Artificial Intelligence for Healthcare Payer Global Markets, 2019-2024, 2024-2029F, 2034F: Opportunities in Claim Automation, Risk Modeling, Payer-provider Collaborations, and Cloud-based Solutions

The AI healthcare payer market is poised for notable growth, driven by rising healthcare data volumes, digital platform adoption, and the need for cost containment, fraud detection, and personalized services. Key .

Dublin, Jan. 09, 2026 (GLOBE NEWSWIRE) -- The "Artificial Intelligence for Healthcare Payer Global Market Report 2025" has been added to ResearchAndMarkets.com's offering.

The artificial intelligence (AI) for healthcare payer market is experiencing impressive growth, with its size projected to expand from $2.43 billion in 2024 to $2.89 billion in 2025, maintaining a compound annual growth rate (CAGR) of 19.1%. This growth has been catalyzed by increasing healthcare data volumes, the rising adoption of digital health platforms, and an escalating need for cost-effective healthcare solutions. Further driving this expansion is the growing use of predictive analytics, a heightened focus on fraud detection and prevention, and the rising demand for personalized healthcare services.

Looking ahead, the market is expected to burgeon to $5.74 billion by 2029, with a slightly reduced but strong CAGR of 18.7%. This anticipated growth stems from increased emphasis on value-based care models, an uptick in healthcare expenditure, burgeoning payer-provider collaborations, and a focus on improving member engagement. Notable trends include advanced natural language processing, development of AI-based claims automation, and innovations in predictive risk modeling and explainable AI.

The surge in healthcare data is a critical growth driver, enabling AI technologies to enhance decision-making through data-driven insights, optimizing fraud detection, risk assessment, and claims management. For example, the UK's NHS aims to reach 100% adoption of electronic health records by 2025, a testament to the digitalization wave sweeping the healthcare sector.

Key companies in this market, such as CVS Caremark Health Corporation, are innovating with AI-powered tools to streamline patient navigation and improve member experience. In a notable move, Cohere Health Inc. recently acquired ZignaAI Inc., a specialist in payment integrity and revenue optimization, signaling the market's evolving focus on operational efficiency through AI.

Major players include industry giants like Amazon Web Services Inc., Alphabet LLC, Microsoft , and Accenture plc., among others, driving innovations in this field. North America is currently the largest region in the market, while Asia-Pacific is set to be the fastest-growing, reflecting global shifts and investments in healthcare technologies.

The industry is adapting to rapid economic and trade changes, although challenges such as U.S. tariffs and trade tensions in 2025 have impacted costs and supply chains for critical medical devices and pharmaceuticals. In response, the sector is diversifying sourcing strategies and advocating for tariff exemptions to mitigate healthcare delivery disruptions.

This market overview provides crucial insights into current and future scenarios for AI in healthcare payers, analyzing industry size, regional dynamics, competitive landscapes, and strategic opportunities. The evolution of AI applications across administrative, financial, and clinical domains signifies a transformative era, enhancing claims processing, fraud detection, member engagement, and cost management through innovative solutions.

Key Attributes:

Report Scope:

Markets Covered:

• Component: Software AG ; Services
• Technology: Machine Learning (ML); Natural Language Processing (NLP); Other Technologies
• Deployment: Cloud; on-Premises
• Application: Claims Processing Optimization; Fraud Detection and Prevention; Revenue Management; Member Engagement; Risk Adjustment; Workflow Automation; Other Applications

Subsegments:

• Software AG : Predictive Analytics Platforms; Claims Management Solutions; Fraud Detection Systems; Risk Assessment Tools; Member Engagement Solutions
• Services: Implementation and Integration Services; Consulting Services; Support and Maintenance Services; Training and Education Services; Managed Services

Companies Featured

• Amazon Web Services Inc.
• Alphabet LLC
• Microsoft
• Accenture plc.
• Oracle Corporation
• Cognizant Technology Solutions Corporation
• Wipro Limited
• SAS Institute Inc.
• Hexaware Technologies Limited
• Firstsource Solutions Limited
• Innovaccer Incorporated
• Cohere Health Incorporated
• Softheon
• MST Solutions LLC
• Lyric AI Incorporated
• Inovaare Corporation
• Codoxo
• Iatros Health Incorporated
• Alaffia Health Incorporated

For more information about this report visit https://www.researchandmarkets.com/r/ttrho6

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• Artificial Intelligence for Healthcare Payer Market

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