U.S. Healthcare Payer Analytics Market Worth $19.4 Billion By 2030

May 2022 | Report Format: Electronic (PDF)

U.S. Healthcare Payer Analytics Market Growth & Trends

The U.S. healthcare payer analytics market is expected to reach USD 19.4 billion by 2030, registering a CAGR of 22.1% from 2023 to 2030, according to a new report by Grand View Research, Inc. The digital advancements in the healthcare field, and the digitization of records, are one of the key factors driving the growth of this market. Adoption of such technologies is on an upward trend thus propelling the market. Digital data is being used to derive meaningful results, cost reduction, and minimize fraudulent insurance claims. 

The U.S. government has been increasingly spending on healthcare and focusing on improving digital infrastructure, which is boosting technological advancements in the field. Due to technological advancements, decision-making for payers and healthcare providers has become easier with the help of analytical tools. The overall increase in healthcare expenditure has amounted to more than USD 4 trillion in the year 2020. It is not only helping the healthcare industry develop faster but has also made healthcare more affordable and precise. 

The healthcare analytical tools are helping administrators and policymakers in determining what is the best course of action, how successful is it going to be, and how much cost can be saved by cutting unnecessary expenditures. For insurance companies, analytical tools have helped in recognizing patterns of insurance fraud and in turn saving billions of dollars per year. Doctors’ analytical tools have helped to determine the best treatment plans for a particular patient by studying and analyzing their history. 

In the analytics type, the descriptive analysis held the largest market share of 358% in 2022. Descriptive analytics has been widely used during COVID by various research organizations as well as laboratories, to determine how contagious the virus is by studying the past and present tests being conducted for coronavirus. Descriptive analytics analyzes data to derive meaningful results and can significantly impact future decisions. The fastest-growing was the predictive analytics segment, this helps in charting the best treatment plan for a personalized treatment plan, it can help the doctor to find out what works best for a patient and can give better treatment outcomes. 

In the components, the service segment dominated the market in 2022. Since the majority of establishments do not have an analytics department, it is generally outsourced to industry experts which saves the cost of training and teaching the staff about tools and methods. The fastest-growing component was the hardware, with rapid investment in healthcare IT, the need for better computers and hardware components has been responsible for the growth of the market. 

Currently, the largest market share is held by the on-premises delivery model. Healthcare organizations have been opting for the installment of analytical tools and software. The on-premises installation results in less theft of data and provide easier access and maintenance of data and patient records. However, cloud-based storage has been gaining popularity due to ease of storage, and minimum requirement of setup, which has been a key driving factor for the growth of the market.

 In the applications segment, the largest market share is currently held by financial applications. Private and government facilities have been increasingly adopting analytics for financial applications. Healthcare analytics is being used for claim settlement, risk analysis, and identifying frauds in insurance claims. The fastest-growing application is also financial applications, for use in identifying frauds related to insurance which cost the payers billions of dollars per year. These factors have contributed significantly to the growth of the healthcare payer analytics market. 

The COVID-19 pandemic created a huge opportunity for the healthcare analytics market. The amount of patient data generated during the pandemic has greatly helped in studying how the disease spreads, how contagious it is, and what implications it can have on people. Economies around the world have suffered gravely due to supply chain disruptions saw a decline in the market, but the usage and rate of adoption of analytics have increased overall. Telehealth, a means to communicate with patients and doctors saw 38 times increase in adoption from pre-COVID times, as per McKinsey. 

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U.S. Healthcare Payer Analytics Market Report Highlights

  • The largest market share was held by descriptive analysis in the analytics type segment, it was used by laboratories and research organizations for studying the spread of the virus during the COVID outbreak

  • The largest component was serviced, to cut down on costs incurred by training staff on healthcare analytics tools

  • The on-premise delivery model had the largest share due to its ease of use and security of patient data; the cloud-based delivery model is gaining momentum due to its higher capacity

  • The financial application segment has been the largest in 2022, due to its far-reaching implications in minimizing risks, identifying frauds in insurance claims, etc.

U.S. Healthcare Payer Analytics Market Segmentation

Grand View Research has segmented the U.S. healthcare payer analytics market based on analytics type, component, delivery model, and application: 

U.S. Healthcare Payer Analytics Analytics Type Outlook (Revenue, USD Million, 2018 - 2030)

  • Descriptive Analytics

  • Predictive Analytics

  • Prescriptive Analytics

U.S. Healthcare Payer Analytics Component Outlook (Revenue, USD Million, 2018 - 2030)

  • Software

  • Hardware

  • Services

U.S. Healthcare Payer Analytics Delivery Model Outlook (Revenue, USD Million, 2018 - 2030)

  • On–Premises

  • Web-Hosted

  • Cloud-Based

U.S. Healthcare Payer Analytics Application Outlook (Revenue, USD Million, 2018 - 2030)

  • Clinical

  • Financial

  • Operational & Administrative

List of Key Players in the U.S. Healthcare Payer Analytics Market

  • CloudMedx

  • DataSmart Solutions

  • Amitech Solutions

  • Altegra Health

  • Caserta Concepts

  • Greenway Health, LLC

  • IMAT Solutions

  • Health Catalyst

  • Indegene

  • IBM

  • Optum

  • Oracle

  • HMS

  • Citius Tech

  • MedeAnalytics

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