July 24, 2020

Healthcare Electronic Data Interchange Market: Historical Analysis, Business Opportunities and Industry Outlook

Healthcare Electronic Data Interchange Market Scope

The global healthcare electronic data interchange market 2020 logged 8.8% CAGR rise during the forecast period 2018–2023, as per the study conducted by Market Research Future. The profit of the Healthcare Electronic Data Interchange Market is observed in the part where a lift in revenue occurred after the year 2017 when the market gained worth USD 2674 million in revenue.

Healthcare Electronic Data Interchange Market: Overview

Healthcare electronic data interchange (EDI) is generally defined as a structured method to transmit healthcare data between computer and data management systems.

Over the year, electronic data interchange has witnessed a sharp rise in their use, which directs towards assisting in keeping costs of healthcare facilities at an affordable level, improving the quality of healthcare delivery, supporting the healthcare process, and making the services accurate, fast, reliable, and secure. The electronic data interchange further has gained a lot of traction due to its assistance in minimizing various kinds of time-consuming processes and streamlines the claim management processes.

To support the market for healthcare electronic data interchange and its growth, the market achieved a lot of prominences. In the case of point, in 2010, the ObamaCare Act (the Affordable Care Act) was passed in the U.S., mandating the use of enrolled or dis-enrolled transactions between the payers and providers in the U.S. Also, the implementation of favorable policy such as Health Insurance Portability & Accountability Act (HIPAA). This was to provide data privacy and security provisions to protect medical information.

Many recent government initiatives of developed, as well as emerging countries worldwide, are supporting healthcare that results in wide adopting EDI systems are the prevalent drivers of the healthcare EDI market. The management, processing, and transfer of the healthcare data, including as medication, patient credentials, diagnostic data, and emergency service records are kept private with the help of electronic data interchange, which has made it demand to the highest level in the emerging healthcare centers. However, concerning digitalization, EDI has helped to manage a considerable amount of data in a systematic, efficient, and accessible manner.

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Top Market Drivers & Key Challenges

The global market of healthcare electronic data interchange is presumed to gain traction over the years leading to the advent of big data analytics, the initiatives and incentive programs by different organizations to promote healthcare IT, and favorable policy implementation. The implementation of these has eventually taken the market to earn more valuation in the forecast period. On the other side, EDI healthcare transactions are getting traction by the elimination of all paper trails and digitization of transactions, which is resulting in lower handling costs of processing healthcare documents. Therefore, based on the Workgroup for Electronic Data Interchange (WEDI) estimations, healthcare players can now easily create significant savings of USD 1 per claim for health plans, USD 1.49 for physicians, USD 0.86 for hospitals, and USD 0.83 for others by implementing EDI.

At the same time, a surge in the number of end-users such as providers, payers, pharmaceutical & medical device industries are equally anticipated to fuel the demand of the EDI services or solutions. The EDI services or solutions are enjoying massive demand as healthcare payers are highly making use of EDI for the evaluation of insurance claims before their payment settlement, prevention & detection of fraudulent claims. This advantage is helping the market to expand its worth in the foreseeable years.

Further key findings from the study suggest that the snowballing number of end-users are probable to force the demand for the global healthcare electronic data interchange market over the assessment period. Massive influx of investments is also coming from giant pharmaceutical industries and medical device manufacturers who are adopting electronic data interchange services or solutions into their process due to growing competitiveness, pricing pressure, and lower profit margins. Given this advantage, the market from here is also anticipated to assist in the growth in the coming years

On the contrary, the factor of high implementation cost of EDI software, hesitancy to switch from conventional methods, and data security might hinder the global healthcare electronic data interchange market growth over the forecast period.

Healthcare Electronic Data Interchange Market Segmentation

The global healthcare electronic data interchange market has been analyzed based on segmental analysis, which includes component, delivery mode, transaction, and end-user.

The component segment of the market includes software and services.

The delivery mode segment of the market includes direct (Point-to-Point) EDI, EDI value-added network (VAN), cloud-based EDI, and mobile EDI.

The transaction segment of the market includes claim attachments, eligibility inquiry and response, claims & encounters and payment & remittance advance, referral certification and authorization claim status and response, enrollments.

The end-user segment of the market includes pharmaceutical & medical device industries, healthcare providers, healthcare payers, and others. Wherein, the healthcare payers segment has the possibility to occupy the largest market share in support of increasing adoption of EDI for financial management by physicians and clinicians. Even the pharmaceutical & medical device industries are likely to expand at the highest CAGR with the growing demand for insurance plans.

Healthcare Electronic Data Interchange Market Regional Framework

The global healthcare electronic data interchange market has been further studied among the critical regions of the Americas, Europe, Asia-Pacific, and the Middle East & Africa.

As per the study conducted, the region of the Americas has a promising future in terms of leading the global healthcare electronic data interchange (EDI) market. The reason behind its leadership is due to the rising healthcare expenditure, active participation of market players, and technological advancements in EDI software. In the case of point, back in 2016, PLEXIS Healthcare Systems publicized the development of its EDI services with the formal launch of Ignite EDI. The Ignite EDI hub is powered by four smart, foundational building blocks, i.e., the EDI gateway, the Atlas engine, portal technologies, and EDI exploration services.

The market of EDI in the region of Europe can also become the second most expanding market in the global healthcare electronic data interchange (EDI) market. Such an expansion of the market growth in this region is credited to the government funding and favorable policy implementation.

The healthcare electronic data interchange market in Asia-Pacific, most of the key players, are making high investments, especially from the countries such as China, Japan, Republic of Korea, India, Australia and Rest of Asia-Pacific. Due to this reason, the Asia-Pacific region can become the fastest-growing region. Escalating spending on information technology in the Asia-Pacific region has also given the market a substantial push resulting in a great expansion that will continue to the forecast period as well. Claiming to the data suggested by the India Brand Equity Foundation (IBEF), expenditure in information technology in India might grow by over 9 percent to reach USD 87.1 billion in the coming years.

In the last comes the market in the Middle East & Africa, which is also likely to occupy the least share of the market in support of raising awareness about healthcare electronic data interchange (EDI) software.

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Healthcare Electronic Data Interchange Market Key Players

GE Healthcare, Cognizant, Passport Health Communications, McKesson Corporation, Siemens Healthineers, Allscripts Healthcare Solutions Inc., Optum, Inc., Schreiner Group, The SSI Group, LLC, Experian Information Solutions, Inc., Emdeon Inc., ZirMed Inc., HealthFusion are the top major market players known for their high investments making the market more profitable.

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Akash Anand

Market Research Future

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