    • Australia

    • South Korea

  • Latin America

    • Brazil

    • Mexico

    • Argentina

  • MEA

    • South Africa

    • Saudi Arabia