Nigeria Healthcare Claims Management Market Analysis

Nigeria Healthcare Claims Management Market Analysis


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The Nigeria healthcare claims management market is projected to grow from $24.03 Mn in 2022 to $137.82 Mn by 2030, registering a CAGR of 24.4% during the forecast period of 2022 - 2030. The main factors driving the growth would be increasing healthcare expenditure, adoption of digital technologies, government initiatives and growing health insurance coverage. The market is segmented by component, type, by delivery mode and end-user. Some of the major players include AXA Mansard Health, Octamile, Curacel, AXA, Cigna and Allianz.

ID: IN10NGHS006 CATEGORY: Healthcare Services GEOGRAPHY: Nigeria AUTHOR: Neha Davda

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Nigeria Healthcare Claims Management Market Executive Summary

The Nigeria healthcare claims management market is projected to grow from $24.03 Mn in 2022 to $137.82 Mn by 2030, registering a CAGR of 24.4% during the forecast period of 2022 - 2030. In 2019, Nigeria's national health expenditures as a share of GDP totalled 3.03% or $71 per person.

Nigeria's market for healthcare claim management is expanding quickly as a result of the country's rising need for good and affordable healthcare services. Nigeria, which has a population of over 200 million, has a sizable market for healthcare services, and the government is working to raise the quality of healthcare delivery there through a number of different projects.

Private health insurance providers dominate the healthcare claim management business in Nigeria, accounting for a sizable portion of the market. These businesses offer people and businesses a variety of health insurance plans that cover a variety of healthcare services, such as doctor visits, lab work, and hospitalisation. The Nigerian government has also started a number of initiatives to increase the effectiveness of healthcare claim management in the nation, in addition to private health insurance firms. For instance, the National Health Insurance Scheme (NHIS) is a government-run health insurance program that offers low-income individuals and vulnerable groups in the nation access to cheap healthcare services.

Nigeria Healthcare Claims Management Market

Market Dynamics

Market Growth Drivers

The Nigeria healthcare claims management market is expected to be driven by factors such as:

  1. Increasing healthcare expenditure- In recent years, the Nigerian government has raised the amount it spends on healthcare, which has encouraged the construction of new institutions and the expansion of already existing ones. As a result, there is a significant increase in the need for healthcare claim management services
  2. Adoption of digital technologies- The expansion of the healthcare claim management market in Nigeria is also being fueled by the deployment of digital technologies like EHRs and telemedicine. These technologies have simplified patient data management and patient communication for healthcare professionals, improving patient outcomes and boosting efficiency
  3. Government initiatives- The Nigerian government has started a number of projects to raise the level of healthcare service in the nation. As more individuals look for inexpensive and effective healthcare services, efforts like the National Health Insurance Scheme (NHIS) have increased demand for healthcare claim management services
  4. Growing health insurance coverage- The demand for healthcare claim management services has increased as more people in Nigeria are now covered by health insurance. A variety of healthcare services are included in the affordable, comprehensive healthcare plans that health insurance firms are increasingly offering

Market Restraints

The following factors are expected to limit the growth of the healthcare claims management market in Nigeria:

  1. Inadequate healthcare infrastructure- Despite government efforts to upgrade Nigeria's healthcare infrastructure, the nation still suffers from a severe lack of healthcare services, especially in rural areas. Due to a potential shortage of healthcare professionals to deliver services to patients, this lack of infrastructure may be able to restrain the growth of the healthcare claim management market
  2. Low healthcare literacy- Many Nigerians still lack a thorough understanding of healthcare and health insurance. This may make it challenging for healthcare providers and insurance firms to convey the value of healthcare services and the necessity of health insurance, which may restrain the market's ability to grow for healthcare claim management
  3. Fragmented healthcare system- Many healthcare providers in Nigeria operate independently of one another, creating a highly fragmented healthcare system. As a result, it may be challenging to coordinate healthcare services and handle healthcare claims, which may restrain the market's expansion for healthcare claim management

Competitive Landscape

Key Players

  • AXA Mansard Health (NGA)- is dedicated to providing customers with a quality claims experience both during and after the loss. To help their clients quickly handle their day-to-day operations and resume their activities, they offer a coordinated approach to claims management that adopts effective claims-processing methods
  • Octamile (NGA)- allow insurance and non-insurance companies to streamline insurance access and shield Africans from financial loss. With its ClaimsTech technology, insurers can quickly process payouts in under an hour while assisting in the detection of fraud. Via its integrated insurance API, B2C enterprises can sell insurance as a standalone product or as an add-on to their current offerings on digital platforms or mobile apps. They safeguard their customers while producing a new source of income
  • Curacel (NGA)- Curacel, a Nigerian startup, is assisting African insurance businesses by facilitating rapid claims administration and correct payouts. However, it began in the e-health sector. The insurance claims process is automated using Curacel, enabling personnel to process large numbers of claims swiftly and effectively. Curacel also automatically screens claims for fraud, waste, and abuse
  • Cigna- a global provider of healthcare services, provides health insurance and related services. Provider network management, customer assistance, and claims processing are just a few of the healthcare claims management services offered by the company
  • Allianz- is the one-stop shop for all of your life and health insurance needs. Alternatives are provided for short-term or emergency protection, critical sickness, life and disability insurance, and international health insurance

Notable Deals

March 2022:  With the help of a business alliance with AXA Mansard, the East African company Turaco has declared its entry into Nigeria. The partnership between AXA and Turaco will enable them to increase the distribution of AXA 's all-inclusive insurance solutions.

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Claims Management Market Segmentation

By Component (Revenue, USD Billion):

Further breakdown of the software and services segment of the healthcare claims management market

  • Software
  • Services

By Type (Revenue, USD Billion):

Although they have nothing to do with it, skills unrelated to patient care are equally crucial for any healthcare organization that wants to stay in business. Among these are managing intricate insurance regulations, comprehending best practices for data collection, and analyzing data to identify areas for development. For the above reasons, providers are constantly looking for methods to improve claim administration and medical billing systems. Setting up an integrated billing and claims processing system is one approach to accomplish this, which has a number of benefits.

  • Integrated Solutions
  • Standalone Solutions

By Delivery Mode (Revenue, USD Billion):

  • On-Premise
  • Cloud-Based

By End User (Revenue, USD Billion):

  • Healthcare Payers
  • Healthcare Providers
  • Other End Users

Healthcare payers in this market are anticipated to rise quickly over the course of the projection period because of the installation of strict regulatory requirements, a lack of experienced personnel internally for claims processing, rising healthcare expenditures, and fraud associated with those charges. Payers have also assisted healthcare providers by creating a web-based and cloud-based interface that helps them manage medical billing and associated claims and offers accurate and timely information about the epidemic.

Insights10 will provide you with the reports within 10 key parameters which are:

  1. Market Overview
  2. Market Growth Drivers & Restraints
  3. Epidemiology of Disease Type
  4. Market Segmentation
  5. Market Share
  6. Competitive Landscape
  7. Key Company Profiles
  8. Healthcare Policies & Regulatory Framework
  9. Reimbursement Scenario
  10. Factors Driving Future Growth

Based on our many years of experience, we believe that these are the parameters that are critical to decision-making for business stakeholders. Our focused approach to developing reports focused on 10 key parameters, enabled us to arrive at the name “Insights10”.

 

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Stage II: Market Data Analysis and Statistical Model

Market Trends: We generally look at macro parameters and micro indicators. The macro parameters include changes in government policies, demand and supply of the market, government intervention programs, and major market share. The micro indicators are GDP growth, market size, market volume, etc. We also understand nuances specific to each country like the US, Canada, India, Germany, etc., and have worked across 60+ countries and hence not only understand global trends but how these differ by country, how payment models, market structure, cultural parameters, etc. differ in each country.

Market Sizing and Analysis: Our expert data analytics team has created various market forecast models by employing the top-down approach i.e. starting with the large overall market and segmenting different areas and the bottom-up approach i.e. starting with population and epidemiology and rolling up based on spend, etc., estimating the size of the market, and distributing among the geographic and/or product segments.

The top-down approach is mainly used for new product forecasting and the bottom-up approach is used for demand estimation of any product for different countries summed up to form the total market. We are able to round off insights and build stronger forecasts because we always do both these methods and triangulate the final numbers.

The study on the market covers the analysis of the leading geographies such as Asia-Pacific, Africa, Europe, Middle East, North America, and  Latin America for the period of 2022 to 2030. The qualitative analysis covers the industry landscape and trends, market opportunities, competitive landscape, and policy and regulatory scenario, and the quantitative analysis covers different market estimates and forecasts.

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We make sure to finalize the numbers in alignment with the market research. Firstly, our internal experts ensure thorough validation and checking to ensure accurate and precise analysis and then validation is also done using a multiple-data analysis model. Two-level validation is done and entails the finalization of the report scope and the way of representation pattern.

 

 

Stage III: Interpretation and Presentation

Analysis & Interpretation: The information gathered is then analyzed and synthesized. The second series of interviews are done if necessary to check and validate. The future opportunities are analyzed by understanding product commercialization and many other factors. It also comprises the analysis of data discrepancies observed across various data sources. Information procured from secondary and primary results is then, interpreted by considering the following parameters: (a partial list)

  • Establishing market drivers and trends
  • Analyzing the regulatory landscape to understand future growth
  • Market Segment based analysis to obtain revenue/volume
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The foreign exchange rates are calculated on the respective dates and for the respective regions covered in the study.

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Last updated on: 23 March 2023
Updated by: Ritu Baliya

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