Market Trends of Patient Access Solutions Industry
Claims Denial and Appeal Management Solutions Segment is Expected to Witness Significant Growth During the Forecast Period
The claims denial and appeal management solutions segment is expected to witness significant growth over the forecast period, as this software uses current and historical data to maintain every patient detail. With digital data collection, there is more healthcare data to be analyzed every second. With the increasing application of electronic record keeping and other electronic means of data collection and storage, there is a significant amount of data being collected in real time. Many companies are developing software that can be used to do the same, thereby boosting the segment's growth.
Patient access solutions consist of claims denial and appeal management solutions, payment estimation solutions, and other software that helps patients with patient registration and determination of insurance eligibility. The rising awareness of healthcare denial management has given rise to the development of claims denial and appeal management solutions. For instance, a study published by a Journal for Healthcare Quality in April 2022 stated that increased workloads and a shortage of staff, new documentation, and backlogs of both procedures and claims denials have contributed to a rise in claim denials. Hayes, a healthcare technology company, found that an astounding 40% of the claims related to COVID-19 care were denied in the first 10 months of 2021. Hence, this problem may boost the adoption of claims denial and appeal management solutions, thereby contributing to the market's growth.
Further, technological developments and the introduction and launch of new electronic health record (EHR) systems are propelling the demand for these solutions. For instance, in August 2022, Anomaly launched its new offering, Anomaly Smart Response, which uses AI to enable providers and payers to reduce avoidable claim denials and rework and increase payment transparency, which are the top priorities for healthcare stakeholders. The product gives providers a real-time response, predicting actionable denials and payment amounts so they can correct and avoid denials before they occur. Smart Response operates directly within providers' native workflows by integrating with payers, practice management software, and claims clearing houses. Such developments are expected to drive the segment's growth in the future.
North America is Expected to Witness Significant Growth During the Forecast Period
North America is expected to witness significant growth over the forecast period due to technological developments, acquisitions, mergers, and partnerships by key market players. For instance, in May 2021, Optum collaborated with Bassett Healthcare Network (United States) to provide software and data analytics technology-enabled services and research and advisory and revenue cycle management to advance quality care and the patient experience.
Similarly, in July 2021, Philips and Cognizant collaborated to develop an end-to-end digital health solution that will enable life science companies to improve patient care and accelerate clinical trials. The strategic alliance brings together Philips HealthSuite, a cloud-based platform, and Cognizant's digital engineering expertise to deliver and maintain leading-edge digital health solutions at scale, providing advanced connectivity and using big data to create actionable insights. Thus, such collaborations are providing better services to patients, thereby encouraging the engagement of patients on this portal and driving the growth of the market in the region.
Digital tools have led to the minimized cost of services, further resulting in more patient engagement. Many such digital tools were developed during the pandemic for COVID-19 testing. For instance, in January 2022, CureMD Healthcare, the manufacturer of SMART Cloud Health IT solutions, launched its rapid testing platform for COVID-19. CureMD has assisted governments, public and private healthcare facilities, businesses, educational institutions, and nonprofit organizations to mobilize and manage rapid testing at scale through the new rapid testing platform. The solution is designed to introduce efficient, intuitive, and automated workflows to manage COVID-19 testing at an unprecedented scale, thereby driving the market in the region.
Thus, technological developments, new product launches, and mergers and acquisitions in the region are expected to drive the growth of the market.
