Healthcare Claims Management Market Size & Share Analysis - Growth Trends & Forecasts (2025 - 2030)

The Market Research Report Covers Global Healthcare Claims Management Software Companies and is Segmented by solution type (Integrated Solutions and Standalone Solutions), component (Services and Software), delivery mode (On-Premise and Cloud-Based), end-user (Healthcare Payers, Healthcare Providers and Other End Users), and geography (North America, Europe, Asia-Pacific, Middle East and Africa, and South America). The value is provided in (USD million) for the above segments.

Healthcare Claims Management Market Size & Share Analysis - Growth Trends & Forecasts (2025 - 2030)

Healthcare Claims Management Market Size

Healthcare Claim Management Market Summary
Study Period 2019 - 2030
Market Size (2025) USD 27.72 Billion
Market Size (2030) USD 58.96 Billion
CAGR (2025 - 2030) 16.29 %
Fastest Growing Market Asia Pacific
Largest Market North America
Market Concentration High

Major Players

Healthcare Claim Management Market Major Players

*Disclaimer: Major Players sorted in no particular order

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Healthcare Claims Management Market Analysis

The Global Healthcare Claim Management Market size is estimated at USD 27.72 billion in 2025, and is expected to reach USD 58.96 billion by 2030, at a CAGR of 16.29% during the forecast period (2025-2030).

The COVID-19 pandemic is expected to have a significant impact on market growth. Due to the large number of people getting infected and then admitted into hospitals, there has been tremendous pressure since the start of the pandemic on claim management software developers and providers. Claim denials have also sky-rocketed due to the COVID-19 pandemic. For instance, according to a survey conducted by Harmony Healthcare between late April and mid-May 2021, nearly one-third of the respondents in the poll stated that their hospital had an average denial rate exceeding the 'denials danger zone' of 10%. Companies across the world, and especially in countries most affected by COVID-19, have seen a massive increase in claims. For instance, as of February 2021, the General Insurance Council of India stated that general and standalone health insurers had received 908,849 Covid-related claims, amounting to INR 13,752.41 crore. The processing of such a large amount of claims by companies is expected to boost market growth.

The major factors for the growth of the healthcare claim management market include the government initiatives supporting the health insurance market, the rising importance of denials management, and the growing aging population with chronic diseases.

Claims denial by insurers is very common and is a major cause of revenue loss for many healthcare providers. Disjointed systems, processes and workflows within health provider organizations, as well as incompatible IT systems, often lead to untimely denial filings and increased cost to collect. Most importantly, companies don't have the right reporting and diagnostic tools to review denials data. These tools are the first step in denial resolution management. Even as healthcare systems are working towards identifying the root cause of denials, traditional analytics used by many organizations have been a cause of hindrance. Companies devote a lot of time, money and resources just to review trends and analyze denials manually, and to attempt fixes after the fact. As a result, certain types of denials continue, hurting healthcare's bottom line. This is a major reason why there is a greater demand for healthcare claim management to sort out these issues. The sector can use data analytics, robotic process automation (RPA) and Artificial Intelligence (AI) to overcome denial challenges. Using automated discovery and analysis of patterns, AI can help insurance companies address issues at the inception, bring up denials that have a low chance of being accepted and guide agents to close out claims that have a higher chance of being approved. These benefits of using Artificial Inetlligence and other automated processes is expected to boost the growth of the market.

Healthcare Claims Management Industry Overview

The market studied is a moderately consolidated market owing to the presence of many small and large market players. Some of the market players are Accenture plc, Allscripts Healthcare Solutions, Inc., Athenahealth Inc, Oracle (Cerner Corporation), Genpact limited, IBM Corporation, Mckesson Corporation, Optum, Inc. among others.

Healthcare Claims Management Market Leaders

  1. Accenture plc

  2. Athenahealth Inc

  3. Genpact limited

  4. Conduent Inc. (Health Solutions Plus)

  5. Oracle

  6. *Disclaimer: Major Players sorted in no particular order
Healthcare Claim Management Market Concentration
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Healthcare Claims Management Market News

In February 2022 Health Edge formed a strategic partnership with Citius Tech for joint go-to-market implementation and consultation services for HealthEdge solutions in Core administration, care management, and payment integrity to health plans pursuing value-based care and streamlined operations. 

In December 2021 HealthEdge Software completed its previously announced acquisition of well frame Inc, a leading digital health management platform. 

Healthcare Claims Management Market Report - Table of Contents

1. INTRODUCTION

  • 1.1 Study Assumptions and Market Definition
  • 1.2 Scope of the Study

2. RESEARCH METHODOLOGY

3. EXECUTIVE SUMMARY

4. MARKET DYNAMICS

  • 4.1 Market Overview
  • 4.2 Market Drivers
    • 4.2.1 Government Initiatives Supporting Health Insurance Market
    • 4.2.2 Rising Importance of Denials Management
    • 4.2.3 Growing Aging population with chronic diseases
  • 4.3 Market Restraints
    • 4.3.1 Patient Data Privacy and Security Concerns
    • 4.3.2 High Deployment Costs
  • 4.4 Porter's Five Force Analysis
    • 4.4.1 Threat of New Entrants
    • 4.4.2 Bargaining Power of Buyers/Consumers
    • 4.4.3 Bargaining Power of Suppliers
    • 4.4.4 Threat of Substitute Products
    • 4.4.5 Intensity of Competitive Rivalry

5. MARKET SEGMENTATION

  • 5.1 By Solution Type
    • 5.1.1 Integrated Solutions
    • 5.1.2 Standalone Solutions
  • 5.2 By Component
    • 5.2.1 Services
    • 5.2.2 Software
  • 5.3 By Delivery Mode
    • 5.3.1 On-Premise
    • 5.3.2 Cloud-Based
  • 5.4 By End User
    • 5.4.1 Healthcare Payers
    • 5.4.2 Healthcare Providers
    • 5.4.3 Other End Users
  • 5.5 Geography
    • 5.5.1 North America
    • 5.5.1.1 United States
    • 5.5.1.2 Canada
    • 5.5.1.3 Mexico
    • 5.5.2 Europe
    • 5.5.2.1 Germany
    • 5.5.2.2 United Kingdom
    • 5.5.2.3 France
    • 5.5.2.4 Italy
    • 5.5.2.5 Spain
    • 5.5.2.6 Rest of Europe
    • 5.5.3 Asia-Pacific
    • 5.5.3.1 China
    • 5.5.3.2 Japan
    • 5.5.3.3 India
    • 5.5.3.4 Australia
    • 5.5.3.5 South Korea
    • 5.5.3.6 Rest of Asia-Pacific
    • 5.5.4 Middle East and Africa
    • 5.5.4.1 GCC
    • 5.5.4.2 South Africa
    • 5.5.4.3 Rest of Middle East and Africa
    • 5.5.5 South America
    • 5.5.5.1 Brazil
    • 5.5.5.2 Argentina
    • 5.5.5.3 Rest of South America

6. COMPETITIVE LANDSCAPE

  • 6.1 Company Profiles
    • 6.1.1 Accenture plc
    • 6.1.2 Allscripts Healthcare Solutions, Inc.
    • 6.1.3 Athenahealth Inc
    • 6.1.4 Oracle Corporation (Cerner Corporation)
    • 6.1.5 Genpact Limited
    • 6.1.6 Conduent Inc. (Health Solutions Plus)
    • 6.1.7 IBM Corporation
    • 6.1.8 Mckesson Corporation
    • 6.1.9 Optum, Inc
    • 6.1.10 OSP Labs
    • 6.1.11 RP Sanjiv Goenka Group (FirstSource)
  • *List Not Exhaustive

7. MARKET OPPORTUNITIES AND FUTURE TRENDS

**Competitive Landscape covers- Business Overview, Financials, Products and Strategies and Recent Developments
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Healthcare Claims Management Industry Segmentation

As per the scope of this report, healthcare claim management refers to services that enable healthcare payers to efficiently manage healthcare provider data and automate claims processes to help the healthcare provider claim submission and get faster approval. 

The market is segmented by solution type (Integrated Solutions and Standalone Solutions), component (Services and Software), delivery mode (On-Premise and Cloud-Based), end-user (Healthcare Payers, Healthcare Providers and Other End Users), and geography (North America, Europe, Asia-Pacific, Middle East and Africa, and South America). The market report also covers the estimated market sizes and trends for 17 different countries across major regions, globally. The report offers the value (in USD million) for the above segments.

By Solution Type Integrated Solutions
Standalone Solutions
By Component Services
Software
By Delivery Mode On-Premise
Cloud-Based
By End User Healthcare Payers
Healthcare Providers
Other End Users
Geography North America United States
Canada
Mexico
Europe Germany
United Kingdom
France
Italy
Spain
Rest of Europe
Asia-Pacific China
Japan
India
Australia
South Korea
Rest of Asia-Pacific
Middle East and Africa GCC
South Africa
Rest of Middle East and Africa
South America Brazil
Argentina
Rest of South America
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Healthcare Claims Management Market Research FAQs

How big is the Global Healthcare Claim Management Market?

The Global Healthcare Claim Management Market size is expected to reach USD 27.72 billion in 2025 and grow at a CAGR of 16.29% to reach USD 58.96 billion by 2030.

What is the current Global Healthcare Claim Management Market size?

In 2025, the Global Healthcare Claim Management Market size is expected to reach USD 27.72 billion.

Who are the key players in Global Healthcare Claim Management Market?

Accenture plc, Athenahealth Inc, Genpact limited, Conduent Inc. (Health Solutions Plus) and Oracle are the major companies operating in the Global Healthcare Claim Management Market.

Which is the fastest growing region in Global Healthcare Claim Management Market?

Asia Pacific is estimated to grow at the highest CAGR over the forecast period (2025-2030).

Which region has the biggest share in Global Healthcare Claim Management Market?

In 2025, the North America accounts for the largest market share in Global Healthcare Claim Management Market.

What years does this Global Healthcare Claim Management Market cover, and what was the market size in 2024?

In 2024, the Global Healthcare Claim Management Market size was estimated at USD 23.20 billion. The report covers the Global Healthcare Claim Management Market historical market size for years: 2019, 2020, 2021, 2022, 2023 and 2024. The report also forecasts the Global Healthcare Claim Management Market size for years: 2025, 2026, 2027, 2028, 2029 and 2030.

Healthcare Claims Management Industry Report

Statistics for the 2025 Global Healthcare Claim Management market share, size and revenue growth rate, created by Mordor Intelligence™ Industry Reports. Global Healthcare Claim Management analysis includes a market forecast outlook for 2025 to 2030 and historical overview. Get a sample of this industry analysis as a free report PDF download.