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The global healthcare provider network management market is poised to reach USD 2.96 billion by 2020 from USD 1.78 billion in 2015, growing at a CAGR of 10.7% during the forecast period of 2015 to 2020.
Provider network management helps payer organizations to manage a provider’s network with greater efficiency for optimal financial results, process claims with greater accuracy (which reduces cost and errors), and increase provider satisfaction. The global healthcare provider network management market is bifurcated into provider network management services and provider network management platform/software segments. The provider network management services segment is further categorized into outsourcing services and internal services.

A provider network consists of a set of doctors, hospitals, and other healthcare providers such as nurse practitioners, therapists, and other clinicians that are a part of the health insurance plan. Provider network management includes database management, credentialing, contracting services, pricing maintenance, and configuration, among others. With the help of provider network management, the payer organization is able to uncover insights which may have been overlooked previously by conventional analytical tools. Provider network management helps in leveraging data obtained in daily operations by payer organizations to identify high-risk providers, create consistency in care delivery, and ensure necessary health insurance coverage for patients.

In 2015, the services segment is expected to account for the largest share of the global healthcare provider network management market, by component. Moreover, the internal services segment is expected to account for the largest share of provider network management services market, by sub-component. This can be attributed to the fact that internal services help ensure profitability, better provider network management, long-term provider relationships, and regulatory compliance. These advantages are driving the growth of this market segment over outsourcing services.

In 2015, North America is expected to account for the largest share of the global healthcare provider network management market, followed by Europe, Asia-Pacific, and the Rest of the World (RoW). The North American market is also likely to witness the highest growth rate of the global healthcare provider network management market in the coming years. North America’s large share and high growth rate can be attributed to the increase in health insurance coverage triggered by the Patient Protection and Affordable Act (PPACA) in the U.S., the rising need to curtail escalating healthcare costs in the U.S. and Canada, and the government focus on healthcare IT solutions in Canada.

The market witnesses high competitive intensity, as there are several big and many small firms with similar product offerings. These companies adopt various strategies (expansions, agreements/collaboration/ partnerships, acquisitions, marketing and promotional activities, product enhancements, repositioning, and service launches) to increase their market shares and establish a strong foothold in the global market.

Reasons to Buy the Report:
The report will enrich both established firms as well as new entrants/smaller firms to gauge the pulse of the market, which in turn helps the firms to garner a greater market share. Firms purchasing the report could use any one or a combination of the below-mentioned five strategies (market penetration, product development/innovation, market development, market diversification, and competitive assessment) for strengthening their market shares.

The report provides insights on the following pointers:
- Market Penetration: Comprehensive information on the product portfolios of top players in the healthcare provider network management market. The report analyzes the healthcare provider network management market, by component
- Product Development/Innovation: Detailed insights on upcoming technologies, research and development activities, and new product launches in the healthcare provider network management market
- Market Development: Comprehensive information about the lucrative emerging markets. The report analyzes the markets for various provider network management services and software across regions
- Market Diversification: Exhaustive information about new products, untapped regions, recent developments, and investments in the healthcare provider network management market
- Competitive Assessment: In-depth assessment of market shares, strategies, products, distribution networks, and manufacturing capabilities of the leading players in the healthcare provider network management market

Table Of Contents

Healthcare Provider Network Management Market by Component, Platform/Software - Analysis and Global Forecast to 2020
TABLE OF CONTENTS

1 INTRODUCTION 12
1.1 OBJECTIVES OF STUDY 12
1.2 MARKET DEFINITION 12
1.3 MARKET SCOPE 13
1.3.1 MARKETS COVERED 13
1.3.2 YEARS CONSIDERED FOR THE STUDY 14
1.4 CURRENCY 14
1.5 LIMITATIONS 14
1.6 STAKEHOLDERS 14
2 RESEARCH METHODOLOGY 15
2.1 RESEARCH METHODOLOGY STEPS 15
2.2 SECONDARY AND PRIMARY RESEARCH METHODOLOGY 16
2.2.1 SECONDARY RESEARCH 16
2.2.2 PRIMARY RESEARCH 17
2.2.3 KEY INDUSTRY INSIGHTS 18
2.3 KEY DATA FROM PRIMARY SOURCES 19
2.4 KEY INSIGHTS FROM PRIMARY SOURCES 19
2.5 MARKET SIZE ESTIMATION METHODOLOGY 20
2.6 MARKET DATA VALIDATION AND TRIANGULATION 23
2.7 ASSUMPTIONS FOR THE STUDY 24
3 EXECUTIVE SUMMARY 25
3.1 INTRODUCTION 25
3.2 CURRENT SCENARIO 27
3.3 FUTURE OUTLOOK 28
4 PREMIUM INSIGHTS 30
4.1 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET 30
4.2 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET, BY COMPONENT 31
4.3 REGIONAL SNAPSHOT OF THE GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET 32
4.4 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET, BY SUBCOMPONENT (2015) 33

5 MARKET OVERVIEW 34
5.1 INTRODUCTION 35
5.2 MARKET DYNAMICS 35
5.2.1 DRIVERS 36
5.2.1.1 Implementation of stringent federal mandates in the U.S. 36
5.2.1.2 Growing focus on improving the quality of care through the effective use of payer reporting requirements 36
5.2.2 RESTRAINTS 37
5.2.2.1 High cost of deployment 37
5.2.3 OPPORTUNITIES 38
5.2.3.1 Advanced data analytics 38
5.2.4 CHALLENGE 38
5.2.4.1 Reluctance of users to migrate from legacy systems 38
6 HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET, BY COMPONENT 40
6.1 INTRODUCTION 41
6.2 PROVIDER NETWORK MANAGEMENT SERVICES 43
6.3 PROVIDER NETWORK MANAGEMENT PLATFORMS/SOFTWARE 47
7 HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET, BY REGION 49
7.1 INTRODUCTION 50
7.2 NORTH AMERICA 51
7.2.1 U.S. 53
7.2.1.1 Increase in health insurance coverage 53
7.2.1.2 Rising need to curtail escalating healthcare costs 54
7.2.2 CANADA 55
7.2.2.1 Government focus on Healthcare IT solutions 55
7.2.2.2 Need to curtail healthcare costs in Canada 55
7.3 EUROPE 57
7.3.1 GOVERNMENT INITIATIVES TO MODERNIZE HEALTHCARE SYSTEM IN GERMANY 58
7.3.2 INCREASED FOCUS OF MAJOR PLAYERS IN EUROPE 58
7.4 ASIA-PACIFIC 60
7.4.1 ALLOCATION OF UNIQUE ID NUMBER TO HOSPITALS EXPECTED TO DRIVE THE PROVIDER NETWORK MANAGEMENT MARKET IN INDIA 62
7.4.2 REFORMS IMPLEMENTED BY THE CHINESE GOVERNMENT TO BENEFIT THE PROVIDER NETWORK MANAGEMENT MARKET 62
7.5 REST OF THE WORLD 64
7.5.1 INITIATIVES BY MARKET PLAYERS TO ENTER EMERGING MARKETS SUCH AS BRAZIL 65

8 COMPETITIVE LANDSCAPE 66
8.1 OVERVIEW 66
8.2 OFFERINGS ASSESSMENT 66
8.2.1 INTRODUCTION 66
8.3 COMPETITIVE SITUATION AND TRENDS 68
8.3.1 INTRODUCTION 69
8.3.2 EXPANSION 70
8.3.3 AGREEMENTS, COLLABORATIONS, AND PARTNERSHIPS 71
8.3.4 ACQUISITIONS 72
8.3.5 OTHERS 73
9 COMPANY PROFILES 74
(Overview, Financials, Products and Services, Strategy, and Developments)*
9.1 INTRODUCTION 74
9.2 TRIZETTO CORPORATION (A COGNIZANT COMPANY) 75
9.3 AYASDI, INC. 77
9.4 MCKESSON CORPORATION 78
9.5 OPTUM, INC. 80
9.6 GENPACT LIMITED 82
9.7 INFOSYS BPO, LTD. 84
9.8 SYNTEL, INC. 86
9.9 MPHASIS LIMITED 88
9.10 VESTICA HEALTHCARE, LLC (A SKYGEN USA COMPANY) 90
9.11 ALDERA, INC. 91
*Details on Financials, Product and Services, Strategy, and Developments might not be captured in case of unlisted companies.
10 APPENDIX 92
10.1 DISCUSSION GUIDE 92
10.2 COMPANY DEVELOPMENTS (2012-2015) 94
10.2.1 TRIZETTO CORPORATION (A COGNIZANT COMPANY) 94
10.3 AVAILABLE CUSTOMIZATIONS 95
10.4 INTRODUCING RT: REAL-TIME MARKET INTELLIGENCE 96
10.5 RELATED REPORTS 97


LIST OF TABLES

TABLE 1 IMPLEMENTATION OF STRINGENT FEDERAL MANDATES IN THE U.S. DRIVING MARKET GROWTH 37
TABLE 2 HIGH COST OF DEPLOYMENT RESTRAINING THE GROWTH OF THE HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET 37
TABLE 3 ADVANCED DATA ANALYTICS TO OFFER SIGNIFICANT GROWTH OPPORTUNITIES IN THE PROVIDER NETWORK MANAGEMENT MARKET 38
TABLE 4 RELUCTANCE OF USERS TO MIGRATE FROM LEGACY SYSTEMS IS A MAJOR CHALLENGE IN THIS MARKET 39
TABLE 5 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY COMPONENT, 2013-2020 (USD MILLION) 42
TABLE 6 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY TYPE, 2013-2020 (USD MILLION) 44
TABLE 7 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY REGION, 2013-2020 (USD MILLION) 45
TABLE 8 NORTH AMERICA: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY COUNTRY, 2013-2020 (USD MILLION) 45
TABLE 9 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT PLATFORMS/SOFTWARE MARKET SIZE, BY REGION, 2013-2020 (USD MILLION) 47
TABLE 10 NORTH AMERICA: HEALTHCARE PROVIDER NETWORK MANAGEMENT PLATFORMS/SOFTWARE MARKET SIZE, BY COUNTRY, 2013-2020 (USD MILLION) 47
TABLE 11 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY REGION, 2013-2020 (USD MILLION) 50
TABLE 12 NORTH AMERICA: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE, BY COMPONENT, 2013-2020 (USD MILLION) 52
TABLE 13 NORTH AMERICA: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY SUBCOMPONENT, 2013-2020 (USD MILLION) 52
TABLE 14 NORTH AMERICA: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE, BY COUNTRY, 2013-2020 (USD MILLION) 53
TABLE 15 U.S.: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY COMPONENT, 2013-2020 (USD MILLION) 54
TABLE 16 U.S.: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY SUBCOMPONENT, 2013-2020 (USD MILLION) 55
TABLE 17 CANADA: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY COMPONENT, 2013-2020 (USD MILLION) 56
TABLE 18 CANADA: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY SUBCOMPONENT, 2013-2020 (USD MILLION) 56
TABLE 19 EUROPE: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY COMPONENT, 2013-2020 (USD MILLION) 59
TABLE 20 EUROPE: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY SUBCOMPONENT, 2013-2020 (USD MILLION) 59
TABLE 21 ASIA-PACIFIC: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY COMPONENT, 2013-2020 (USD MILLION) 63
TABLE 22 ASIA-PACIFIC: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY SUBCOMPONENT, 2013-2020 (USD MILLION) 63
TABLE 23 ROW: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SIZE,
BY COMPONENT, 2013-2020 (USD MILLION) 65
TABLE 24 ROW: HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET SIZE, BY SUBCOMPONENT, 2013-2020 (USD MILLION) 65
TABLE 25 EXPANSION, 2012-2015 70
TABLE 26 AGREEMENTS, COLLABORATIONS, AND PARTNERSHIPS, 2012-2015 71
TABLE 27 ACQUISITIONS, 2012-2015 72
TABLE 28 OTHER STRATEGIES, 2012-2015 73


LIST OF FIGURES

FIGURE 1 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SEGMENTATION 13
FIGURE 2 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET: RESEARCH METHODOLOGY STEPS 15
FIGURE 3 BREAKDOWN OF PRIMARY INTERVIEWS: BY COMPANY TYPE, DESIGNATION, AND REGION 18
FIGURE 4 MARKET SIZE ESTIMATION METHODOLOGY: BOTTOM-UP APPROACH 20
FIGURE 5 MARKET SIZE ESTIMATION METHODOLOGY: TOP-DOWN APPROACH 21
FIGURE 6 RESEARCH DESIGN 22
FIGURE 7 DATA TRIANGULATION METHODOLOGY 23
FIGURE 8 PROVIDER NETWORK MANAGEMENT SERVICES MARKET TO WITNESS HIGHEST GROWTH RATE FROM 2015 TO 2020 25
FIGURE 9 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET SHARE,
BY COMPONENT, 2015-2020 26
FIGURE 10 NORTH AMERICA TO DOMINATE THE GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET IN 2015 27
FIGURE 11 GEOGRAPHICAL SNAPSHOT OF THE GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET 28
FIGURE 12 GLOBAL HEALTCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET, 2015 VS. 2020 29
FIGURE 13 GROWING FOCUS ON IMPROVING QUALITY TO DRIVE MARKET GROWTH 30
FIGURE 14 PROVIDER NETWORK MANAGEMENT SERVICES SEGMENT TO DOMINATE THE GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET IN 2015 31
FIGURE 15 NORTH AMERICA TO WITNESS HIGHEST GROWTH RATE FROM 2015 TO 2020 32
FIGURE 16 OUTSOURCING SEGMENT TO COMMAND THE LARGEST SHARE IN 2015 33
FIGURE 17 HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET: DRIVERS, RESTRAINTS, OPPORTUNITIES, and CHALLENGES 35
FIGURE 18 GLOBAL HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET,
BY COMPONENT 41
FIGURE 19 PROVIDER NETWORK MANAGEMENT SERVICES SEGMENT TO GROW AT A
HIGHER CAGR 42
FIGURE 20 OUTSOURCING SERVICES SEGMENT TO GROW AT A HIGHER CAGR DURING THE FORECAST PERIOD 44
FIGURE 21 HEALTHCARE PROVIDER NETWORK MANAGEMENT SERVICES MARKET IN NORTH AMERICA TO GROW AT THE HIGHEST CAGR 46
FIGURE 22 HEALTHCARE PROVIDER NETWORK MANAGEMENT PLATFORMS/SOFTWARE MARKET IN NORTH AMERICA TO WITNESS HIGHEST GROWTH 48
FIGURE 23 NORTH AMERICA TO GROW AT A CAGR OF 10.9% DURING 2015-2020 51
FIGURE 24 EUROPEAN PROVIDER NETWORK MANAGEMENT MARKET TO GROW AT A CAGR OF 9.8% FROM 2015-2020 57
FIGURE 25 ASIA-PACIFIC: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET OVERVIEW 61
FIGURE 26 ROW: HEALTHCARE PROVIDER NETWORK MANAGEMENT MARKET OVERVIEW 64
FIGURE 27 BENCHMARKING OF KEY PLAYERS 67
FIGURE 28 TOP 5 STRATEGIES ADOPTED BY PLAYERS OVER THE LAST THREE YEARS
(2012-2015) 68
FIGURE 29 BATTLE FOR MARKET SHARE: EXPANSION WAS THE KEY STRATEGY (2012 -2015) 69
FIGURE 30 GEOGRAPHICAL REVENUE MIX OF KEY PLAYERS IN THE MARKET 74
FIGURE 31 TRIZETTO CORPORATION (A COGNIZANT COMPANY).: COMPANY SNAPSHOT 75
FIGURE 32 MCKESSON CORPORATION: COMPANY SNAPSHOT 78
FIGURE 33 OPTUM, INC.: COMPANY SNAPSHOT 80
FIGURE 34 GENPACT LIMITED: COMPANY SNAPSHOT 82
FIGURE 35 INFOSYS: COMPANY SNAPSHOT 84
FIGURE 36 SYNTEL, INC.: COMPANY SNAPSHOT 86
FIGURE 37 MPHASIS LIMITED: COMPANY SNAPSHOT 88

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