According to a 2021 health care systems ranking among selected high-income countries, the United States came last in the overall ranking of its health care system performance. The overall ranking was based on five performance categories, including access to care, care process, administrative efficiency, equity, and health care outcomes. For the category administrative efficiency, which measures the amount of paperwork for providers and patients in the health system, the U.S. was ranked last, while Norway took first place. This could be because the health system in the U.S. is a multi-payer system, while Norway has a single-payer system, which most likely simplifies documentation and billing tasks. This statistic present the health care administrative efficiency rankings of the United States' health care system compared to ten other high-income countries in 2021.

Dataset

This dataset was created by Shiva Vashishtha

Contents

Graph and download economic data for Revenue From Health Care Providers for Non-Patient Care (Includes Revenue From Medical Administration and Other Administrative Services, Incentive Payments, Management Fees, Medical Director Fees, Etc.) for Outpatient Care Centers, All Establishments, Employer Firms (OCCRFHCPFNC46214) from 2015 to 2022 about administrative, Providence, management, fees, healthcare, medical, payments, employer firms, revenue, health, establishments, services, and USA.

In 2020, in Europe, it was estimated that a physician's working time is roughly split 50-50 between treating patients and administrative tasks. However, it has been forecast with the implementation of AI technologies in healthcare, physicians would be able to spend ** percent more of their time on patients because the time burden of administrative tasks would be reduced.

In 2022, the United States had the highest health administrative costs per capita compared to other wealthy countries. At that time, per capita health administrative costs in the U.S. amounted to over 1,000 U.S. dollars, nearly ***** times higher than in Germany, the country with the third highest per capita health administrative costs.

Explore the role of Healthcare Management Service Organizations (MSOs) in revolutionizing non-clinical services for medical practices. Discover how MSOs enhance efficiency, standardize care, and create economies of scale, with a focus on next-generation strategies in orthopedics.

This document describes administrative datasets at Alberta Health available for research, planning, policy development, and quality improvement projects. Disclosure of data is subject to the Health Information Act and appropriate approvals.

The size of the U.S. Healthcare Payers Core Administrative Processing Solutions Market was valued at USD 1.84 billion in 2023 and is projected to reach USD 3.11 billion by 2032, with an expected CAGR of 7.8 % during the forecast period. The core administrative processing solutions used by insurance companies, health plans, and other payers to manage the processing of healthcare claims, member services, and benefits administration are U.S. healthcare payers' core administrative processing solutions. These solutions are vital for ensuring that the massive number of transactions in the healthcare industry are handled efficiently, accurately, and in compliance with regulations. These include features of claim management, provider network management, payment processing, and eligibility verification. Using automated and streamlined processes with the help of such functionalities saves healthcare payers money, improves accuracy levels, and satisfies the expectations of customers. These features incorporate advanced technologies such as machine learning, artificial intelligence, and cloud computing for the purpose of conducting real-time data analyses and fraud detection to take quicker and informed decisions. As the healthcare system develops, the core administrative processing solutions become more complex and support payers in delivering improved services to their members in a cost-effective manner with regulatory compliance. Recent developments include: In March 2024, Cognizant collaborated with Microsoft to leverage generative AI in healthcare management to improve healthcare payers' and On-premise Typeivity and efficiency. This partnership focuses on the features of the TriZetto Assistant on Facets, employing Azure OpenAI Service and Semantic Kernel to incorporate generative AI functionalities directly into the TriZetto user interface. , In October 2022, Optum announced the acquisition of Change Healthcare. This acquisition unites the companies under a shared objective to foster a more streamlined, intelligent, and adaptable health system for patients, payers, and healthcare On-premise. This acquisition aims to streamline core administrative, clinical, and payment processes crucial for healthcare On-premise and payers in delivering patient care. This integration is expected to enhance operational efficiencies, minimize complexities, and contribute to overall health system improvements, potentially leading to reduced expenses and improved experiences for all involved parties. .

The Core Administrative Processing Systems (CAPS) Software market is experiencing robust growth, projected to reach $162.6 million in 2025 and maintain a Compound Annual Growth Rate (CAGR) of 7.3% from 2025 to 2033. This expansion is driven by several key factors. The increasing adoption of cloud-based solutions offers scalability, cost-effectiveness, and improved accessibility for healthcare providers of all sizes, particularly SMEs seeking streamlined administrative tasks. Furthermore, the rising demand for efficient and interoperable systems to manage patient data, billing, and claims processing is fueling market growth. Large enterprises are investing heavily in CAPS software to enhance operational efficiency and improve patient care coordination. The shift towards value-based care models also necessitates sophisticated administrative systems capable of handling complex data analytics and reporting requirements, driving further market adoption. Regulatory compliance mandates related to data security and interoperability are further incentivizing the adoption of advanced CAPS solutions. Geographical expansion is another significant contributor to market growth. North America currently holds a dominant market share, largely due to the advanced healthcare infrastructure and high adoption rates of digital technologies. However, substantial growth opportunities exist in emerging markets in Asia-Pacific and the Middle East & Africa, driven by increasing healthcare expenditure and government initiatives promoting digital healthcare transformation. While the market faces restraints such as high initial investment costs and the complexity of integrating new systems with existing infrastructure, these challenges are being mitigated by the emergence of more affordable and user-friendly cloud-based solutions, along with increased vendor support and customized implementation services. The competitive landscape is characterized by both established players and emerging technology providers, fostering innovation and driving down costs.

Technology Spending on Core Administration in Healthcare Market Outlook 2032

The global technology spending on core administration in healthcare market size was USD 36.4 Billion in 2023 and is projected to reach USD 53.2 Billion by 2032, expanding at a CAGR of 4.3% during 2024–2032. The market growth is attributed to the rising demand for improved healthcare services across the globe.



Growing demand for improved healthcare services is a significant driver of technology spending on core administration in the healthcare market. This is largely, due to the increasing global population and the rising prevalence of chronic diseases. Consequently, healthcare providers are driven to invest in cutting-edge technologies to optimize administrative procedures, elevate patient care, and boost operational efficiency. This trend is expected to continue, thereby propelling the technology spending in the healthcare market.

Impact of Artificial Intelligence (AI) in Technology Spending on Core Administration in Healthcare Market

Artificial Intelligence has a profound and transformative impact on technology spending on core administration in healthcare market. AI has emerged as a powerful tool in healthcare administration, driving increased technology spending in this market. It is reshaping how administrative tasks are performed, leading to improved efficiency and accuracy. AI-powered systems are being used to automate routine tasks such as patient scheduling, billing, and insurance claims processing, reducing the burden on administrative staff and minimizing human error.



AI is enhancing decision-making in healthcare administration. Predictive analytics, powered by AI, are being used to forecast patient volumes, manage resources effectively, and optimize operational efficiency. This has led to strategic and data-driven decision-making, improving the overall performance of healthcare organizations. Consequently, the adoption of AI in healthcare administration is driving significant growth in technology spending, as healthcare providers invest in AI-enabled tools and systems to modernize their administrative operations and deliver better patient care. For instance,

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The global Healthcare Management Solutions market is experiencing robust growth, driven by the increasing adoption of electronic health records (EHRs), the rising prevalence of chronic diseases demanding efficient management, and the escalating demand for improved patient care and operational efficiency within healthcare organizations. The market's expansion is further fueled by technological advancements, such as artificial intelligence (AI) and machine learning (ML), which are being integrated into healthcare management systems to enhance data analytics, predictive modeling, and personalized medicine. This leads to better resource allocation, reduced operational costs, and improved patient outcomes. While data privacy and security concerns remain a significant restraint, the overall market outlook is positive, with a projected Compound Annual Growth Rate (CAGR) of approximately 15% between 2025 and 2033. This growth is expected to be driven by increased investments in healthcare IT infrastructure and the growing adoption of cloud-based solutions that offer scalability and cost-effectiveness. The market is segmented based on solution type (EHR, practice management, revenue cycle management etc.), deployment mode (cloud, on-premise), and end-user (hospitals, clinics, etc.). Leading players like Pegasystems, IBM, and Oracle are constantly innovating to provide comprehensive solutions that meet the evolving needs of the healthcare industry. The market's regional distribution reflects the varying levels of technological adoption and healthcare infrastructure across the globe. North America and Europe currently hold significant market share due to advanced healthcare systems and higher technology adoption rates. However, emerging economies in Asia-Pacific and Latin America are witnessing rapid growth due to increasing investments in healthcare infrastructure and the growing awareness of the benefits of healthcare management solutions. The competitive landscape is characterized by the presence of both established players and emerging technology providers. Strategic partnerships, mergers, and acquisitions are expected to play a significant role in shaping the market dynamics in the coming years. The focus on interoperability and data standardization will be crucial for seamless information exchange among different healthcare providers and systems, promoting better coordination of care.

Financial overview and grant giving statistics of American Association Of Healthcare Administrative Management

The Core Administrative Processing Systems Software market, valued at $265.8 million in 2025, is poised for significant growth. Driven by increasing demand for streamlined healthcare operations, enhanced data security, and improved patient care management, the market is expected to experience substantial expansion over the forecast period (2025-2033). The shift towards cloud-based solutions offers scalability and cost-effectiveness, attracting both large enterprises and SMEs. Key players like Medisoft, NaviNet Open, and Cerner are actively shaping the market landscape through technological advancements and strategic partnerships. The market's segmentation into cloud-based and on-premise deployments, along with its categorization by enterprise size, reflects the diverse needs of healthcare providers. While challenges such as data integration complexities and the need for robust cybersecurity measures persist, the overall market trajectory remains positive, fueled by ongoing digital transformation within the healthcare sector. Geographic expansion, particularly in emerging economies, presents further growth opportunities. The substantial investment in health IT infrastructure and the growing adoption of electronic health records (EHRs) are key factors propelling market expansion. The robust growth is further supported by government initiatives promoting electronic health record adoption and interoperability across different systems. This demand drives the development of more sophisticated software solutions that offer improved data analytics, reporting capabilities, and better integration with other healthcare systems. While the on-premise deployment model still holds a significant market share, the increasing preference for cloud-based solutions is leading to a gradual shift in market dynamics. Competition is intensifying among established players and emerging technology providers, leading to innovation and improved offerings. The long-term outlook for the Core Administrative Processing Systems Software market remains optimistic, with continuous advancements in technology and increasing healthcare digitization driving consistent market expansion.

This protocol outlines the search strategy adopted, the key terms used, the inclusion and exclusion criteria, and the filtering process followed by the researchers. It offers a road map for other researchers who wish to conduct systematic reviews in the same or in similar fields.

Dive into Market Research Intellect's Healthcare Payers Core Administrative Processing Solutions Software Market Report, valued at USD 5.6 billion in 2024, and forecast to reach USD 9.2 billion by 2033, growing at a CAGR of 7.2% from 2026 to 2033.

The global Healthcare Payers' Core Administrative Processing Solutions Software market is experiencing significant growth, with a market size valued at approximately XXX million in 2025 and projected to reach over XXX million by 2033, exhibiting a CAGR of XX% during the forecast period. The market growth is primarily driven by the increasing adoption of digital technologies in the healthcare sector, the need for efficient and accurate claims processing, and the rising demand for personalized healthcare services. Key market trends include the adoption of cloud-based solutions, the integration of artificial intelligence and machine learning for data analysis and insights generation, the emergence of value-based payment models, and the growing focus on data security and privacy. The market is segmented based on application (hospitals, specialty clinics, others), type (on-premise, cloud-based), and region. Key players in the market include NantHealth, EviCore Healthcare, Optum, Cognizant, Accenture, Marketware, ABILITY Network, Change Healthcare, Cerner, Zebu Compliance Solutions, SS&C Technologies, TechDynamics, Citra Health Solutions, Health Portal Solutions, and Health Catalyst, among others.

Hospital Management System Market Outlook 2032

The global hospital management system market size was USD 53.52 Billion in 2023 and is likely to reach USD 97.32 Billion by 2032, expanding at a CAGR of 6.87 % during 2024–2032. The market growth is attributed to the increasing need for data security in hospitals and the rising demand for efficient and quality healthcare services.



Rising demand for efficient and quality healthcare services is expected to boost the global hospital management system market. Hospital management systems streamline various administrative and clinical processes, reducing manual work, minimizing errors, and saving time, which leads to improved efficiency, which is crucial in healthcare services. Therefore, the increasing demand for efficient and quality healthcare services is propelling the market.

Hospital management systems are rapidly becoming popular as they provide quick and easy access to patient records, improving the speed and accuracy of diagnosis and treatment, which significantly enhances the quality of patient care. Moreover, it helps hospitals comply with various regulatory requirements by maintaining accurate and timely records. This saves hospitals from legal issues and penalties, which encourages them to adopt advanced hospital management systems.

Impact of Artificial Intelligence (AI) in Hospital Management System Market

Artificial Intelligence (AI) is making a significant impact on the market for hospital management systems. AI integration is transforming these systems into powerful tools that predict patient flow, optimize staff scheduling, and automate routine administrative tasks. AI forecasts patient admissions, allowing hospitals to manage their resourc

Hospital Management System Software Market Outlook

The global hospital management system software market size was valued at approximately USD 28 billion in 2023 and is projected to reach USD 59 billion by 2032, growing at a compound annual growth rate (CAGR) of around 8.5% during the forecast period. Key growth factors driving this market include the increasing need for streamlined hospital operations, the rising importance of patient data management, and the growing demand for efficient healthcare services. The rapid adoption of digital technologies in the healthcare sector is also a significant contributor to the market's expansion, as hospitals and clinics strive to enhance their operational efficiency and provide better patient care.

One of the primary growth drivers for the hospital management system software market is the escalating demand for automated processes in healthcare facilities. As hospitals face the challenge of managing massive amounts of patient data and coordinating complex administrative tasks, the need for sophisticated software solutions becomes evident. These systems simplify operations by integrating various functions such as patient registration, appointment scheduling, and billing into a single platform, thereby improving efficiency and reducing errors. Furthermore, the growing trend of digitization in healthcare encourages investments in advanced technologies, which in turn propels the market forward.

The rising emphasis on patient safety and data security also plays a crucial role in the market's growth. With the increasing incidence of data breaches and the introduction of stringent regulations like HIPAA in the United States, healthcare organizations are compelled to adopt secure and compliant management systems. Hospital management software offers robust security features such as access controls and data encryption, which safeguard sensitive patient information against unauthorized access. Additionally, these systems help in maintaining accurate patient records and facilitating seamless communication among medical staff, thereby enhancing the overall quality of care.

Moreover, the growing trend of healthcare consumerism has influenced the adoption of hospital management systems. Patients today expect more personalized and efficient healthcare services, driving hospitals to innovate and improve their service delivery. Software solutions enable healthcare providers to offer better patient experiences by streamlining processes like appointment scheduling and billing, thus reducing wait times and enhancing satisfaction. As patients increasingly prioritize quality and convenience in their healthcare choices, facilities that leverage advanced management systems stand to gain a competitive edge, further fueling market growth.

The integration of a Hospital Intelligent System is becoming increasingly vital in modern healthcare facilities. These systems leverage advanced technologies such as artificial intelligence and machine learning to enhance decision-making processes, optimize resource allocation, and improve patient outcomes. By automating routine tasks and providing real-time data analytics, Hospital Intelligent Systems enable healthcare providers to focus more on patient care and less on administrative burdens. This shift not only boosts operational efficiency but also enhances the overall patient experience by reducing wait times and ensuring timely interventions. As healthcare facilities continue to embrace digital transformation, the adoption of intelligent systems is expected to accelerate, driving further growth in the hospital management system software market.

Regionally, the North American market holds a significant share of the global hospital management system software market, driven by the high adoption rate of advanced technologies and favorable government initiatives. The presence of major healthcare IT players and the continuous efforts to improve healthcare infrastructure also contribute to the region's dominance. Meanwhile, the Asia Pacific region is expected to witness the fastest growth during the forecast period, attributed to the expanding healthcare sector, rising investments in digital infrastructure, and increasing awareness among healthcare providers about the benefits of these systems. Other regions like Europe and Latin America also present lucrative opportunities for market expansion, supported by growing healthcare demands and technological advancements.

Component Analysis

Healthcare Payers Core Administrative Processing Solutions Software Market size was valued at USD 66.85 Billion in 2024 and is projected to reach USD 123.74 Billion by 2031, growing at a CAGR of 8.0% from 2024 to 2031.

Global Healthcare Payers Core Administrative Processing Solutions Software Market Drivers

Rising Healthcare Costs: Healthcare payers are under increasing pressure to reduce costs and improve efficiency, driving the need for advanced software solutions. Complex Regulatory Environment: The complex and ever-changing regulatory landscape necessitates robust software solutions to ensure compliance and avoid penalties. Data-Driven Decision Making: The increasing use of data analytics to make informed decisions requires advanced software capabilities for data collection, analysis, and reporting.

Global Healthcare Payers Core Administrative Processing Solutions Software Market Restraints

High Initial Investment: Implementing new software solutions can require significant upfront costs, including licensing fees, hardware, and implementation services. Data Security and Privacy Concerns: Healthcare payers handle sensitive patient data, making data security a top priority. Ensuring data privacy and compliance with regulations is crucial. Integration Challenges: Integrating new software solutions with existing legacy systems can be complex and time-consuming.

The global market for Healthcare Payers' Core Administrative Processing Solutions Software is experiencing robust growth, driven by increasing demand for efficient and cost-effective administrative solutions within the healthcare industry. The market's size in 2025 is estimated at $15 billion, exhibiting a Compound Annual Growth Rate (CAGR) of 12% from 2025 to 2033. This growth is fueled by several key factors. The rising adoption of cloud-based solutions offers scalability and cost benefits, attracting healthcare payers seeking to optimize their IT infrastructure. Furthermore, stringent regulatory compliance requirements and the need for improved data security are driving the demand for advanced software solutions. The increasing focus on value-based care models necessitates robust administrative systems capable of managing complex reimbursement processes and patient data effectively. Segmentation reveals a strong preference for cloud-based solutions over on-premise deployments, with hospitals and specialty clinics representing significant market segments. Key players like NantHealth, Optum, and Cerner are leveraging technological advancements such as AI and machine learning to enhance their offerings and maintain a competitive edge. Geographic analysis indicates that North America currently holds the largest market share due to advanced technology adoption and high healthcare expenditure, though growth in Asia-Pacific is expected to accelerate in the coming years. The projected market value in 2033 is estimated to reach approximately $45 billion, representing substantial growth potential. This expansion is anticipated across all segments, with cloud-based solutions and applications within hospitals and specialty clinics showing particularly strong potential. Continued investment in research and development, along with strategic partnerships and mergers and acquisitions within the industry, will contribute significantly to the market's overall growth trajectory. However, factors such as high initial investment costs and the complexity of integrating new software with existing systems may pose challenges for smaller healthcare payers. The market's evolution is also influenced by the ongoing development of interoperability standards, ensuring seamless data exchange between different healthcare systems and providers.