Global Healthcare Reimbursement Market Analysis, Drivers, Restraints, Opportunities, Threats, Trends, Applications, and Growth Forecast to 2029

“Global Healthcare Reimbursement Market” is the title of a report recently produced by MarketResearch.biz, after a detailed study and analysis. The global healthcare reimbursement market report has been segmented on the basis of claims, payers, service provider, and region.

Overview

Healthcare reimbursement is the payment received by hospitals, diagnostic facilities, doctors, or other healthcare providers for providing patients medical services. These payments of healthcare are often done by government payers or health insurers. Usually, reimbursement is provided based on quality, complexity, and quantity of healthcare service provided. Increasingly, the healthcare reimbursement system has adopted value-based models in which hospitals and physicians are paid based on the quality of their services provided and not the volume. Quality of patient outcomes is the base of payer’s assessment as well as provider’s ability to bear costs.  Rates of reimbursement provided by Government for healthcare services are set by Medicare and are usually less than the billed amount or less than the amount a private insurance firm would pay. The most common healthcare reimbursement methods are discount from billed charges, fee-for-service, value-based reimbursement, bundled payments, and shared savings. Providers follow certain steps to receive and retain healthcare reimbursement such as documenting the details necessary for payment, assign medical codes, submit the claim electronically, interpret the payer’s response, and prepare for post-payment audits. Different payment mechanisms are used for reimbursement for healthcare and each of them has different degrees of effectiveness. The introduction of electronic medical records (EMR) related to healthcare reimbursement to monitor patient responsiveness, provider practice, and functioning of the healthcare organization enhances quality of medical care as well as efficiency of reimbursement mechanisms.

Dynamics

One of the major factors driving growth of the global healthcare reimbursement market is increasing cases of various deadly diseases.  In addition, growing expenditure of healthcare due to advancements in the sector is expected to be a significant factor driving demand for healthcare reimbursement services in the global healthcare reimbursement market during the forecast period. Service providers related to healthcare reimbursement are offering various service packages to ensure a high level of customer experience and satisfaction. Due to hectic work schedules, lack of physical activities, and sedentary lifestyles, cases of lifestyle and deadly diseases are increasing. This is expected to be a factor driving demand for healthcare reimbursement services in the global healthcare reimbursement market over the forecast period. Other factors expected to drive growth of the market is growing healthcare burden on developing and developed economies coupled with supportive reimbursement scenario and favorable regulatory policies. Healthcare spending is also increasing due to high doctor consultation fee, and up swinging price of prescription drugs. Various initiatives from both private and public entities have also been driving the market significantly. Changing lifestyles are causing rise prevalence of various chronic diseases such as cancer and diabetes, which increases the healthcare cost. Almost half of the population in the US is suffering from one of these diseases and treatment for this disease is highly expensive. These factors are expected to drive demand for healthcare reimbursement services in the global reimbursement market during the forecast period.

Global Wellness Tourism Market Segment Analysis:

By Claims: Among the claims segments, the underpaid segment is projected to account for majority revenue share in the global healthcare reimbursement market, and is expected to continue its dominance over the forecast period. This growth of the segment is attributed to an increasing number of unnecessary utilization of healthcare services false claims. There are many incidences of defrauding of state and federal healthcare programs by businesses and individuals, which include claims for services, healthcare treatment, medical devices that were never rendered. Later, False Claim Act was introduced to have control over all the fraud.

By Payers: The private payers segment among the payers segments accounts for relatively higher revenue share in the global healthcare reimbursement market, and is to continue its dominance over the forecast period. This growth is attributed to rising demand for treatments for diseases such as diabetes and cancer, which is expensive.

By Service Provider: The hospitals segment among the service provider segments is projected to continue to account for highest revenue share owing to rising number of surgeries and increasing geriatric population.

Global Wellness Tourism Market Regional Analysis:

The market in North America continues to account for highest revenue share, and the trend is expected to continue over the forecast period. This growth is attributed presence of a large number of insurance payers and strong reimbursement framework.

Global Wellness Tourism Market Segment Analysis: 

By Claims:

• Underpaid
• Full Paid

 By Payers:

• Private Payers
• Public Payers

 By Service Provider:

• Physician office
• Hospitals
• Diagnostic Laboratories
• Others

 By region:

• North America
• Europe
• Asia Pacific
• Latin America
• Middle East & Africa

• UnitedHealth Group
• Aviva
• Allianz
• CVS Health
• BNP Paribas
• Aetna
• Nippon Life Insurance
• WellCare Health Plans
• AgileHealthInsurance
• The Blue Cross Blue Shield Association