North America Healthcare Reimbursement Market Size, Share & Trends Analysis Report by Claim (Underpaid and Full Paid), Service Provider, Payer (Public Payers and Private Payers), and Country with Growth Forecasts, 2024-2031

The North America Healthcare Reimbursement Market is expected to witness market growth of 17.2% CAGR during the forecast period (2024-2031).

The US market dominated the North America Healthcare Reimbursement Market by country in 2023, and is expected to continue to be a dominant market till 2031; thereby, achieving a market value of $29.44 billion by 2031. The Canada market is experiencing a CAGR of 19.6% during 2024-2031. Additionally, the Mexico market is expected to exhibit a CAGR of 18.7% during 2024-2031.



The market plays a pivotal role in the global healthcare ecosystem. It encompasses a complex framework involving healthcare providers' compensation for services rendered to patients. This market comprises multiple stakeholders, including public and private health insurance providers, government agencies, healthcare providers, and patients. Rising healthcare costs, the increasing prevalence of chronic diseases, technological advancements, and expanding health insurance coverage have driven the growth and transformation of this market.

In addition, the healthcare reimbursement system ensures that healthcare providers receive payment for delivering medical services such as diagnostics, treatments, surgeries, and follow-up care. Efficient reimbursement models are critical for promoting access to high-quality care, reducing out-of-pocket expenses for patients, and sustaining healthcare providers’ financial health. This market has witnessed significant changes with the growing focus on value-based care and innovations in digital health, telemedicine, and artificial intelligence (AI)-powered claims processing.

Cancer is the third leading cause of death in Mexico, with over 195,000 new cases recorded in 2020 and 90,222 deaths. The high prevalence of cancers such as breast, prostate, thyroid, colon, and cervical cancer is increasing healthcare expenditures and the need for efficient reimbursement systems to manage treatment costs. Cancer care often involves expensive diagnostics, surgeries, radiation, and chemotherapy, requiring streamlined reimbursement processes to minimize patient financial burdens. The growing number of cancer patients is driving demand for advanced oncology services, leading to an increase in reimbursement claims related to specialized cancer treatments. Therefore, the rising demand for home care services in Canada and the increasing prevalence of cancer in Mexico are significantly influencing the growth of the healthcare reimbursement market.

List of Key Companies Profiled

• United HealthCare Services, Inc.
• Allianz Care (Allianz Group)
• CVS Health Corporation (ActiveHealth Management, Inc.)
• Nippon Life Insurance Company Limited
• The Cigna Group
• Elevance Health, Inc.
• Humana Inc.
• Molina Healthcare, Inc.
• Centene Corporation
• MetLife, Inc.

Market Report Segmentation

By Claim

• Underpaid
• Full Paid

By Service Provider

• Hospitals
• Diagnostic Laboratories
• Physician Office
  
• Other Service Provider

By Payer

• Public Payers
• Private Payers

By Country

• US
• Canada
• Mexico
• Rest of North America