Healthcare EDI Market Report 2025

This Healthcare EDI market report covers market characteristics, size and growth, segmentation, regional and country breakdowns, competitive landscape, market shares, trends and strategies for this market. It traces the market’s historic and forecast market growth by geography.

The healthcare EDI market size has grown rapidly in recent years. It will grow from $5.1 billion in 2024 to $5.63 billion in 2025 at a compound annual growth rate (CAGR) of 10.4%. The growth in the historic period can be attributed to regulatory compliance, administrative efficiency, cost reduction, error reduction, claims processing.

The healthcare EDI market size is expected to see rapid growth in the next few years. It will grow to $8.95 billion in 2029 at a compound annual growth rate (CAGR) of 12.3%. The growth in the forecast period can be attributed to telehealth expansion, data standardization, data privacy and security, inter-organizational data sharing, pandemic preparedness. Major trends in the forecast period include interoperability standards, prior authorization automation, blockchain for secure data exchange, mobile edi solutions, ai for claim scrutiny.

The growing government support for healthcare is anticipated to drive the expansion of the healthcare EDI market in the future. Healthcare EDI is utilized to exchange information between various departments and branches within super-specialty hospitals. This software facilitates the transmission of data such as benefits coordination, claims status, insurance details, payment information, and eligibility forms among healthcare entities. Increased government backing for the healthcare sector enables the development of new equipment and improved services for the population, while also advancing technology adoption in government hospitals. For example, in June 2022, the National Health Service (NHS), a UK-based government department, announced a substantial investment of USD 164.71 million (approximately €150 million) to promote digital adoption and healthcare digitization. This funding initiative is set to transform health and social care through enhanced technological advancements. Thus, the growing government support for healthcare is fueling the demand for the healthcare EDI market.

The growth of telehealth services is expected to boost the healthcare EDI market in the coming years. Telehealth refers to the use of digital information and communication technologies across various aspects of healthcare, including clinical care, patient and professional education, wellness management, and public health. It allows healthcare providers to deliver services remotely by digitally connecting with patients. Healthcare Electronic Data Interchange (EDI) plays a crucial role in supporting telehealth by enhancing administrative processes and data exchange. EDI in telehealth streamlines administrative tasks, improves communication between patients and providers, and ensures the secure, efficient transfer of vital healthcare data, contributing to the effectiveness and affordability of telehealth services. For example, in August 2022, the Australian Digital Health Agency reported that in July 2.02 trillion telehealth services were provided to 18 million people, with nearly 95,000 practitioners using telehealth services. Thus, the expansion of telehealth services is driving the healthcare EDI market.

Technological advancements emerge as a prominent trend in the healthcare EDI market. Key market players focus on innovation to maintain their market position. For example, in May 2022, NextGen Healthcare Inc., a US-based software company specializing in electronic health record software, introduced NextGen Health Data Hub Insights. This innovative data warehouse and analytics solution simplify data access, analytics, and report production for health information exchanges (HIEs) and healthcare providers in the United States. The platform, an extension of the NextGen Health Data Hub, enables users to unleash the value of their data assets by providing customized, near-real-time reporting capabilities and insights at the point of treatment. Technological advancements like these shape the landscape of the healthcare EDI market.

In July 2022, Technology Partners LLC, doing business as ImagineSoftware, a US-based software company, successfully acquired Exchange EDI LLC in a deal of undisclosed value. This strategic move has expanded ImagineSoftware's service portfolio, incorporating Exchange EDI's capabilities to enhance patient billing and collections operations. The amalgamation of their technologies and expertise positions both companies optimally to enhance communication between doctors and patients. Exchange EDI LLC, a US-based company specializing in the electronic interchange of business information using standardized formats, now operates under the ImagineSoftware umbrella.

In October 2022, Change Healthcare Inc., a US-based company operating in the healthcare electronic data interchange sector, announced the successful completion of a merger. This union brings together two companies with a shared objective of creating a simpler, more intelligent, and adaptable health system for individuals, payers, and providers. The integrated approach aims to streamline critical clinical, administrative, and financial procedures essential for healthcare professionals and payers in patient treatment. By enhancing efficiency and reducing friction, the unified entity anticipates benefiting the entire healthcare system, leading to cost savings and increased satisfaction for all stakeholders. Notably, Optum Inc., a US-based healthcare technology and EDI company, is a key player in this sector.

Major companies operating in the healthcare EDI market include McKesson Corporation, Optum Inc., Allscripts, GE Healthcare, Cognizant Technology Solutions India Pvt Ltd., Cerner Corporation, Dell Technologies Inc., The SSI Group, Tallan Inc., Quadax Inc., AthenaHealth, MuleSoft LLC, Boomi Inc., Change Healthcare Inc., Conduent Inc., Epic Systems Corporation, Siemens Healthineers, NextGen Healthcare, Infor Inc., Edifecs Inc., Waystar Inc., Experian Information Solutions Inc., Availity LLC, eClinicalWorks, National Education Association, Ability Network, PracticeSuite Inc., Quest Diagnostics, Jopari Solutions Inc., Alpha II LLC, TransUnion Healthcare, Bizmatics Inc., Healthpac Computer Systems.

North America was the largest region in the healthcare EDI market in 2024. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the healthcare EDI market analysis report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa. The countries covered in the healthcare EDI market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

Electronic data interchange (EDI) serves as the software conduit facilitating data transactions among diverse healthcare stakeholders and insurers through computer systems. Utilizing the EDI service, organizers can efficiently process and monitor claims throughout the entire billing cycle. Healthcare EDI plays a pivotal role in managing critical patient data, encompassing medical history, medication information, and emergency services records.

Key transactions within healthcare EDI involve claim management, healthcare supply chain, and other related processes. Claim management entails the organization, billing, filing, updating, and processing of healthcare claims associated with patient diagnoses, medications, and treatments. This encompasses various components such as software, hardware, and services, delivered through modes like mobile, VAN, web & cloud-based, and point-to-point. These solutions are employed by healthcare providers, payers, pharmacies, and other end users in the industry.

The healthcare EDI market research report is one of a series of new reports that provides healthcare EDI market statistics, including healthcare EDI industry global market size, regional shares, competitors with a healthcare EDI market share, detailed healthcare EDI market segments, market trends and opportunities, and any further data you may need to thrive in the healthcare EDI industry. This healthcare EDI market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenario of the industry.

The healthcare electronic data interchange (EDI) market includes revenues earned by Web & Cloud-based EDI, EDI Value Added Network, Direct EDI and Mobile EDI. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD unless otherwise specified).

The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.

This product will be delivered within 3-5 business days.