Market Scope

Market Research Future (MRFR) expects the Healthcare electronic data interchange market report was valued USD 2674 million in 2017 and is projected to grow at a CAGR of 8.60% by 2030.

Major Growth Boosters and Challenges

Electronic data interchange solutions help reduce healthcare costs, foster the quality of patient care, while also making fast, accurate, secure, detailed, and reliable information. Using the paper form is cumbersome, costly, and incompetent whereas electronic data interchange brings down the number of time-consuming processes to effectively streamline claim management processes. Soaring awareness about these benefits is encouraging healthcare to adopt these solutions, rendering a positive impact on the global market.

The burgeoning pool of end-users should also bolster the demand for electronic data interchange services and solutions in the years to come. Some of the major end-users are payers, pharmaceutical & medical device industries, providers, and more. The rapid escalation in the number of hospitals, especially in France, the UK., Benelux, Denmark and Germany, and their rising focus on curtailing significant healthcare costs should push the demand for electronic data interchange.

EDI outsourcing has emerged as a lucrative opportunity in the market, in line with mounting healthcare costs prompting the healthcare sector to look for ways to deal with the issue. The US hospitals struggle with privacy and security concerns due to the extensive use of social media. As a result, majority of the hospitals are outsourcing their claim and billing services to EDI service vendors.

Renowned Vendors 

GE Healthcare, McKesson Corporation, Cognizant, Allscripts Healthcare Solutions Inc., Siemens Healthineers, Optum, Inc., The SSI Group, LLC, Schreiner Group, ZirMed Inc., Experian Information Solutions, Inc., Emdeon Inc., Passport Health Communications, HealthFusion, are some of the strongest players in the healthcare electronic data interchange solutions market.

Market Segmentation

The healthcare electronic data interchange market research can be segregated into component, delivery mode, transaction, as well as end user.

The components discussed in the market study are software, as well as services.

With respect to delivery mode, the major segments are web and cloud-based EDI, direct (Point-to-Point) EDI, mobile EDI and EDI value added network (VAN).

Transaction-wise, the key segments can be eligibility inquiry and response, claims & encounters and payment & remittance advance, claim status and response, claim attachments, referral certification and authorization and enrollments.

The significant end users in the market are pharmaceutical & medical device industries, healthcare providers, healthcare payers, and others. Healthcare payers form the largest segment in the market, since EDI solutions are increasingly being adopted for financial management by the clinicians and physicians. Meanwhile, pharmaceutical & medical device industries can be the fastest growing segment in the years ahead, due to the heightened uptake of insurance plans.

Regional Study

Healthcare EDI industry is geographically split into the Americas, Asia Pacific/APAC, Middle East & Africa/MEA and Europe.

The Americas has been the biggest gainer globally and will retain its leading position throughout the analysis period. The rampant use of healthcare electronic data interchange solutions in the region, growing healthcare spending and increased involvement of the leading players in this field has catapulted the market position. Frequent technical innovations in EDI software and the vast pool of affluent companies like Cognizant, McKesson Corporation, The SSI Group, LLC; Optum, Inc.; Experian Information Solutions Inc. and ZirMed Inc. add to the market strength as well. Implementation of strict regulations pertaining to the transaction processes coupled with the strong government support with regard to HCIT should further push the market demand in the region.

Europe has taken the second leading position in the global market, in view of the escalating adoption of healthcare electronic data interchange software backed by increasing government spending and supportive policies. The demand has been mounting rapidly among pharmaceutical firms as well as medical device manufacturers to deal with the heightened competitiveness, reduced profit margins and pricing pressure. Hospitals emerging as key end-users to achieve faster transaction processing along with the rising use of EDI software in supply chain management also work in favor of the European market. Pfizer Inc., Bayer AG, Abbott Laboratories and GlaxoSmithKline PLC are some of the EDI solution leaders in the region.

The fastest progress in the global market will be made by Asia Pacific, in view of the increased spending on healthcare information technology. Accelerated cases of chronic disorders, expanding elderly population and the surging adoption of latest healthcare systems in line with growing per capita income bolsters the market expansion rate in the region. healthcare payers and providers are growing aware of the benefits offered by healthcare EDI solutions, which is bond to foster the sales in the ensuing years. Expanding, soaring patient volume that has raised the volume of medical data, and the introduction of HCIT programs across Japan, Australia, and India will further amplify the market demand.

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