Healthcare EDI Market: Rising Investment in Healthcare Infrastructure to Drive Growth

[Snehal Shaha]

Healthcare EDI Market growth is majorly attributed to the development of regulations for transaction processes, the rising need to curtail healthcare costs and government support for HCIT implementation. Also, the need for the efficient management of electronic claims and reimbursement transactions (for healthcare providers) is expected to drive demand growth in the healthcare EDI market during the forecast period.
Currently, Healthcare EDI Market is growing at a Compound Annual Growth Rate (CAGR) of 7.8% to reach USD 4.4 billion by 2025. Among the delivery mode segment, the mobile EDI segment is expected to grow at the highest CAGR during the forecast period. The factors attributing to the high growth of this segment include the technological upgrades in the healthcare industry and growing acceptance of mobile solutions among healthcare providers.
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Growth Drivers
• Favorable regulations for transaction processes
• Rising need to curtail healthcare costs
• Government support for HCIT
Growth Opportunities
• Increase in outsourcing of EDI services
• Introduction of ICD-11 guidelines
Challenges
• Integration between various HCIT solutions within the healthcare industry
• End-user limitations and requirements
Trends
• Growing focus on integration platform as a service (ipaas)
• Increasing use of EDI in healthcare manufacturing/distribution
• Budgetary constraints and cost-cutting measures are driving the adoption of EDI solutions in european hospitals

The prominent players operating in the Healthcare EDI Market are

McKesson Corporation (US), Optum (US), Allscripts Healthcare Solutions Inc. (US), athenahealth (US), and Nextgen Healthcare (US)

McKesson Corporation (US) was the largest player in the healthcare EDI market in 2019. The company offers an extensive range of healthcare EDI solutions. McKesson Corporation aims to be an end-to-end solution provider by providing healthcare providers and payers with products that will aid in the EDI process. The company focuses on organic and inorganic growth strategies to maintain its position in the market and expand its global presence.

Optum (US) is the second-leading player in the global healthcare EDI market. The company has a strong geographical presence in North America. The company offers healthcare EDI software and services to healthcare payers and providers. Optum strategically focuses on collaborating and partnering with other market players to launch technologically advanced products, and to expand its presence globally.
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North America is expected to exhibit the highest growth during the forecast period
• Rising HCIT expenditure,
• Developed healthcare infrastructure,
• Broad insurance coverage
Recent Developments
• In 2020, SSI Group partnered with RCxRules to launch HCC Coding Edit Suite
• In 2020, Waystar Health launched the Waystar Analytics software
• In 2020, Waystar Health acquired eSolutions