The global healthcare BPO market is valued at $92,325.9million in 2013 and is expected to reach $188,856.5 million by 2018, at a CAGR of 10.8%.

The Healthcare outsourcing is a major segment expected to grow substantially over the years.

The global healthcare BPO market is dominated by the U.S.A very large percentage of the healthcare BPO requirement arises out of the U.S.

Europe is quickly emerging as another important source segment in this market. The U.S. and India are the two largest destination geographies. Philippines and Eastern Europe are two of the fastest growing destination segments in this market.

These service segments are further segmented into appropriate service sub-segments. The market is also segmented based on source and destination geographies

Healthcare (Payers)

In health care, Payer generally refers to entities other than the patient that finance or reimburse the cost of health services. In most cases, this term refers to insurance carriers, other third-party payers, or health plan sponsors (employers or unions)

Claims Processing

Claims indexing

Claims investigation

Claims adjudication

Claims re pricing

Claims settlement

Litigation management

Information management

HR Services

Member Services/Customer Care

Finance and Accounts

Health Care (Provider)

A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative healthcare services in a systematic way to individuals, families or communities .

Medical Billing

Medical Coding

Medical Transcription

Finance and Accounts

The pharmaceutical outsourcing market is segmented into contract research organizations (CRO),contract manufacturing organizations (CMO), and business support services. Each service segment in the pharmaceutical outsourcing market is divided into further sub-segments. The CRO service segment is sub-divided into drug discovery, pre-clinical, clinical phases I, II, III and IV, clinical data management and biostatistics, medical writing, regulatory services, and non-clinical functions. The CMO service segment is sub-divided into API manufacturing, and formulation and packaging. The non-clinical service segment is sub-divided into supply chain management and logistics, sales and marketing, and non-clinical functions.

CRO Market

Drug Discovery

Pre-clinical

Phase I

Phase II

Phase III

Phase IV

Clinical Data Management and Biostatistics

Medical Writing

Regulatory Services Outsourcing

Other Services

CMO Market

API Manufacturing

Formulation and Packaging

Non-clinical Services Market

Supply Chain Management and Logistics

Sales and Marketing Management

Marketing KPO/Sales analytics

Other Non-clinical Functions

In this market, cost reduction is the main driver for outsourcing core functions like claims processing, medical billing, and contract research. Furthermore, outsourcing functions like HR services, finance and accounts, and sales and marketing enables payer, provider, and pharmaceutical companies to focus on their core functions. As such, lack of expertise in non-core areas of business is another important driver for payer, provider, and pharmaceutical outsourcing.