In 2023, the U.S. market for business process as a service (BPaaS) in healthcare payers was valued at USD 6.5 billion. It is projected to expand at a compound annual growth rate (CAGR) of 5.62% from 2024 to 2030. The United States allocates over USD 3.8 trillion annually to healthcare—approximately double the expenditure of other leading global economies—largely due to systemic inefficiencies and complexities. BPaaS engagements play a crucial role in boosting payer business process outsourcing revenues, thereby driving market growth.
The healthcare sector in the U.S. is governed by stringent regulations, and healthcare payers operate under an increasingly complex regulatory framework. This complexity is further compounded by dynamic policy changes and evolving expectations from members. Regulatory bodies such as the Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act are continuously influencing payment models and reimbursement structures, prompting ongoing discussions. These pressures, along with narrowing profit margins, are prompting payers to explore strategies for sustainable growth and operational agility. As a result, many are adopting BPaaS models to streamline administrative and back-office operations, allowing a sharper focus on core activities.
Value Chain Processes Insights
The market is segmented by value chain processes into claims management, member engagement, care management, and others. Among these, the care management segment accounted for 31% of the market share in 2023 and is expected to maintain its leading position throughout the forecast period. Care management significantly enhances healthcare efficiency, offering measurable benefits to both healthcare providers and patients by optimizing operations and outcomes.
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Solution Coverage Insights
By solution type, the market is categorized into traditional and best-of-breed offerings. In 2023, traditional BPaaS solutions held the largest share—over 75%—attributed to cost-efficiency and high levels of customer satisfaction. As traditional outsourcing models evolve, there is a growing shift toward BPaaS, which emphasizes total cost of ownership and encourages vendors to deliver greater business value. This shift also changes the nature of vendor-client relationships, fostering more adaptive and collaborative engagements centered on shared goals.
Buyer Type Insights
Government entities dominated the market in 2023, comprising over 73% of the revenue share. Government insurance programs have been early adopters of BPaaS, particularly through modular implementations of Medicaid Management Information Systems (MMIS). States across the U.S. have increasingly partnered with service providers for the design, development, and ongoing support of MMIS platforms. With CMS promoting a modular approach, more states are moving away from outdated, monolithic systems toward flexible, as-a-service solutions.
Buyer Size Insights
When segmented by buyer size, small buyers are projected to lead the market through the forecast period. Smaller payers often drive innovation and can capitalize on niche market opportunities. Midsized health plans, in particular, excel at delivering personalized, member-focused services. Ultimately, success in this space depends on the efficiency of insurance enrollment and claims processing, regardless of payer size.
Leading Companies in the U.S. BPaaS in Healthcare Payers Market
Accenture
Cognizant
HCL Technologies Limited
IBM
Infosys Limited
NTT DATA Corporation
Optum
TATA Consultancy Services Limited
UST
Wipro
EXL
Softheon, Inc.
Genpact
Change Healthcare
Firstsource
Celegence
Highmark Health
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According to new research report “Business Process as a Service Market by Business Process (HRM, Accounting and Finance, Sales and Marketing, Customer Service and Support, Procurement and Supply Chain, Operations, and Legal and R), Organization Size, Vertical, and Region — Global Forecast to 2022”, published by MarketsandMarkets, the Business Process as a Service (BPaaS) Market size is expected to grow from USD 40.20 Billion in 2017 to USD 68.76 Billion by 2022, at a Compound Annual Growth Rate (CAGR) of 11.3%.Request Sample Pages of this report @ https://www.marketsandmarkets.com/requestsampleNew.asp?id=986The major drivers for the Business Process as a Service Market are expected to be the increase in the adoption rate of BPaaS by the Small and Medium-Sized enterprises (SMEs), the increased focus on cost-effectiveness and lower Total Cost of Ownership (TCO), and the need for business agility and a faster time-to–market, leading to the increased deployment of BPaaS.Browse 73 market data Tables and 42 Figures spread through 130 Pages and in-depth TOC on “Business Process as a Service Market”Banking, Financial Services, and Insurance (BFSI) vertical is expected to have the largest market share during the forecast periodThe BFSI vertical is expected to have the largest market share during the forecast period, owing to the adoption of cloud solutions in this segment, which is expected to have enhanced its focus on achieving competences and rebalancing the expenses on systems, not in terms of Capital Expenditure (CAPEX) but Operating Expenditure (OPEX).
Furthermore, the rising commercial and regulatory requirements are making the BFSI companies and Chief Information Officers (CIOs) reconsider their restricted adoption of BPaaS solutions.SMEs segment is expected to grow at the fastest rate during the forecast periodThe SMEs segment is expected to grow at the fastest rate during the forecast period, owing to the high adoption of BPaaS solutions.
The SMEs have realized their gain in operational efficiency and are able to elevate their business requirements to achieve digital business transformations.
The implementation of BPaaS in the SMEs segment is expected to result in decreased CAPEX, desired outcomes, and improved business efficiency.Ask for Report Brochure @ https://www.marketsandmarkets.com/pdfdownloadNew.asp?id=986North America is expected to hold the largest market share during the forecast periodAs per the geographic analysis, North America is estimated to hold the largest market share during the forecast period.
The largest market share can be attributed to the presence of top BPaaS service providers, the globalization of managed cloud services, and the high adoption rate of cloud computing.
These countries are significantly advanced in terms of technologies and its application deployments.The major vendors covered in the Business Process as a Service Market include Accenture (Republic of Ireland), IBM (US), Capgemini (France), Cognizant (US), EXL (US), Fujitsu (Japan), Genpact (UK), HCL (India), TCS (India), and Wipro (India).About MarketsandMarkets™MarketsandMarkets™ provides quantified B2B research on 30,000 high growth niche opportunities/threats which will impact 70% to 80% of worldwide companies’ revenues.
A recent report published by TheBusinessResearchCompany on Business Process as a Service (BPaaS) Market provides in-depth analysis of segments and sub-segments in the global as well as regional.The Business Process as a Service (BPaaS) Global Market Report 2019 which provides strategists, marketers and senior management with the critical information they need to assess the global business process as a service (BPaaS) market.
The report covers the business process as a service (BPaaS) market’s segments- HRM, accounting & finance, sales & marketing, customer service support, procurement and supply chain, operations, and others.Business Process as a Service (BPaaS) Global Market Report 2019 is the most comprehensive report available on this market and will help gain a truly global perspective as it covers 50+ geographies.
The regional and country breakdowns section gives an analysis of the market in each geography and the size of the market by region and by country.
It also compares the market’s historic and forecast growth.
It covers all the regions, key developed countries and major emerging markets.
It draws comparisons with country populations and economies to understand the importance of the market by country and how this is changing.
