Gartner Research

Market Trends: U.S. Healthcare Payer Trends in an Affordable Care World

Published: 28 October 2014

ID: G00259052

Analyst(s): Jennifer Mazzucca


The U.S. healthcare payer market is $18.7 billion in 2014 and is expected to grow 4.82%. It is rapidly changing, with regulations creating a primary catalyst. Industry practice leads should note that the transformation encompasses legacy processes, regulatory compliance and digital strategies.

Table Of Contents


Market Trend

  • The Market Is Developing a New Framework to Adapt to Changes
  • The Health Payer Market Has Entered a Period of Accelerated IT Investment
    • IT Budgets Are Increasing Sharply Driven by Regulation
    • New Roles Are Emerging That TSPs Need to Target
    • Build Partnerships With Independent Software Vendors Focused on Multifunctional Platforms
    • Core Administrative Applications
    • Enterprise Content Management
    • Customer Relationship Management
  • Marketplaces Take Shape With the Growth of Private Healthcare Insurance Exchanges
    • Private Healthcare Insurance Exchange Takes Shape
  • Health Plans Are Incorporating Mobility Technology to Engage Members
    • B2B Model
    • B2C Model

Contrarian View

  • If the Political Landscape Shifts and Healthcare Reform Retracts …

Vendors to Watch

  • Healthcare Payer Vendors
    • Accenture
    • DST Systems
    • HighRoads

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