US Healthcare Financial Analytics Market Report 2022 to 2030

US Healthcare Financial Analytics Market Analysis

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The US Healthcare Financial Analytics market size was valued at $xx Bn in 2022 and is estimated to expand at a compound annual growth rate (CAGR) of 4.8% from 2022 to 2030 and will reach $xx Bn in 2030. The market is segmented by type, component, and deployment. The US Healthcare Financial Analytics market will grow due to adoption of electronic health records (EHRs). The key market players are OptumInsight, McKesson Corporation, Cerner Corporation, IBM Corporation, and others.

ID: IN10USDH082 CATEGORY: Digital Health GEOGRAPHY: US AUTHOR: Chandani Patel

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US Healthcare Financial Analytics Market Executive Summary

Market size for US Healthcare Financial Analytics was $xx Bn in 2022; it is projected to rise at a compound annual growth rate (CAGR) of 4.8% from 2022 to 2030 and reach $xx Bn in 2030. The United States has some of the highest healthcare costs in the world. The Centers for Medicare and Medicaid Services (CMS) reported that the overall national health expenditures in the US surpassed $3.8 trillion in 2019, accounting for 17.7% of the nation's GDP (GDP).

A sizable portion of the entire healthcare analytics business is the US financial healthcare analytics market. The desire for value-based healthcare, increased use of electronic health records (EHRs), and mounting pressure to cut healthcare costs are a few of the key drivers boosting the market for healthcare financial analytics in the US.

Using financial analysis tools for the healthcare industry may benefit healthcare businesses by enhancing revenue cycle management, lowering operational expenses, and improving financial performance. Due to the widespread use of analytics software platforms including Business Intelligence (BI) tools, EHRs, and financial management software, the software sector leads the US healthcare financial analytics industry. The main end-user of healthcare financial analytics in the US is the hospitals and clinics segment, followed by pharmaceutical and biotechnology firms, research and academic institutions, and others. Hospitals and clinics are using healthcare financial analytics because they must manage revenue cycles, maximise financial performance, and enhance patient outcomes.

The largest geographic market for healthcare financial analytics is in North America, which comprises the US, followed by Europe and Asia-Pacific. In the upcoming years, it is anticipated that the US healthcare financial analytics market will continue to expand due to the industry's rising emphasis on value-based care and increased usage of data analytics.

Market Dynamics

Market Growth Drivers

The increased demand on healthcare companies to save costs is one of the main factors driving the US healthcare financial analytics industry. Analytics tools assist healthcare firms in maximising their financial performance by pointing up opportunities to save expenses and boost productivity. Also, the amount of healthcare data that can be utilised for financial analysis has increased as a result of the expanding adoption of EHRs in the US healthcare sector. The need for analytics technologies that may assist healthcare businesses in making sense of this data and enhancing their financial performance has increased as a result.

The US healthcare financial analytics industry is also being stimulated by the move towards value-based healthcare. Healthcare institutions are putting more of an emphasis on enhancing patient outcomes while cutting expenses. Analytics technologies can assist healthcare businesses in finding opportunities to save expenses while raising treatment quality.

Another factor propelling the healthcare financial analytics market is the expanding usage of data analytics in the US healthcare sector. Data analytics are being used more often by healthcare companies to enhance their decision-making procedures, maximise financial performance, and enhance patient outcomes.

Market Restraints

Healthcare data is extremely private and sensitive, and there are worries about privacy violations and data breaches. Due to the heightened scrutiny of healthcare data security as a result, the use of healthcare financial analytics may be constrained.

Another obstacle to the US healthcare financial analytics business is the lack of qualified individuals with financial analytics training. Healthcare firms could have trouble locating skilled individuals who can assist them in deciphering the data and provide insights that can be put to use.

Also, some healthcare companies may find it difficult to employ healthcare financial analytics technologies due to their high implementation and maintenance expenses. Small and medium-sized healthcare organisations, who might not have the financial means to invest in these instruments, may incur expenses that are very expensive.

Competitive Landscape

Key Players

OptumInsight: A leading provider of healthcare analytics, technology, and consulting services, OptumInsight offers solutions for healthcare financial management, clinical performance, and population health management.

McKesson Corporation: A global leader in healthcare technology and services, McKesson Corporation provides healthcare financial analytics solutions for revenue cycle management, supply chain management, and clinical performance.

Cerner Corporation: A provider of healthcare IT solutions, Cerner Corporation offers financial analytics solutions for revenue cycle management, claims management, and clinical performance.

IBM Corporation: A global technology company, IBM Corporation provides healthcare financial analytics solutions for financial management, revenue cycle management, and fraud detection.

Allscripts Healthcare Solutions, Inc.: A provider of healthcare IT solutions, Allscripts Healthcare Solutions, Inc. offers financial analytics solutions for revenue cycle management, claims management, and financial reporting.

Health Catalyst: A provider of healthcare data analytics solutions, Health Catalyst offers financial analytics solutions for cost management, revenue cycle management, and clinical performance.

Change Healthcare: A healthcare technology company, Change Healthcare provides financial analytics solutions for revenue cycle management, claims management, and clinical performance.

Oracle Corporation: A global technology company, Oracle Corporation provides healthcare financial analytics solutions for financial management, revenue cycle management, and cost management.

SAP SE: A provider of enterprise software solutions, SAP SE offers financial analytics solutions for financial management, revenue cycle management, and cost management.

Tableau Software, LLC: A provider of data visualization and business intelligence software, Tableau Software, LLC offers financial analytics solutions for financial reporting, revenue cycle management, and cost management.

Recent Developments

OptumInsight: The Provider Payment Integrity package from OptumInsight was introduced in 2021, and it employs cutting-edge analytics to assist healthcare businesses in identifying and preventing healthcare fraud, waste, and abuse. The package contains instruments for spotting unethical billing practises, examining claims data, and forecasting fraudulent conduct..

McKesson Corporation: The Provider Payment Integrity package from OptumInsight was introduced in 2021, and it employs cutting-edge analytics to assist healthcare businesses in identifying and preventing healthcare fraud, waste, and abuse. The package contains instruments for spotting unethical billing practises, examining claims data, and forecasting fraudulent conduct.

IBM Corporation: The Provider Payment Integrity package from OptumInsight was introduced in 2021, and it employs cutting-edge analytics to assist healthcare businesses in identifying and preventing healthcare fraud, waste, and abuse. The package contains instruments for spotting unethical billing practises, examining claims data, and forecasting fraudulent conduct.

Healthcare Policies and Regulatory Landscape

Policy changes and Reimbursement scenario

Financial analytics is subject to the same stringent regulations as the US healthcare sector as a whole. Some of the main laws that govern financial analytics in healthcare include the following:

Federal law known as the Health Insurance Portability and Accountability Act (HIPAA) establishes guidelines for the security and privacy of protected health information (PHI). To maintain patient information's security and confidentiality, financial analytics software that handles PHI is required to adhere to HIPAA requirements.

Electronic health records (EHRs) and other health information technology are encouraged to be adopted and used in meaningful ways under the Health Information Technology for Economic and Clinical Health (HITECH) Act, a federal statute. Moreover, HITECH outlines guidelines for disclosing PHI data breaches.

A number of financial analytics-related measures are included in the Affordable Care Act (ACA), including the establishment of the Center for Medicare and Medicaid Innovation (CMMI), which is in charge of evaluating novel models of service delivery and payment.

A new physician payment model focused on outcomes and treatment quality was introduced by the Medicare Access and CHIP Reauthorization Act (MACRA). Physicians may analyse their performance under the new payment model and pinpoint areas for improvement with the use of financial analytics technologies.

While not being specifically related to healthcare, the Sarbanes-Oxley Act (SOX) sets standards for the completeness and integrity of financial reporting by publicly listed corporations. Publicly traded healthcare organisations are required to abide by SOX rules.

1. Executive Summary
1.1 Digital Health Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Digital Health Policy in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Diagnosis
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Financial Analytics Market Segmentation

By Type

Claim Analytics
Revenue Cycle Management
Risk Management Analytics
Others

By Component

Hardware
Software & Services

By Deployment

The market is divided into on-premises and cloud-based deployments. Because cloud platforms are being adopted at a faster rate, the cloud-based category is anticipated to experience stronger growth throughout the projected period. The growing use of cloud analytics, which enables businesses to include data from all sources, is what is driving the financial analytics industry. Additionally, the market for healthcare financial analytics is anticipated to benefit from the desire for better claims and revenue management systems in healthcare and the acceptance of cloud computing across numerous industries. Some governments in Europe are starting programmes to promote the growth of information technology in healthcare.

On-premise
Cloud-based

Methodology for Database Creation

Our database offers a comprehensive list of healthcare centers, meticulously curated to provide detailed information on a wide range of specialties and services. It includes top-tier hospitals, clinics, and diagnostic facilities across 30 countries and 24 specialties, ensuring users can find the healthcare services they need.

Additionally, we provide a comprehensive list of Key Opinion Leaders (KOLs) based on your requirements. Our curated list captures various crucial aspects of the KOLs, offering more than just general information. Whether you're looking to boost brand awareness, drive engagement, or launch a new product, our extensive list of KOLs ensures you have the right experts by your side. Covering 30 countries and 36 specialties, our database guarantees access to the best KOLs in the healthcare industry, supporting strategic decisions and enhancing your initiatives.

How Do We Get It?

Our database is created and maintained through a combination of secondary and primary research methodologies.

1. Secondary Research

With many years of experience in the healthcare field, we have our own rich proprietary data from various past projects. This historical data serves as the foundation for our database. Our continuous process of gathering data involves:

Analyzing historical proprietary data collected from multiple projects.
Regularly updating our existing data sets with new findings and trends.
Ensuring data consistency and accuracy through rigorous validation processes.

With extensive experience in the field, we have developed a proprietary GenAI-based technology that is uniquely tailored to our organization. This advanced technology enables us to scan a wide array of relevant information sources across the internet. Our data-gathering process includes:

Searching through academic conferences, published research, citations, and social media platforms
Collecting and compiling diverse data to build a comprehensive and detailed database
Continuously updating our database with new information to ensure its relevance and accuracy

2. Primary Research

To complement and validate our secondary data, we engage in primary research through local tie-ups and partnerships. This process involves:

Collaborating with local healthcare providers, hospitals, and clinics to gather real-time data.
Conducting surveys, interviews, and field studies to collect fresh data directly from the source.
Continuously refreshing our database to ensure that the information remains current and reliable.
Validating secondary data through cross-referencing with primary data to ensure accuracy and relevance.

Combining Secondary and Primary Research

By integrating both secondary and primary research methodologies, we ensure that our database is comprehensive, accurate, and up-to-date. The combined process involves:

Merging historical data from secondary research with real-time data from primary research.
Conducting thorough data validation and cleansing to remove inconsistencies and errors.
Organizing data into a structured format that is easily accessible and usable for various applications.
Continuously monitoring and updating the database to reflect the latest developments and trends in the healthcare field.

Through this meticulous process, we create a final database tailored to each region and domain within the healthcare industry. This approach ensures that our clients receive reliable and relevant data, empowering them to make informed decisions and drive innovation in their respective fields.