- The global electronic data interchange (EDI) market is expected to hit $5.9 billion by 2025, growing at CAGR of 9.4% over the next eight years, Grand View Research reported.
- Fueling demand are government support for health IT, increasing adoption of EDI and growing numbers of end users such as payers, providers and drug and medical device companies.
- Key players include McKesson, GE Healthcare, Allscripts Healthcare Solutions, Siemens Healthineers and Optum, according to Grand View.
The Affordable Care Act has created opportunities for IT solutions that increase workflow efficiencies and protect data privacy and security. At the same time, Congress has increased funding for hospitals and nonprofit organizations through Economic Development Initiative-Special Project grants.
Use of EDI can cut costs by streamlining claims processing, eliminating claims from the work queue, for example, that already are slated to be paid.
According to a 2016 survey by Recondo Technology, 70% of hospitals reported paying on average $4 per claim, a third more than previously estimated, at a cost to providers of $3.1 billion. The reason, in part, was use of manual, outdated methods of claims follow-up.
Last September, the Workgroup for Electronic Data Interchange, which advises HHS on the use of health IT, released recommendations on best practices for electronic payments. The aim is to boost use of Automated Clearing House electronic funds transfer transactions in healthcare and establish guidelines for alternative payment options such as virtual credit cards.
WEDI maintains use of ACH EFT and electronic remittance advice standards and operating rules could save the government, payers, hospitals and other stakeholders up to $4.5 billion over 10 years. One obstacle, however, has been slow provider adoption due to concerns around changing current workflows and the cost of supporting software.
Still, the Grand View Research report sees positive growth for the EDI sector in the years ahead. Among its key findings are:
- Mobile EDI will outpace other segments due to technology advances and growing interest in mobile solutions among healthcare providers.
- The services segment will see strong growth due to demand for tools for healthcare claims filing, verification and accounts receivable.
- North America will dominate the healthcare EDI market, fueled by demand for solutions to streamline workflows and strict patient safety regulations.