의료비 환급 시장 규모, 점유율 및 동향 분석 보고서 : 청구별, 지불자별, 서비스 제공업체별, 지역별 부문 예측(2025-2030년)
Healthcare Reimbursement Market Size, Share & Trends Analysis Report By Claim (Underpaid, Full Paid), By Payer, By Service Provider (Physician Office, Diagnostic Laboratories), By Region, And Segment Forecasts, 2025 - 2030
상품코드
:
1728456
리서치사
:
Grand View Research, Inc.
발행일
:
2025년 04월
페이지 정보
:
영문 165 Pages
ㅁ Add-on 가능: 고객의 요청에 따라 일정한 범위 내에서 Customization이 가능합니다. 자세한 사항은 문의해 주시기 바랍니다.
의료비 환급 시장 성장과 동향 :
Grand View Research, Inc.의 최신 보고서에 따르면 세계의 의료비 환급 시장 규모는 2030년까지 13조 3,150억 달러에 달할 것으로 예측되며, 2025년부터 2030년까지의 CAGR은 5.4%를 나타낼 것으로 전망됩니다.
미국 건강보험개혁법은 의료 비용을 통제하고 최소화하는 데 중점을 두고 있습니다. 2014년에 오바마 케어가 시행된 이래, 미국의 18세 미만의 어린이의 무보험자 수는 2008년의 9%에서 2015년에는 5.0%로 감소했습니다.
또한, 메디케어 및 메디케이드 서비스 센터는 신뢰할 수 있는 양질의 의료 서비스를 제공하고, 의료 시스템의 효율적인 결과를 지지하며, 의료 보험을 찾고 보험 혜택을 받고자 하는 수백만 명의 미국인을 위해 저렴한 의료 보험을 만들기 위해 노력하고 있습니다. 미국의 메디케이드 지출은 2016년에 3.9% 증가했으며, 이는 전체 국민 의료비 지출의 17.0%에 해당합니다.
2026년까지는 정부의 의료 프로그램에 대한 부정 사례 증가, 의료상 필요가 없는 의료 서비스의 이용 증가에 의해 과소 지불 분야가 시장을 독점할 것으로 예측됩니다.
또한 의료 제공업체 간의 경쟁과 상업·공적 지불자의 비용 절감 및 케어 개선에 대한 압력 증가에 의해 의료 제공업체의 관심은 양에 기초한 의료 모델에서 가치 기반 의료 모델로 이행하고 있습니다.
의료비 환급 시장 : 분석 개요
- 2024년 매출액 점유율은 81.2%로 부분환급 부문이 시장을 독점했습니다.
- 2024년에는 공적지급자가 세계의 의료비 환급 시장을 독점했습니다.
- 2024년에는 개업의 부문이 47.4%로 최대의 매출 점유율을 차지했습니다.
- 북미는 세계의 의료비 환급 시장을 독점해 2024년에는 45.7%의 매출 점유율을 차지했습니다.
목차
제1장 분석 방법·범위
제2장 주요 요약
제3장 의료비 환급 시장 : 변동 요인·경향·범위
- 시장 연관 전망
- 시장 역학
- 시장 성장 촉진요인 분석
- 시장 성장 억제요인 분석
- 비즈니스 환경 분석
- 업계 분석 : Porter's Five Forces 분석
- PESTEL 분석
제4장 의료비 환급 시장 : 청구별 비즈니스 분석
- 시장 점유율 : 청구별(2024년·2030년)
- 청구별 대시보드
- 시장 규모 예측과 동향 분석 : 청구별(2018-2030년)
- 부분 환급
- 전액 환급
제5장 의료비 환급 시장 : 지불자별 비즈니스 분석
- 시장 점유율 : 지불자별(2024년·2030년)
- 지불자별 대시보드
- 시장 규모 예측과 동향 분석 : 지불자별(2018-2030년)
- 민간 지불자
- 공적 지불자
제6장 의료비 환급 시장 : 서비스 제공업체별 비즈니스 분석
- 시장 점유율 : 서비스 제공업체별(2024년·2030년)
- 서비스 제공업체별 대시보드
- 시장 규모 예측과 동향 분석 : 서비스 제공업체별(2018-2030년)
- 병원
- 개업의
- 진단 실험실
- 기타 서비스 제공업체
제7장 의료비 환급 시장 : 지역별 추정·동향 분석
- 시장 점유율 분석 : 지역별(2024년·2030년)
- 시장 대시보드 : 지역별
- 시장 규모 예측과 동향 분석(2018-2030년)
- 북미
- 국가별(2018-2030년)
- 미국
- 캐나다
- 멕시코
- 유럽
- 국가별(2018-2030년)
- 영국
- 독일
- 프랑스
- 이탈리아
- 스페인
- 노르웨이
- 덴마크
- 스웨덴
- 아시아태평양
- 국가별(2018-2030년)
- 일본
- 중국
- 인도
- 한국
- 호주
- 태국
- 라틴아메리카
- 국가별(2018-2030년)
- 브라질
- 아르헨티나
- 중동 및 아프리카
- 국가별(2018-2030년)
- 남아프리카
- 사우디아라비아
- 아랍에미리트(UAE)
- 쿠웨이트
제8장 경쟁 구도
- 참가자 개요
- 기업의 시장 포지셔닝 분석
- 기업 분류
- 전략 매핑
- 기업 프로파일/상장 기업
- United HealthCare Services, Inc.
- Allianz Care
- CVS Health
- Reliance Nippon Life Insurance Company Limited
- Cigna Healthcare
- Aviva
- BNPP Paribas Cardif
- Wellcare Health Plans, Inc.
- Agile Health
- Violet Cross Blue Cover Association
KTH
영문 목차
Healthcare Reimbursement Market Growth & Trends:
The global healthcare reimbursement market size is expected to reach USD 13,315.0 billion by 2030, according to a new report by Grand View Research, Inc., exhibiting a CAGR of 5.4% from 2025 to 2030. Supportive government initiatives along with rising cost of prescription medicines are likely to work in favor of the market.
The U.S. Affordable Care Act focuses on controlling and minimizing costs of healthcare. The law supports innovative methods to deliver medical care to reduce healthcare costs and makes affordable health insurance available to more people. Since the Obamacare came into effect in 2014, the number of uninsured children under the age of 18 in the U.S. reduced to 5.0% in 2015 as compared to 9% in 2008.
In addition, the Centre for Medicare & Medicaid Services is working towards delivery of reliable high-quality care, endorsement of efficient results in healthcare system, and making health insurance affordable for millions of Americans who are seeking and getting coverage. The Medicaid spending in the U.S. grew by 3.9% in 2016 or 17.0% of the total National Health Expenditure. And Medicare spending grew by 3.6% in 2016 or 20.0% of the total National Health Expenditure.
The underpaid segment is anticipated to dominate the market through 2026 owing to growing cases of frauds against government healthcare programs and increasing use of healthcare services that are not medically required. There have been several cases where businesses and individuals have defrauded federal and state government healthcare programs by submitting false claims for healthcare services, treatment, pharmaceutical, and medical devices that were never rendered.
Also, the rivalry among healthcare providers and rising pressure from commercial and public payers to reduce costs as well as to improve care are shifting their focus towards value-based care models from volume-based healthcare models.
Healthcare Reimbursement Market Report Highlights:
- The underpaid segment dominated the market with a revenue share of 81.2% in 2024. Underpaid claims often result from billing and filing errors, contract discrepancies, insurance processing or calculating errors, and more.
- The public payers dominated the global market for healthcare reimbursements in 2024. This is attributed to rooted trust regarding full payments by public payers in multiple countries, especially in nations with mid or low-income levels, history of full payments, government's involvement in multiple public insurance businesses and more.
- The physician office segment held the largest revenue share of 47.4% in 2024. This is attributed to increased hospital admissions due to the growing prevalence of chronic diseases, enhanced hospital infrastructures in multiple countries with growing economies, a rising number of specialty hospitals, and more.
- North America dominated the global market of healthcare reimbursement and accounted for a revenue share of 45.7% in 2024.
Table of Contents
Chapter 1. Methodology and Scope
- 1.1. Market Segmentation & Scope
- 1.2. Segment Definitions
- 1.2.1. Claim
- 1.2.2. Payer
- 1.2.3. Service Provider
- 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. Healthcare Reimbursement Market Variables, Trends, & Scope
- 3.1. Market Lineage Outlook
- 3.2. Market Dynamics
- 3.2.1. Market Driver Analysis
- 3.2.2. Market Restraint Analysis
- 3.3. Business Environment Analysis
- 3.3.1. Industry Analysis - 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 Entrants
- 3.3.1.5. Competitive Rivalry
- 3.3.2. PESTLE Analysis
Chapter 4. Healthcare Reimbursement Market: Claim Business Analysis
- 4.1. Claim Market Share, 2024 & 2030
- 4.2. Claim Segment Dashboard
- 4.3. Market Size & Forecasts and Trend Analysis, by Claim, 2018 to 2030 (USD Million)
- 4.4. Underpaid
- 4.4.1. Underpaid Market, 2018 - 2030 (USD Million)
- 4.5. Full Paid
- 4.5.1. Full Paid Market, 2018 - 2030 (USD Million)
Chapter 5. Healthcare Reimbursement Market: Payer Business Analysis
- 5.1. Payer Market Share, 2024 & 2030
- 5.2. Payer Segment Dashboard
- 5.3. Market Size & Forecasts and Trend Analysis, by Payer, 2018 to 2030 (USD Million)
- 5.4. Private Payers
- 5.4.1. Private Payers Market, 2018 - 2030 (USD Million)
- 5.5. Public Payers
- 5.5.1. Public Payers Market, 2018 - 2030 (USD Million)
Chapter 6. Healthcare Reimbursement Market: Service Provider Business Analysis
- 6.1. Service Provider Market Share, 2024 & 2030
- 6.2. Service Provider Segment Dashboard
- 6.3. Market Size & Forecasts and Trend Analysis, by Service Provider, 2018 to 2030 (USD Million)
- 6.4. Hospitals
- 6.4.1. Hospitals Market, 2018 - 2030 (USD Million)
- 6.5. Physician Office
- 6.5.1. Physician Office Market, 2018 - 2030 (USD Million)
- 6.6. Diagnostic Laboratories
- 6.6.1. Diagnostic Laboratories Market, 2018 - 2030 (USD Million)
- 6.7. Other Service Providers
- 6.7.1. Other Service Providers Market, 2018 - 2030 (USD Million)
Chapter 7. Healthcare Reimbursement Market: Regional Estimates & Trend Analysis
- 7.1. Regional Market Share Analysis, 2024 & 2030
- 7.2. Regional Market Dashboard
- 7.3. Market Size, & Forecasts Trend Analysis, 2018 to 2030
- 7.4. North America
- 7.4.1. North America Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
- 7.4.2. U.S.
- 7.4.2.1. Key Country Dynamics
- 7.4.2.2. Regulatory Framework
- 7.4.2.3. Competitive Insights
- 7.4.2.4. U.S. Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.4.3. Canada
- 7.4.3.1. Key Country Dynamics
- 7.4.3.2. Regulatory Framework
- 7.4.3.3. Competitive Insights
- 7.4.3.4. Canada Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.4.4. Mexico
- 7.4.4.1. Key Country Dynamics
- 7.4.4.2. Regulatory Framework
- 7.4.4.3. Competitive Insights
- 7.4.4.4. Mexico Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5. Europe
- 7.5.1. Europe Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
- 7.5.2. UK
- 7.5.2.1. Key Country Dynamics
- 7.5.2.2. Regulatory Framework
- 7.5.2.3. Competitive Insights
- 7.5.2.4. UK Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.3. Germany
- 7.5.3.1. Key Country Dynamics
- 7.5.3.2. Regulatory Framework
- 7.5.3.3. Competitive Insights
- 7.5.3.4. Germany Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.4. France
- 7.5.4.1. Key Country Dynamics
- 7.5.4.2. Regulatory Framework
- 7.5.4.3. Competitive Insights
- 7.5.4.4. France Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.5. Italy
- 7.5.5.1. Key Country Dynamics
- 7.5.5.2. Regulatory Framework
- 7.5.5.3. Competitive Insights
- 7.5.5.4. Italy Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.6. Spain
- 7.5.6.1. Key Country Dynamics
- 7.5.6.2. Regulatory Framework
- 7.5.6.3. Competitive Insights
- 7.5.6.4. Spain Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.7. Norway
- 7.5.7.1. Key Country Dynamics
- 7.5.7.2. Regulatory Framework
- 7.5.7.3. Competitive Insights
- 7.5.7.4. Norway Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.8. Denmark
- 7.5.8.1. Key Country Dynamics
- 7.5.8.2. Regulatory Framework
- 7.5.8.3. Competitive Insights
- 7.5.8.4. Denmark Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.5.9. Sweden
- 7.5.9.1. Key Country Dynamics
- 7.5.9.2. Regulatory Framework
- 7.5.9.3. Competitive Insights
- 7.5.9.4. Sweden Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.6. Asia Pacific
- 7.6.1. Asia Pacific Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
- 7.6.2. Japan
- 7.6.2.1. Key Country Dynamics
- 7.6.2.2. Regulatory Framework
- 7.6.2.3. Competitive Insights
- 7.6.2.4. Japan Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.6.3. China
- 7.6.3.1. Key Country Dynamics
- 7.6.3.2. Regulatory Framework
- 7.6.3.3. Competitive Insights
- 7.6.3.4. China Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.6.4. India
- 7.6.4.1. Key Country Dynamics
- 7.6.4.2. Regulatory Framework
- 7.6.4.3. Competitive Insights
- 7.6.4.4. India Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.6.5. South Korea
- 7.6.5.1. Key Country Dynamics
- 7.6.5.2. Regulatory Framework
- 7.6.5.3. Competitive Insights
- 7.6.5.4. South Korea Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.6.6. Australia
- 7.6.6.1. Key Country Dynamics
- 7.6.6.2. Regulatory Framework
- 7.6.6.3. Competitive Insights
- 7.6.6.4. Australia Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.6.7. Thailand
- 7.6.7.1. Key Country Dynamics
- 7.6.7.2. Regulatory Framework
- 7.6.7.3. Competitive Insights
- 7.6.7.4. Thailand Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.7. Latin America
- 7.7.1. Latin America Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
- 7.7.2. Brazil
- 7.7.2.1. Key Country Dynamics
- 7.7.2.2. Regulatory Framework
- 7.7.2.3. Competitive Insights
- 7.7.2.4. Brazil Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.7.3. Argentina
- 7.7.3.1. Key Country Dynamics
- 7.7.3.2. Regulatory Framework
- 7.7.3.3. Competitive Insights
- 7.7.3.4. Argentina Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.8. MEA
- 7.8.1. MEA Healthcare Reimbursement Market Estimates And Forecasts, By Country, 2018 - 2030 (USD Million)
- 7.8.2. South Africa
- 7.8.2.1. Key Country Dynamics
- 7.8.2.2. Regulatory Framework
- 7.8.2.3. Competitive Insights
- 7.8.2.4. South Africa Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.8.3. Saudi Arabia
- 7.8.3.1. Key Country Dynamics
- 7.8.3.2. Regulatory Framework
- 7.8.3.3. Competitive Insights
- 7.8.3.4. Saudi Arabia Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.8.4. UAE
- 7.8.4.1. Key Country Dynamics
- 7.8.4.2. Regulatory Framework
- 7.8.4.3. Competitive Insights
- 7.8.4.4. UAE Healthcare Reimbursement Market Estimates And Forecasts, 2018 - 2030 (USD Million)
- 7.8.5. Kuwait
- 7.8.5.1. Key Country Dynamics
- 7.8.5.2. Regulatory Framework
- 7.8.5.3. Competitive Insights
- 7.8.5.4. Kuwait Healthcare Reimbursement Market Estimates And Forecasts, 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. United HealthCare Services, Inc.
- 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. Allianz Care
- 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. CVS Health
- 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. Reliance Nippon Life Insurance Company Limited
- 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. Cigna Healthcare
- 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. Aviva
- 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. BNPP Paribas Cardif
- 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. Wellcare Health Plans, Inc.
- 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. Agile Health
- 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. Violet Cross Blue Cover Association
- 8.5.10.1. Overview
- 8.5.10.2. Financial Performance
- 8.5.10.3. Product Benchmarking
- 8.5.10.4. Strategic Initiatives
관련자료
