PUBLISHER: Grand View Research | PRODUCT CODE: 1751257
PUBLISHER: Grand View Research | PRODUCT CODE: 1751257
U.S. Healthcare Payer Analytics Market Size, Share & Trends Analysis Report By Analytics Type (Descriptive Analytics), By Component (Software), By Delivery Model, By Application, And Segment Forecasts, 2025 - 2030
U.S. Healthcare Payer Analytics Market Growth & Trends:
The U.S. healthcare payer analytics market size is expected to reach USD 19.38 billion by 2030, registering a CAGR of 21.5% from 2025 to 2030, according to a new report by Grand View Research, Inc. The digital advancements in the healthcare field, and the digitization of records, are one of the key factors driving the growth of this market. Adoption of such technologies is on an upward trend thus propelling the market. Digital data is being used to derive meaningful results, cost reduction, and minimize fraudulent insurance claims.
The U.S. government has been increasingly spending on healthcare and focusing on improving digital infrastructure, which is boosting technological advancements in the field. Due to technological advancements, decision-making for payers and healthcare providers has become easier with the help of analytical tools. The overall increase in healthcare expenditure has amounted to more than USD 4 trillion in the year 2020. It is not only helping the healthcare industry develop faster but has also made healthcare more affordable and precise.
The healthcare analytical tools are helping administrators and policymakers in determining what is the best course of action, how successful is it going to be, and how much cost can be saved by cutting unnecessary expenditures. For insurance companies, analytical tools have helped in recognizing patterns of insurance fraud and in turn saving billions of dollars per year. Doctors' analytical tools have helped to determine the best treatment plans for a particular patient by studying and analyzing their history.
In the analytics type, the descriptive analysis held the largest market share of 358% in 2022. Descriptive analytics has been widely used during COVID by various research organizations as well as laboratories, to determine how contagious the virus is by studying the past and present tests being conducted for coronavirus. Descriptive analytics analyzes data to derive meaningful results and can significantly impact future decisions. The fastest-growing was the predictive analytics segment, this helps in charting the best treatment plan for a personalized treatment plan, it can help the doctor to find out what works best for a patient and can give better treatment outcomes.
In the components, the service segment dominated the market in 2022. Since the majority of establishments do not have an analytics department, it is generally outsourced to industry experts which saves the cost of training and teaching the staff about tools and methods. The fastest-growing component was the hardware, with rapid investment in healthcare IT, the need for better computers and hardware components has been responsible for the growth of the market.
Currently, the largest market share is held by the on-premises delivery model. Healthcare organizations have been opting for the installment of analytical tools and software. The on-premises installation results in less theft of data and provide easier access and maintenance of data and patient records. However, cloud-based storage has been gaining popularity due to ease of storage, and minimum requirement of setup, which has been a key driving factor for the growth of the market.
In the applications segment, the largest market share is currently held by financial applications. Private and government facilities have been increasingly adopting analytics for financial applications. Healthcare analytics is being used for claim settlement, risk analysis, and identifying frauds in insurance claims. The fastest-growing application is also financial applications, for use in identifying frauds related to insurance which cost the payers billions of dollars per year. These factors have contributed significantly to the growth of the healthcare payer analytics market.
The COVID-19 pandemic created a huge opportunity for the healthcare analytics market. The amount of patient data generated during the pandemic has greatly helped in studying how the disease spreads, how contagious it is, and what implications it can have on people. Economies around the world have suffered gravely due to supply chain disruptions saw a decline in the market, but the usage and rate of adoption of analytics have increased overall. Telehealth, a means to communicate with patients and doctors saw 38 times increase in adoption from pre-COVID times, as per McKinsey.
U.S. Healthcare Payer Analytics Market Report Highlights:
- The descriptive analytics segment had the largest market share in 2024. This analytics type is widely used in process optimization and administrative activities.
- The on-premises segment dominated the market with a share of 47.0% in 2024. The healthcare industry is evolving in terms of technology.
- Based on application, the financial application segment dominated the market with the largest revenue share in 2024.
- Based on the components, the services segment had the largest market share of 42.4% in 2024.
Table of Contents
Chapter 1. Methodology and Scope
- 1.1. Market Segmentation & Scope
- 1.2. Segment Definitions
- 1.2.1. Analytics Type
- 1.2.2. Component
- 1.2.3. Delivery Model
- 1.2.4. Application
- 1.3. Estimates and Forecast Timeline
- 1.4. Research Methodology
- 1.5. Information Procurement
- 1.5.1. Purchased Database
- 1.5.2. GVR's Internal Database
- 1.5.3. Secondary Sources
- 1.5.4. Primary Research
- 1.6. Information Analysis
- 1.6.1. Data Analysis Models
- 1.7. Market Formulation & Data Visualization
- 1.8. Model Details
- 1.8.1. Commodity Flow Analysis
- 1.9. List of Secondary Sources
- 1.10. Objectives
Chapter 2. Executive Summary
- 2.1. Market Snapshot
- 2.2. Segment Snapshot
- 2.3. Competitive Landscape Snapshot
Chapter 3. Market Variables, Trends, & Scope
- 3.1. Market Lineage Outlook
- 3.2. Market Dynamics
- 3.2.1. Market Driver Analysis
- 3.2.1.1. Growing usage of AI/ML-Driven in payer analytics solutions
- 3.2.1.2. Declining payer profit margins of insurance companies
- 3.2.1.3. Increasing need for risk management and predictive insights:
- 3.2.2. Market Restraint Analysis
- 3.2.2.1. Data privacy and Security Concerns
- 3.2.2.2. Shortage of qualified professionals
- 3.2.2.3. Complex regulatory environment
- 3.2.3. Market Opportunity Analysis
- 3.2.3.1. Expansion into predictive and prescriptive analytics:
- 3.2.4. Market Threat Analysis
- 3.2.1. Market Driver Analysis
- 3.3. Business Environment Analysis
- 3.3.1. Porter's Five Forces Analysis
- 3.3.1.1. Supplier power
- 3.3.1.2. Buyer power
- 3.3.1.3. Substitution threat
- 3.3.1.4. Threat of new entrant
- 3.3.1.5. Competitive rivalry
- 3.3.2. PESTLE Analysis
- 3.3.3. Impact of COVID 19
- 3.3.1. Porter's Five Forces Analysis
Chapter 4. U.S. Healthcare Payer Analytics Market: Analytics Type Estimates & Trend Analysis
- 4.1. Segment Dashboard
- 4.1.1. U.S. Healthcare Payer Analytics Market: Type Movement Analysis, 2024 & 2030 (USD Million)
- 4.2. Descriptive Analytics
- 4.2.1. Descriptive Analytics Market Revenue Estimates and Forecasts, 2018 - 2030 (USD Million)
- 4.3. Predictive Analytics
- 4.3.1. Predictive Analytics Market Revenue Estimates and Forecasts, 2018 - 2030 (USD Million)
- 4.4. Prescriptive Analytics
- 4.4.1. Prescriptive Analytics Market Revenue Estimates and Forecasts, 2018 - 2030 (USD Million)
- 4.5. Diagnostic Analytics
- 4.5.1. Diagnostic Analytics Market Revenue Estimates and Forecasts, 2018 - 2030 (USD Million)
- 4.6. Discovery Analytics
- 4.6.1. Discovery Analytics Market Revenue Estimates and Forecasts, 2018 - 2030 (USD Million)
Chapter 5. U.S. Healthcare Payer Analytics Market: Component Estimates & Trend Analysis
- 5.1. Component Segment Dashboard
- 5.2. Component Market Share Movement Analysis, 2024 & 2030
- 5.3. Market Size & Forecasts and Trend Analysis, by Component, 2018 to 2030 (USD Million)
- 5.4. Software
- 5.4.1. Software market, 2018 - 2030 (USD Million)
- 5.5. Hardware
- 5.5.1. Hardware market 2018 - 2030 (USD Million)
- 5.6. Services
- 5.6.1. Services market, 2018 - 2030 (USD Million)
Chapter 6. U.S. Healthcare Payer Analytics Market: Delivery Model Estimates & Trend Analysis
- 6.1. Delivery Model Segment Dashboard
- 6.2. Delivery Model Market Share Movement Analysis, 2024 & 2030
- 6.3. Market Size & Forecasts and Trend Analysis, by Delivery Model, 2018 to 2030 (USD Million)
- 6.4. On-premises
- 6.5. Web & cloud-based market, 2018 - 2030 (USD Million)
- 6.6. Web & cloud-based
- 6.6.1. Web & cloud-based market, 2018 - 2030 (USD Million)
- 6.7. Cloud-Based
- 6.7.1. Cloud-Based market, 2018 - 2030 (USD Million)
Chapter 7. U.S. Healthcare Payer Analytics Market: Application Estimates & Trend Analysis
- 7.1. Application Segment Dashboard
- 7.2. Application Market Share Movement Analysis, 2024 & 2030
- 7.3. Market Size & Forecasts and Trend Analysis, by Application, 2018 to 2030 (USD Million)
- 7.4. Clinical
- 7.4.1. Clinical I market, 2018 - 2030 (USD Million)
- 7.5. Financial
- 7.5.1. Financial market, 2018 - 2030 (USD Million)
- 7.6. Operational and Administrative
- 7.6.1. Operational and Administrative market, 2018 - 2030 (USD Million)
Chapter 8. Competitive Landscape
- 8.1. Participant Overview
- 8.2. Company Market Position Analysis
- 8.3. Company Categorization
- 8.4. Strategy Mapping
- 8.5. Company Profiles/Listing
- 8.5.1. CloudMedx
- 8.5.1.1. Overview
- 8.5.1.2. Financial performance
- 8.5.1.3. Product benchmarking
- 8.5.1.4. Strategic initiatives
- 8.5.2. DataSmart Solutions
- 8.5.2.1. Overview
- 8.5.2.2. Financial performance
- 8.5.2.3. Product benchmarking
- 8.5.2.4. Strategic initiatives
- 8.5.3. Amitech Solutions
- 8.5.3.1. Overview
- 8.5.3.2. Financial performance
- 8.5.3.3. Product benchmarking
- 8.5.3.4. Strategic initiatives
- 8.5.4. Caserta Concepts
- 8.5.4.1. Overview
- 8.5.4.2. Financial performance
- 8.5.4.3. Product benchmarking
- 8.5.4.4. Strategic initiatives
- 8.5.5. Greenway Health, LLC
- 8.5.5.1. Overview
- 8.5.5.2. Financial performance
- 8.5.5.3. Product benchmarking
- 8.5.5.4. Strategic initiatives
- 8.5.6. IMAT Solutions
- 8.5.6.1. Overview
- 8.5.6.2. Financial performance
- 8.5.6.3. Product benchmarking
- 8.5.6.4. Strategic initiatives
- 8.5.7. Health Catalyst
- 8.5.7.1. Overview
- 8.5.7.2. Financial performance
- 8.5.7.3. Product benchmarking
- 8.5.7.4. Strategic initiatives
- 8.5.8. Indegene
- 8.5.8.1. Overview
- 8.5.8.2. Financial performance
- 8.5.8.3. Product benchmarking
- 8.5.8.4. Strategic initiatives
- 8.5.9. IBM
- 8.5.9.1. Overview
- 8.5.9.2. Financial performance
- 8.5.9.3. Product benchmarking
- 8.5.9.4. Strategic initiatives
- 8.5.10. Optum
- 8.5.10.1. Overview
- 8.5.10.2. Financial performance
- 8.5.10.3. Product benchmarking
- 8.5.10.4. Strategic initiatives
- 8.5.11. Oracle
- 8.5.11.1. Overview
- 8.5.11.2. Financial performance
- 8.5.11.3. Product benchmarking
- 8.5.11.4. Strategic initiatives
- 8.5.12. Citius Tech
- 8.5.12.1. Overview
- 8.5.12.2. Financial performance
- 8.5.12.3. Product benchmarking
- 8.5.12.4. Strategic initiatives
- 8.5.13. MedeAnalytics
- 8.5.13.1. Overview
- 8.5.13.2. Financial performance
- 8.5.13.3. Product benchmarking
- 8.5.13.4. Strategic initiatives
- 8.5.14. Verisk Analytics, Inc.
- 8.5.14.1. Overview
- 8.5.14.2. Financial performance
- 8.5.14.3. Product benchmarking
- 8.5.14.4. Strategic initiatives
- 8.5.15. McKesson Medical-Surgical Inc.
- 8.5.15.1. Overview
- 8.5.15.2. Financial performance
- 8.5.15.3. Product benchmarking
- 8.5.15.4. Strategic initiatives
- 8.5.16. Veradigm LLC
- 8.5.16.1. Overview
- 8.5.16.2. Financial performance
- 8.5.16.3. Product benchmarking
- 8.5.16.4. Strategic initiatives
- 8.5.17. IQVIA
- 8.5.17.1. Overview
- 8.5.17.2. Financial performance
- 8.5.17.3. Product benchmarking
- 8.5.17.4. Strategic initiatives
- 8.5.1. CloudMedx
List of Tables
- Table 1. List of secondary sources
- Table 2. List of abbreviations
- Table 3. U.S. Healthcare payer analytics market, Type, 2018 - 2030 (USD Million)
- Table 4. U.S. Healthcare payer analytics market, by Analytics Types, 2018 - 2030 (USD Million)
- Table 5. U.S. Healthcare payer analytics market, by Component, 2018 - 2030 (USD Million)
- Table 6. U.S. Healthcare payer analytics market, by Delivery Model, 2018 - 2030 (USD Million)
- Table 7. U.S. Healthcare payer analytics market, by Application, 2018 - 2030 (USD Million)
List of Figures
- Fig. 1 Market research process
- Fig. 2 Information procurement
- Fig. 3 Primary research pattern
- Fig. 4 Market research approaches
- Fig. 5 Value chain-based sizing & forecasting
- Fig. 6 Market formulation & validation
- Fig. 7 Market segmentation
- Fig. 8 Market snapshot
- Fig. 9 Segment snapshot
- Fig. 10 Competitive landscape snapshot
- Fig. 11 Market trends & outlook
- Fig. 12 Market driver relevance analysis (current & future impact)
- Fig. 13 Market restraint relevance analysis (current & future impact)
- Fig. 14 PESTLE analysis
- Fig. 15 Porter's five forces analysis
- Fig. 16 U.S.U.S. healthcare payer analytics market analytics type outlook: Key Takeaways
- Fig. 17 U.S.U.S. healthcare payer analytics market: Analytics type movement analysis, 2018 & 2030
- Fig. 18 Descriptive analytics market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 19 Predictive analytics market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 20 Prescriptive analytics market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 21 Diagnostic Analytics market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 22 Discovery Analytics market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 23 U.S.U.S. Healthcare payer analytics Market component outlook: Key takeaways
- Fig. 24 U.S.U.S. Healthcare payer analytics market: Component movement analysis, 2018 & 2030
- Fig. 25 Software market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 26 Hardware market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 27 Services market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 28 U.S.U.S. healthcare payer analytics market delivery model outlook: Key takeaways
- Fig. 29 U.S.U.S. healthcare payer analytics market: Delivery model movement analysis, 2018 & 2030 (USD Million)
- Fig. 30 On-Premises market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 31 Web-based market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 32 Cloud-based market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 33 U.S.U.S. healthcare payer analytics market application outlook: Key takeaways
- Fig. 34 U.S.U.S. healthcare payer analytics market: Application movement analysis, 2018 & 2030 (USD Million)
- Fig. 35 Clinical market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 36 Financial market estimates and forecasts 2018 - 2030 (USD Million)
- Fig. 37 Operational and Administrative market estimates and forecasts 2018 - 2030 (USD
- Fig. 38 Market Participant Categorization
- Fig. 39 Strategy mapping
- Fig. 40 Company market position analysis
