The turbulent economy is putting a myriad of challenges before health insurers, including member attrition, cost containment data transparency and security and more. In particular, health insurers are focused on accelerating claims settlements, fighting fraud, improving underwriting, and managing claims litigation.
As a result, there may be significant opportunities for insurance claims vendors—especially those in Europe—in this space, particularly those that can provide a cost-benefit paradigm to users by offering optimal technology, quality and customer value.
Such are the findings in a report from Frost & Sullivan, European Market for Insurance Claims Management in Healthcare, which finds that multi-million dollar opportunities are emerging for a broad range of services.
The market will experience considerable expansion as insurers reconsider claims handling and processing changes and the insurance industry ties the development of such solutions to wealth management.
"The adoption of claims management solutions is increasing, while creating a sizeable potential market for the next four to five years," notes Frost & Sullivan Research Analyst T. E. Jayapradha. "There exists a tremendous scope and opportunity for insurance claims management vendors able to provide competitive claims handling and processing."
The constantly evolving health care insurance industry is highly competitive.
This situation supports insurance claims management solutions that offer high-performance, low-cost claims processing and handling that meet the specific requirements of customers.
The processing of health care reimbursements in many parts of Europe falls under the purview of the public sector. As reimbursement systems and funding bodies vary across Europe, there is little incentive to develop payer IT solutions that support reduced reimbursement turnaround times.
"The dominance of legacy systems and the high price of insurance claims management solutions also affect market prospects," says Jayapradha. "These solutions are relatively more expensive for claims payers and providers and can attenuate sales."
With global trends focused on enhancing revenue cycles, vendors are looking at improving their own administrative processes and adopting cost-curbing measures.
Scalable systems architecture, quantifiable benefits to business processes and justifiable return on investment are other factors that systems vendors should incorporate, according to the Frost & Sullivan report.
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