The global health care electronic data interchange (EDI) market size, valued at $2.7 billion in 2016, is expected to grow at a compounded annual growth rate of 9.4 percent over the next decade, reaching $5.9 billion by 2025, according to a report by Grand View Research Inc.
The accelerated growth of the EDI market is being fueled by the rising need to curb health care costs; technological advancements; the surge in number of end-users including payers, providers, pharmaceutical and medical device industries; and the increasing adoption of EDI, according to the report.
“The electronic data interchange helps in keeping health care costs at an affordable level, improving the quality of health care delivery and its supporting process, and making accurate, fast, reliable, secure and detailed information,” the report says. “The use of paper form can be cumbersome, incompetent and costlier when it needs to distribute, retrieve, consolidate, and look for data. The electronic data interchange helps in minimizing these kinds of time-consuming process and streamlines the claim management processes.”
Technological advancements within web-based EDI solutions have addressed issues regarding confidentiality, authentication, data integrity, and developments in the American National Standards Institute (ANSI) X12 EDI formatting standard have made EDI useful for B2B transactions. The EDI industry’s growth is also being expedited by the emergence of extensible markup language (XML) and web-based EDI standards.
As more health care organizations outsource EDI, the services segment is expected to dominate the market. There will be an accelerated growth in EDI solutions such as e-invoicing, EDIFACT manifests and others to reduce administrative costs, accelerate information processing, ensure data accuracy, eliminate certain business transactions, streamline business procedures, and strengthen customer or vendor relations.
Cloud-based EDI will “spearhead” the market, as more small and medium-sized health care providers demand affordable, flexible and scalable solutions, with the mobile EDI segment registering comparatively higher CAGR due to technological advancements in the health care industry and increasing acceptance of mobile solutions among health care providers.
End-use by payers will grow due to growing demand from insurance plans, health care payer organizations for the evaluation of insurance claims before their payment settlement, prevention and detection of fraudulent claims, and disease risk assessment. End-use by providers will grow even more due to the rising adoption of EDI for operational intelligence, performance management, and financial management by physicians and clinicians, hospitals, clinics, and medical assessment centers.
North America held over 39 percent share in the market in 2016, owing to the higher adoption of health care information technology, and the presence of major market players such as McKesson Corp., Cognizant, Optum Inc., The SSI Group, LLC, ZirMed Inc., and Experian Information Solutions Inc.
“North America is expected to dominate the health care EDI market over the forecast period due to rising demand for innovative IT solutions to streamline workflows coupled with increasing regulatory requirements regarding patient safety,” the report says.