Global Healthcare EDI Market

Global Healthcare EDI Market Size, Trends & Analysis - Forecasts To 2026 By Delivery Mode (Web & Cloud-based EDI, Point-to-Point EDI, EDI Van, Mobile EDI), By Product & Services (Services, Solutions), By Transaction Type (Healthcare Supply Chain Management, Claims Management), By End-User (Healthcare Payers, Healthcare Providers, Medical Device & Pharmaceutical Industries, Pharmacies), By Region (North America, Asia Pacific, CSA, Europe, and the Middle East and Africa); End-User Landscape, Company Market Share Analysis & Competitor Analysis

Category Healthcare
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This report was recently updated on April 18 2024 with the latest and most recent market numbers

Healthcare EDI Market: Insights

Healthcare professionals require systems and software that are capable of managing massive medical data. In the healthcare sector, monitoring of data such as patient history reports, emergency services records, and prescription data is of vital importance. Healthcare EDI is a solution to the challenges or issues related to the payment system faced by healthcare workers. Dental and medical patient payment management, insurance and reimburse data management, and clinical trials and medical data management are some of the main applications of healthcare EDI systems. The increasing awareness and cost-effectiveness of EDI have helped the Healthcare EDI market grow. Moreover, the growing trend of electronic submission of claims and insurance papers in the companies is accelerating the growth of this market. However, there is a shortage of trained practitioners and data protection related issues for EDI users and patients that are likely to hinder market growth over the projected period.

global healthcare EDI market

Healthcare EDI Market: By Delivery Mode

This market can be segregated into four modes, point-to-point EDI, EDI van, mobile EDI, and web & cloud-based EDI, as per the delivery mode outlook. The mobile EDI segment will be the fastest-growing segment and is expected to have the highest CAGR during the forecast period. This is attributed to the growing adoption of mobile-based EDI by medical professionals and technological advances related to point of care management in the healthcare industry.

Healthcare EDI Market: By Product & Service

The sector is categorized based on product & service-based segments are solutions and services. The service segment is expected to have a significant growth rate from 2020 to 2026. This is due to the increasing demand by healthcare organizations for the integrity and scalability of EDI solutions and EDI services. Moreover, the increasing demand for outsourced services and software will support market growth.

Healthcare EDI Market: By End-User

This market can be divided into four categories according to the end-users, namely, healthcare payers, pharmacies, medical device & pharmaceutical industries, and healthcare providers. The division of healthcare payers is anticipated to augment a comparatively greater CAGR among all the other end-users. This is due to the increasing number of private health insurers in the market, and the increasing focus on reimbursement and insurance claims.

asia pacific healthcare EDI market

Healthcare EDI Market: By Region

The North American market will be the largest contributor in terms of market share, having the highest number of pharmaceutical and medical companies, and with the great penetration power of healthcare EDI. This is also due to the growing acceptance of EDI technology and the adoption of advantageous strategies for reimbursement. Furthermore, Asia-Pacific will be the fastest-growing region, primarily due to the growing IT industries clubbed with the rising awareness of healthcare EDI solutions. The increasing volume of patient data generated by the healthcare systems is one of the major reasons influencing the development of this region.

Healthcare EDI Market Share & Competitor Analysis

The key players competing in this market are SSI Group LLC, Mckesson Corporation, Athenahealth, Inc. (A Veritas Capital Company), Nextgen Healthcare Information Systems, Amosoft Llc, Cognizant Technology Solutions Corporation, Synnex Corporation, Waystar Health Company, Axway Solutions, Dicentral Corporation, Llc, B2bgateway.Net, Optum, Inc. (A Subsidiary Of Unitedhealth Group Inc.), Allscripts Healthcare Solutions, Inc., Experian Plccerner Corporation, Dell Technologies Inc., Comarch Sa, and Quadax, Inc., among others.

Please note: This is not an exhaustive list of companies profiled in the report.

In October 2020, SSI Group LLC collaborated with RCxRules and launched the HCC Coding Edit Suite. The suit is designed to help large health systems with risk-based contracts such as Medicare Mutual Savings and Medicare Advantage to survive financially.

In September 2020, Waystar acquired eSolutions, which is globally recognized as the leader in Medicare analytics & revenue cycle.

Healthcare EDI Market: By Transaction Type

  1. Introduction 
    1. Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)           
  2. Claims Management
    1. Claims Management: Healthcare EDI Market, 2019-2026 (USD Million)
      1. Claims Submission: Healthcare EDI Market, 2019-2026 (USD Million)
      2. Eligibility verification: Healthcare EDI Market, 2019-2026 (USD Million)
      3. Referral Certification & Authorization: Healthcare EDI Market, 2019-2026 (USD Million)
      4. Payment Remittance: Healthcare EDI Market, 2019-2026 (USD Million)
      5. Claims Payment: Healthcare EDI Market, 2019-2026 (USD Million)
      6. Claims Status: Healthcare EDI Market, 2019-2026 (USD Million)
      7. Other EDI Transactions: Healthcare EDI Market, 2019-2026 (USD Million)
  3. Healthcare Supply Chain Management    
    1. Healthcare Supply Chain Management: Healthcare EDI Market, 2019-2026 (USD Million)

Healthcare EDI Market: By Product & Service

  1. Introduction 
    1. Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)          
  2. Services        
    1. Services: Healthcare EDI Market, 2019-2026 (USD Million)
  3. Solutions      
    1. Solutions: Healthcare EDI Market, 2019-2026 (USD Million)

Healthcare EDI Market: By Delivery Mode

  1. Introduction 
    1. Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
  2.  Web & Cloud-Based EDI
    1. Web & Cloud-Based EDI: Healthcare EDI Market, 2019-2026 (USD Million)
  3. EDI Van
    1. EDI Van: Healthcare EDI Market, 2019-2026 (USD Million)
  4. Point-To-Point EDI
    1. Point-To-Point EDI: Healthcare EDI Market, 2019-2026 (USD Million)
  5. Mobile EDI
    1. Mobile EDI: Healthcare EDI Market, 2019-2026 (USD Million)

Healthcare EDI Market: By End-User

  1. Introduction 
    1. Healthcare EDI Market, By End-User, 2019-2026 (USD Million) 
  2. Healthcare Payers   
    1. Healthcare Payers: Healthcare EDI Market, 2019-2026 (USD Million)
  3. Pharmacies
    1. Pharmacies: Healthcare EDI Market, 2019-2026 (USD Million)
  4. Healthcare Providers
    1. Healthcare Providers: Healthcare EDI Market, 2019-2026 (USD Million)
  5. Medical Device & Pharmaceutical Companies
    1. Medical Device & Pharmaceutical Companies: Healthcare EDI Market, 2019-2026 (USD Million)

Healthcare EDI Market: By Region

  1. Introduction 
    1. Global Healthcare EDI Market, Regional Analysis, 2019-2026 (USD Million)   
  2. North America         
    1. North America Healthcare EDI Market, Regional Analysis, 2019-2026 (USD Million) 
      1. By Transaction Type 
        1. North America Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)           
      2. By Product & Service
        1. North America Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)
      3. By Delivery Mode      
        1. North America Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)         
      4. By End-User   
        1. North America Healthcare EDI Market, By End-User, 2019-2026 (USD Million)         
      5. By Country     
        1. U.S     
          1. By Transaction Type 
            1. U.S Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)    
          2. By Product & Service
            1. U.S Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)    
          3. By Delivery Mode      
            1. U.S Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. U.S Healthcare EDI Market, By End-User, 2019-2026 (USD Million)     
        2. Canada
          1. By Transaction Type 
            1. Canada Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)      
          2. By Product & Service
            1. Canada Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)      
          3. By Delivery Mode      
            1. Canada Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. Canada Healthcare EDI Market, By End-User, 2019-2026 (USD Million)    
        3. Mexico           
          1. By Transaction Type 
            1. Mexico Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)      
          2. By Product & Service
            1. Mexico Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)      
          3. By Delivery Mode      
            1. Mexico Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)
          4. By End-User   
            1. Mexico Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
  3. Europe          
    1. Europe Healthcare EDI Market, Regional Analysis, 2019-2026 (USD Million)  
      1. By Transaction Type 
        1. Europe Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)
      2. By Product & Service
        1. Europe Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)         
      3. By Delivery Mode      
        1. Europe Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)          
      4. By End-User   
        1. Europe Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
      5. By Country
        1. Germany
          1. By Transaction Type
            1. Germany Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)      
          2. By Product & Service
            1. Germany Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)      
          3. By Delivery Mode      
            1. Germany Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)                  
          4. By End-User   
            1. Germany Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
        2. UK      
          1. By Transaction Type 
            1. UK Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)    
          2. By Product & Service
            1. UK Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)    
          3. By Delivery Mode      
            1. UK Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. UK Healthcare EDI Market, By End-User, 2019-2026 (USD Million)     
        3. France
          1. By Transaction Type 
            1. France Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)
          2. By Product & Service
            1. France Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)      
          3. By Delivery Mode      
            1. France Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)
          4. By End-User   
            1. France Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
        4. Italy,   
          1. By Transaction Type 
            1. Italy, Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)    
          2. By Product & Service
            1. Italy, Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)    
          3. By Delivery Mode      
            1. Italy, Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. Italy, Healthcare EDI Market, By End-User, 2019-2026 (USD Million)     
        5. Rest of Europe
          1. By Transaction Type 
            1. Rest of Europe, Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)        
          2. By Product & Service
            1. Rest of Europe, Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)        
          3. By Delivery Mode      
            1. Rest of Europe, Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)        
          4. By End-User   
            1. Rest of Europe, Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
  4. Asia Pacific  
    1. Asia Pacific Healthcare EDI Market, Regional Analysis, 2019-2026 (USD Million)      
      1. By Transaction Type 
        1. Asia Pacific Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)         
      2. By Product & Service
        1. Asia Pacific Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)         
      3. By Delivery Mode      
        1. Asia Pacific Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)
      4. By End-User   
        1. Asia Pacific Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
      5. By Country     
        1. China 
          1. By Transaction Type 
            1. China Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)    
          2. By Product & Service
            1. China Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)      
          3. By Delivery Mode      
            1. China Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)                
          4. By End-User   
            1. China Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
        2. Japan 
          1. By Transaction Type 
            1. Japan Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)      
          2. By Product & Service
            1. Japan Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)      
          3. By Delivery Mode      
            1. Japan Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. Japan Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
        3. India  
          1. By Transaction Type 
            1. India Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)    
          2. By Product & Service
            1. India Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)    
          3. By Delivery Mode      
            1. India Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. India Healthcare EDI Market, By End-User, 2019-2026 (USD Million)     
        4. South Korea  
          1. By Transaction Type 
            1. South Korea Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)
          2. By Product & Service
            1. South Korea Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)        
          3. By Delivery Mode      
            1. South Korea Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)                  
          4. By End-User   
            1. South Korea Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
  5. Central & South America   
    1. Central & South America Healthcare EDI Market, Regional Analysis, 2019-2026 (USD Million)  
      1. By Transaction Type 
        1. Central & South America Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)
      2. By Product & Service
        1. Central & South America Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)   
      3. By Delivery Mode      
        1. Central & South America Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million) 
      4. By End-User   
        1. Central & South America Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
      5. By Country     
        1. Brazil 
          1. By Transaction Type 
            1. Brazil Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)    
          2. By Product & Service
            1. Brazil Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)
          3. By Delivery Mode      
            1. Brazil Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)                
          4. By End-User   
            1. Brazil Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
  6. Middle East & Africa           
    1. Middle East & Africa Healthcare EDI Market, Regional Analysis, 2019-2026 (USD Million)   
      1. By Transaction Type
        1. Middle East & Africa Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million) 
      2. By Product & Service
        1. Middle East & Africa Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million) 
      3. By Delivery Mode      
        1. Middle East & Africa Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)           
      4. By End-User   
        1. Middle East & Africa Healthcare EDI Market, By End-User, 2019-2026 (USD Million)         
      5. By Country     
        1. Saudi Arabia 
          1. By Transaction Type 
            1. Saudi Arabia Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)        
          2. By Product & Service
            1. Saudi Arabia Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)        
          3. By Delivery Mode      
            1. Saudi Arabia Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)                  
          4. By End-User   
            1. Saudi Arabia Healthcare EDI Market, By End-User, 2019-2026 (USD Million)
        2. UAE    
          1. By Transaction Type 
            1. UAE Healthcare EDI Market, By Transaction Type, 2019-2026 (USD Million)
          2. By Product & Service
            1. UAE Healthcare EDI Market, By Product & Service, 2019-2026 (USD Million)    
          3. By Delivery Mode      
            1. UAE Healthcare EDI Market, By Delivery Mode, 2019-2026 (USD Million)    
          4. By End-User   
            1. UAE Healthcare EDI Market, By End-User, 2019-2026 (USD Million)

The Global Healthcare EDI Market has been studied from the year 2017 till 2026. However, the CAGR provided in the report is from the year 2018 to 2026. The research methodology involved three stages: Desk research, Primary research, and Analysis & Output from the entire research process.

The desk research involved a robust background study which meant referring to paid and unpaid databases to understand the market dynamics; mapping contracts from press releases; identifying the key players in the market, studying their product portfolio, competition level, annual reports/SEC filings & investor presentations; and learning the demand and supply side analysis for the Healthcare EDI Market.

The primary research activity included telephonic conversations with more than 50 tier 1 industry consultants, distributors, and end-use product manufacturers.

Finally, based on the above thorough research process, an in-depth analysis was carried out considering the following aspects: market attractiveness, current & future market trends, market share analysis, SWOT analysis of the companies and customer analytics.

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