Global Healthcare Payer Network Management Market 2026-2030

Description

The global healthcare payer network management market is forecasted to grow by USD 5378.3 mn during 2025-2030, accelerating at a CAGR of 15.1% during the forecast period. The report on the global healthcare payer network management market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.

The report offers an up-to-date analysis regarding the current market scenario, the latest trends and drivers, and the overall market environment. The market is driven by adoption of AI for cost containment and fraud prevention, transition toward value-based care and reimbursement models, escalating regulatory pressures for directory accuracy.

The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market size data, segment with regional analysis and vendor landscape in addition to an analysis of the key companies. Reports have historic and forecast data.

Market Scope
Base Year	2026
End Year	2030
Series Year	2026-2030
Growth Momentum	Accelerate
YOY 2026	14.5%
CAGR	15.1%
Incremental Value	$5378.3 mn

Technavio's global healthcare payer network management market is segmented as below:

By Component

Platform and software
Services

By Delivery Mode

Cloud
On-premises

By End-User

Public health insurance
Private health insurance

Geography

North America
- US
- Canada
- Mexico
Europe
- Germany
- UK
- France
- The Netherlands
- Italy
- Spain
- Russia
Asia
Rest of World (ROW)
Rest of World (ROW)

This study identifies the integration of machine learning for network optimization as one of the prime reasons driving the global healthcare payer network management market growth during the next few years. Also, consumer-centric digital platforms for price transparency and expansion of virtual-first and hybrid provider networks will lead to sizable demand in the market.

The report on the global healthcare payer network management market covers the following areas:

Global healthcare payer network management market sizing
Global healthcare payer network management market forecast
Global healthcare payer network management market industry analysis

The robust vendor analysis is designed to help clients improve their market position, and in line with this, this report provides a detailed analysis of several leading global healthcare payer network management market vendors that include Availity, Cedar Gate Technologies, Cognizant Technology Solution, Cotiviti Inc., Gainwell Technologies LLC, HealthEdge Software Inc., Infosys Ltd., Innovaccer Inc., LexisNexis Risk Solutions., Mphasis Ltd., Optum Inc., Oracle Corp., Quest Analytics LLC, Salesforce Inc., SS and C Technologies Inc., Symplr, Verisys, Zelis. Also, the global healthcare payer network management market analysis report includes information on upcoming trends and challenges that will influence market growth. This is to help companies strategize and leverage all forthcoming growth opportunities.

The publisher presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive primary and secondary research. The market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.

Product Code: IRTNTR81239

1 Executive Summary

1.1 Market overview
- Executive Summary - Chart on Market Overview
- Executive Summary - Data Table on Market Overview
- Executive Summary - Chart on Global Market Characteristics
- Executive Summary - Chart on Market by Geography
- Executive Summary - Chart on Market Segmentation by Component
- Executive Summary - Chart on Market Segmentation by Delivery Mode
- Executive Summary - Chart on Market Segmentation by End-user
- Executive Summary - Chart on Incremental Growth
- Executive Summary - Data Table on Incremental Growth
- Executive Summary - Chart on Company Market Positioning

2 Technavio Analysis

2.1 Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
- Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
2.2 Criticality of inputs and Factors of differentiation
- Chart on Overview on criticality of inputs and factors of differentiation
2.3 Factors of disruption
- Chart on Overview on factors of disruption
2.4 Impact of drivers and challenges
- Chart on Impact of drivers and challenges in 2025 and 2030

3 Market Landscape

3.1 Market ecosystem
- Chart on Parent Market
- Data Table on - Parent Market
3.2 Market characteristics
- Chart on Market characteristics analysis
3.3 Value chain analysis
- Chart on Value chain analysis

4 Market Sizing

4.1 Market definition
- Data Table on Offerings of companies included in the market definition
4.2 Market segment analysis
- Market segments
4.3 Market size 2025
4.4 Market outlook: Forecast for 2025-2030
- Chart on Global - Market size and forecast 2025-2030 ($ million)
- Data Table on Global - Market size and forecast 2025-2030 ($ million)
- Chart on Global Market: Year-over-year growth 2025-2030 (%)
- Data Table on Global Market: Year-over-year growth 2025-2030 (%)

5 Historic Market Size

5.1 Global Healthcare Payer Network Management Market 2020 - 2024
- Historic Market Size - Data Table on Global Healthcare Payer Network Management Market 2020 - 2024 ($ million)
5.2 Component segment analysis 2020 - 2024
- Historic Market Size - Component Segment 2020 - 2024 ($ million)
5.3 Delivery Mode segment analysis 2020 - 2024
- Historic Market Size - Delivery Mode Segment 2020 - 2024 ($ million)
5.4 End-user segment analysis 2020 - 2024
- Historic Market Size - End-user Segment 2020 - 2024 ($ million)
5.5 Geography segment analysis 2020 - 2024
- Historic Market Size - Geography Segment 2020 - 2024 ($ million)
5.6 Country segment analysis 2020 - 2024
- Historic Market Size - Country Segment 2020 - 2024 ($ million)

6 Qualitative Analysis

6.1 Impact of AI on the Global Healthcare Payer Network Management Market

7 Five Forces Analysis

7.1 Five forces summary
- Five forces analysis - Comparison between 2025 and 2030
7.2 Bargaining power of buyers
- Bargaining power of buyers - Impact of key factors 2025 and 2030
7.3 Bargaining power of suppliers
- Bargaining power of suppliers - Impact of key factors in 2025 and 2030
7.4 Threat of new entrants
- Threat of new entrants - Impact of key factors in 2025 and 2030
7.5 Threat of substitutes
- Threat of substitutes - Impact of key factors in 2025 and 2030
7.6 Threat of rivalry
- Threat of rivalry - Impact of key factors in 2025 and 2030
7.7 Market condition
- Chart on Market condition - Five forces 2025 and 2030

8 Market Segmentation by Component

8.1 Market segments
- Chart on Component - Market share 2025-2030 (%)
- Data Table on Component - Market share 2025-2030 (%)
8.2 Comparison by Component
- Chart on Comparison by Component
- Data Table on Comparison by Component
8.3 Platform and software - Market size and forecast 2025-2030
- Chart on Platform and software - Market size and forecast 2025-2030 ($ million)
- Data Table on Platform and software - Market size and forecast 2025-2030 ($ million)
- Chart on Platform and software - Year-over-year growth 2025-2030 (%)
- Data Table on Platform and software - Year-over-year growth 2025-2030 (%)
8.4 Services - Market size and forecast 2025-2030
- Chart on Services - Market size and forecast 2025-2030 ($ million)
- Data Table on Services - Market size and forecast 2025-2030 ($ million)
- Chart on Services - Year-over-year growth 2025-2030 (%)
- Data Table on Services - Year-over-year growth 2025-2030 (%)
8.5 Market opportunity by Component
- Market opportunity by Component ($ million)
- Data Table on Market opportunity by Component ($ million)

9 Market Segmentation by Delivery Mode

9.1 Market segments
- Chart on Delivery Mode - Market share 2025-2030 (%)
- Data Table on Delivery Mode - Market share 2025-2030 (%)
9.2 Comparison by Delivery Mode
- Chart on Comparison by Delivery Mode
- Data Table on Comparison by Delivery Mode
9.3 Cloud - Market size and forecast 2025-2030
- Chart on Cloud - Market size and forecast 2025-2030 ($ million)
- Data Table on Cloud - Market size and forecast 2025-2030 ($ million)
- Chart on Cloud - Year-over-year growth 2025-2030 (%)
- Data Table on Cloud - Year-over-year growth 2025-2030 (%)
9.4 On-premises - Market size and forecast 2025-2030
- Chart on On-premises - Market size and forecast 2025-2030 ($ million)
- Data Table on On-premises - Market size and forecast 2025-2030 ($ million)
- Chart on On-premises - Year-over-year growth 2025-2030 (%)
- Data Table on On-premises - Year-over-year growth 2025-2030 (%)
9.5 Market opportunity by Delivery Mode
- Market opportunity by Delivery Mode ($ million)
- Data Table on Market opportunity by Delivery Mode ($ million)

10 Market Segmentation by End-user

10.1 Market segments
- Chart on End-user - Market share 2025-2030 (%)
- Data Table on End-user - Market share 2025-2030 (%)
10.2 Comparison by End-user
- Chart on Comparison by End-user
- Data Table on Comparison by End-user
10.3 Public health insurance - Market size and forecast 2025-2030
- Chart on Public health insurance - Market size and forecast 2025-2030 ($ million)
- Data Table on Public health insurance - Market size and forecast 2025-2030 ($ million)
- Chart on Public health insurance - Year-over-year growth 2025-2030 (%)
- Data Table on Public health insurance - Year-over-year growth 2025-2030 (%)
10.4 Private health insurance - Market size and forecast 2025-2030
- Chart on Private health insurance - Market size and forecast 2025-2030 ($ million)
- Data Table on Private health insurance - Market size and forecast 2025-2030 ($ million)
- Chart on Private health insurance - Year-over-year growth 2025-2030 (%)
- Data Table on Private health insurance - Year-over-year growth 2025-2030 (%)
10.5 Market opportunity by End-user
- Market opportunity by End-user ($ million)
- Data Table on Market opportunity by End-user ($ million)

11 Customer Landscape

11.1 Customer landscape overview
- Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria

12 Geographic Landscape

12.1 Geographic segmentation
- Chart on Market share by geography 2025-2030 (%)
- Data Table on Market share by geography 2025-2030 (%)
12.2 Geographic comparison
- Chart on Geographic comparison
- Data Table on Geographic comparison
12.3 North America - Market size and forecast 2025-2030
- Chart on North America - Market size and forecast 2025-2030 ($ million)
- Data Table on North America - Market size and forecast 2025-2030 ($ million)
- Chart on North America - Year-over-year growth 2025-2030 (%)
- Data Table on North America - Year-over-year growth 2025-2030 (%)
- Chart on Regional Comparison - North America
- Data Table on Regional Comparison - North America
- 12.3.1 US - Market size and forecast 2025-2030
  - Chart on US - Market size and forecast 2025-2030 ($ million)
  - Data Table on US - Market size and forecast 2025-2030 ($ million)
  - Chart on US - Year-over-year growth 2025-2030 (%)
  - Data Table on US - Year-over-year growth 2025-2030 (%)
- 12.3.2 Canada - Market size and forecast 2025-2030
  - Chart on Canada - Market size and forecast 2025-2030 ($ million)
  - Data Table on Canada - Market size and forecast 2025-2030 ($ million)
  - Chart on Canada - Year-over-year growth 2025-2030 (%)
  - Data Table on Canada - Year-over-year growth 2025-2030 (%)
- 12.3.3 Mexico - Market size and forecast 2025-2030
  - Chart on Mexico - Market size and forecast 2025-2030 ($ million)
  - Data Table on Mexico - Market size and forecast 2025-2030 ($ million)
  - Chart on Mexico - Year-over-year growth 2025-2030 (%)
  - Data Table on Mexico - Year-over-year growth 2025-2030 (%)
12.4 Europe - Market size and forecast 2025-2030
- Chart on Europe - Market size and forecast 2025-2030 ($ million)
- Data Table on Europe - Market size and forecast 2025-2030 ($ million)
- Chart on Europe - Year-over-year growth 2025-2030 (%)
- Data Table on Europe - Year-over-year growth 2025-2030 (%)
- Chart on Regional Comparison - Europe
- Data Table on Regional Comparison - Europe
- 12.4.1 Germany - Market size and forecast 2025-2030
  - Chart on Germany - Market size and forecast 2025-2030 ($ million)
  - Data Table on Germany - Market size and forecast 2025-2030 ($ million)
  - Chart on Germany - Year-over-year growth 2025-2030 (%)
  - Data Table on Germany - Year-over-year growth 2025-2030 (%)
- 12.4.2 UK - Market size and forecast 2025-2030
  - Chart on UK - Market size and forecast 2025-2030 ($ million)
  - Data Table on UK - Market size and forecast 2025-2030 ($ million)
  - Chart on UK - Year-over-year growth 2025-2030 (%)
  - Data Table on UK - Year-over-year growth 2025-2030 (%)
- 12.4.3 France - Market size and forecast 2025-2030
  - Chart on France - Market size and forecast 2025-2030 ($ million)
  - Data Table on France - Market size and forecast 2025-2030 ($ million)
  - Chart on France - Year-over-year growth 2025-2030 (%)
  - Data Table on France - Year-over-year growth 2025-2030 (%)
- 12.4.4 The Netherlands - Market size and forecast 2025-2030
  - Chart on The Netherlands - Market size and forecast 2025-2030 ($ million)
  - Data Table on The Netherlands - Market size and forecast 2025-2030 ($ million)
  - Chart on The Netherlands - Year-over-year growth 2025-2030 (%)
  - Data Table on The Netherlands - Year-over-year growth 2025-2030 (%)
- 12.4.5 Italy - Market size and forecast 2025-2030
  - Chart on Italy - Market size and forecast 2025-2030 ($ million)
  - Data Table on Italy - Market size and forecast 2025-2030 ($ million)
  - Chart on Italy - Year-over-year growth 2025-2030 (%)
  - Data Table on Italy - Year-over-year growth 2025-2030 (%)
- 12.4.6 Spain - Market size and forecast 2025-2030
  - Chart on Spain - Market size and forecast 2025-2030 ($ million)
  - Data Table on Spain - Market size and forecast 2025-2030 ($ million)
  - Chart on Spain - Year-over-year growth 2025-2030 (%)
  - Data Table on Spain - Year-over-year growth 2025-2030 (%)
- 12.4.7 Russia - Market size and forecast 2025-2030
- Chart on Russia - Market size and forecast 2025-2030 ($ million)
- Data Table on Russia - Market size and forecast 2025-2030 ($ million)
- Chart on Russia - Year-over-year growth 2025-2030 (%)
- Data Table on Russia - Year-over-year growth 2025-2030 (%)
12.5 Asia - Market size and forecast 2025-2030
- Chart on Asia - Market size and forecast 2025-2030 ($ million)
- Data Table on Asia - Market size and forecast 2025-2030 ($ million)
- Chart on Asia - Year-over-year growth 2025-2030 (%)
- Data Table on Asia - Year-over-year growth 2025-2030 (%)
- Chart on Regional Comparison - Asia
- Data Table on Regional Comparison - Asia
- 12.5.1 China - Market size and forecast 2025-2030
  - Chart on China - Market size and forecast 2025-2030 ($ million)
  - Data Table on China - Market size and forecast 2025-2030 ($ million)
  - Chart on China - Year-over-year growth 2025-2030 (%)
  - Data Table on China - Year-over-year growth 2025-2030 (%)
- 12.5.2 Japan - Market size and forecast 2025-2030
  - Chart on Japan - Market size and forecast 2025-2030 ($ million)
  - Data Table on Japan - Market size and forecast 2025-2030 ($ million)
  - Chart on Japan - Year-over-year growth 2025-2030 (%)
  - Data Table on Japan - Year-over-year growth 2025-2030 (%)
- 12.5.3 India - Market size and forecast 2025-2030
  - Chart on India - Market size and forecast 2025-2030 ($ million)
  - Data Table on India - Market size and forecast 2025-2030 ($ million)
  - Chart on India - Year-over-year growth 2025-2030 (%)
  - Data Table on India - Year-over-year growth 2025-2030 (%)
- 12.5.4 South Korea - Market size and forecast 2025-2030
  - Chart on South Korea - Market size and forecast 2025-2030 ($ million)
  - Data Table on South Korea - Market size and forecast 2025-2030 ($ million)
  - Chart on South Korea - Year-over-year growth 2025-2030 (%)
  - Data Table on South Korea - Year-over-year growth 2025-2030 (%)
- 12.5.5 Indonesia - Market size and forecast 2025-2030
  - Chart on Indonesia - Market size and forecast 2025-2030 ($ million)
  - Data Table on Indonesia - Market size and forecast 2025-2030 ($ million)
  - Chart on Indonesia - Year-over-year growth 2025-2030 (%)
  - Data Table on Indonesia - Year-over-year growth 2025-2030 (%)
- 12.5.6 Thailand - Market size and forecast 2025-2030
- Chart on Thailand - Market size and forecast 2025-2030 ($ million)
- Data Table on Thailand - Market size and forecast 2025-2030 ($ million)
- Chart on Thailand - Year-over-year growth 2025-2030 (%)
- Data Table on Thailand - Year-over-year growth 2025-2030 (%)
- 12.5.7 Singapore - Market size and forecast 2025-2030
- Chart on Singapore - Market size and forecast 2025-2030 ($ million)
- Data Table on Singapore - Market size and forecast 2025-2030 ($ million)
- Chart on Singapore - Year-over-year growth 2025-2030 (%)
- Data Table on Singapore - Year-over-year growth 2025-2030 (%)
12.6 Rest of World (ROW) - Market size and forecast 2025-2030
- Chart on Rest of World (ROW) - Market size and forecast 2025-2030 ($ million)
- Data Table on Rest of World (ROW) - Market size and forecast 2025-2030 ($ million)
- Chart on Rest of World (ROW) - Year-over-year growth 2025-2030 (%)
- Data Table on Rest of World (ROW) - Year-over-year growth 2025-2030 (%)
- Chart on Regional Comparison - Rest of World (ROW)
- Data Table on Regional Comparison - Rest of World (ROW)
- 12.6.1 Australia - Market size and forecast 2025-2030
  - Chart on Australia - Market size and forecast 2025-2030 ($ million)
  - Data Table on Australia - Market size and forecast 2025-2030 ($ million)
  - Chart on Australia - Year-over-year growth 2025-2030 (%)
  - Data Table on Australia - Year-over-year growth 2025-2030 (%)
- 12.6.2 Brazil - Market size and forecast 2025-2030
  - Chart on Brazil - Market size and forecast 2025-2030 ($ million)
  - Data Table on Brazil - Market size and forecast 2025-2030 ($ million)
  - Chart on Brazil - Year-over-year growth 2025-2030 (%)
  - Data Table on Brazil - Year-over-year growth 2025-2030 (%)
- 12.6.3 UAE - Market size and forecast 2025-2030
  - Chart on UAE - Market size and forecast 2025-2030 ($ million)
  - Data Table on UAE - Market size and forecast 2025-2030 ($ million)
  - Chart on UAE - Year-over-year growth 2025-2030 (%)
  - Data Table on UAE - Year-over-year growth 2025-2030 (%)
- 12.6.4 Saudi Arabia - Market size and forecast 2025-2030
  - Chart on Saudi Arabia - Market size and forecast 2025-2030 ($ million)
  - Data Table on Saudi Arabia - Market size and forecast 2025-2030 ($ million)
  - Chart on Saudi Arabia - Year-over-year growth 2025-2030 (%)
  - Data Table on Saudi Arabia - Year-over-year growth 2025-2030 (%)
- 12.6.5 South Africa - Market size and forecast 2025-2030
  - Chart on South Africa - Market size and forecast 2025-2030 ($ million)
  - Data Table on South Africa - Market size and forecast 2025-2030 ($ million)
  - Chart on South Africa - Year-over-year growth 2025-2030 (%)
  - Data Table on South Africa - Year-over-year growth 2025-2030 (%)
- 12.6.6 Turkey - Market size and forecast 2025-2030
  - Chart on Turkey - Market size and forecast 2025-2030 ($ million)
  - Data Table on Turkey - Market size and forecast 2025-2030 ($ million)
  - Chart on Turkey - Year-over-year growth 2025-2030 (%)
  - Data Table on Turkey - Year-over-year growth 2025-2030 (%)
12.7 Market opportunity by geography
- Market opportunity by geography ($ million)
- Data Tables on Market opportunity by geography ($ million)

13 Drivers, Challenges, and Opportunity

13.1 Market drivers
- Adoption of AI for cost containment and fraud prevention
- Transition toward value-based care and reimbursement models
- Escalating regulatory pressures for directory accuracy
13.2 Market challenges
- Cybersecurity threats and data privacy compliance
- Integration with legacy systems and interoperability issues
- Managing provider relationships and network adequacy
13.3 Impact of drivers and challenges
- Impact of drivers and challenges in 2025 and 2030
13.4 Market opportunities
- Integration of machine learning for network optimization
- Consumer-centric digital platforms for price transparency
- Expansion of virtual-first and hybrid provider networks

14 Competitive Landscape

14.1 Overview
14.2 Competitive Landscape
- Overview on criticality of inputs and factors of differentiation
14.3 Landscape disruption
- Overview on factors of disruption
14.4 Industry risks
- Impact of key risks on business

15 Competitive Analysis

15.1 Companies profiled
- Companies covered
15.2 Company ranking index
- Company ranking index
15.3 Market positioning of companies
- Matrix on companies position and classification
15.4 Availity
- Availity - Overview
- Availity - Product / Service
- Availity - Key offerings
- SWOT
15.5 Cognizant Technology Solution
- Cognizant Technology Solution - Overview
- Cognizant Technology Solution - Business segments
- Cognizant Technology Solution - Key news
- Cognizant Technology Solution - Key offerings
- Cognizant Technology Solution - Segment focus
- SWOT
15.6 Cotiviti Inc.
- Cotiviti Inc. - Overview
- Cotiviti Inc. - Product / Service
- Cotiviti Inc. - Key offerings
- SWOT
15.7 Gainwell Technologies LLC
- Gainwell Technologies LLC - Overview
- Gainwell Technologies LLC - Product / Service
- Gainwell Technologies LLC - Key offerings
- SWOT
15.8 HealthEdge Software Inc.
- HealthEdge Software Inc. - Overview
- HealthEdge Software Inc. - Product / Service
- HealthEdge Software Inc. - Key offerings
- SWOT
15.9 Innovaccer Inc.
- Innovaccer Inc. - Overview
- Innovaccer Inc. - Product / Service
- Innovaccer Inc. - Key offerings
- SWOT
15.10 LexisNexis Risk Solutions.
- LexisNexis Risk Solutions. - Overview
- LexisNexis Risk Solutions. - Product / Service
- LexisNexis Risk Solutions. - Key offerings
- SWOT
15.11 Mphasis Ltd.
- Mphasis Ltd. - Overview
- Mphasis Ltd. - Product / Service
- Mphasis Ltd. - Key news
- Mphasis Ltd. - Key offerings
- SWOT
15.12 Optum Inc.
- Optum Inc. - Overview
- Optum Inc. - Product / Service
- Optum Inc. - Key offerings
- SWOT
15.13 Oracle Corp.
- Oracle Corp. - Overview
- Oracle Corp. - Business segments
- Oracle Corp. - Key news
- Oracle Corp. - Key offerings
- Oracle Corp. - Segment focus
- SWOT
15.14 Quest Analytics LLC
- Quest Analytics LLC - Overview
- Quest Analytics LLC - Product / Service
- Quest Analytics LLC - Key offerings
- SWOT
15.15 Salesforce Inc.
- Salesforce Inc. - Overview
- Salesforce Inc. - Product / Service
- Salesforce Inc. - Key news
- Salesforce Inc. - Key offerings
- SWOT
15.16 SS and C Technologies Inc.
- SS and C Technologies Inc. - Overview
- SS and C Technologies Inc. - Product / Service
- SS and C Technologies Inc. - Key news
- SS and C Technologies Inc. - Key offerings
- SWOT
15.17 Symplr
- Symplr - Overview
- Symplr - Product / Service
- Symplr - Key offerings
- SWOT
15.18 Zelis
- Zelis - Overview
- Zelis - Product / Service
- Zelis - Key offerings
- SWOT

16 Appendix

16.1 Scope of the report
- Market definition
- Objectives
- Notes and caveats
16.2 Inclusions and exclusions checklist
- Inclusions checklist
- Exclusions checklist
16.3 Currency conversion rates for US$
- Currency conversion rates for US$
16.4 Research methodology
- Research methodology
16.5 Data procurement
- Information sources
16.6 Data validation
- Data validation
16.7 Validation techniques employed for market sizing
- Validation techniques employed for market sizing
16.8 Data synthesis
- Data synthesis
16.9 360 degree market analysis
- 360 degree market analysis
16.10 List of abbreviations
- List of abbreviations