|
Forecast Period
|
2026-2030
|
|
Market Size (2024)
|
USD
265.82 Million
|
|
CAGR (2025-2030)
|
5.80%
|
|
Fastest Growing Segment
|
Software
|
|
Largest Market
|
Midwest
|
|
Market Size (2030)
|
USD 368.63 Million
|
Market Overview
United States Credentialing Software And
Services In Healthcare Market was valued at USD 265.82 Million in 2024 and is
expected to reach USD 368.63 Million by 2030 with a CAGR of 5.80%. Credentialing,
a critical component of healthcare administration, involves verifying and
assessing the qualifications, experience, and professional standing of
healthcare providers to ensure they meet established standards of care and
regulatory compliance.
In recent years, the traditional,
paper-based credentialing process has proven to be inefficient, error-prone,
and time-consuming. As a result, healthcare providers are increasingly adopting
digital credentialing software and outsourcing credentialing services to
streamline operations, reduce administrative burden, and enhance data accuracy.
Hospitals, physician groups, managed care organizations, and telehealth
providers represent the primary customer segments, each with unique
credentialing needs and workflows.
Key Market Drivers
Growth
in Healthcare Industry
The steady expansion of the U.S. healthcare industry
is a major driving force behind the increasing demand for credentialing
software and services. In 2022, the United States allocated approximately
17.8% of its Gross Domestic Product (GDP) to healthcare expenditures substantially
higher than the 11.5% average among other high-income nations. Healthcare
coverage in the U.S. varies significantly across the population, with groups
such as the elderly, individuals with disabilities, and low-income populations
receiving more comprehensive coverage through government programs like Medicare
and Medicaid. As the sector continues to grow in scale and complexity spurred
by the rise in healthcare facilities, medical professionals, and regulatory
standards the need for efficient and accurate credentialing solutions has
become more critical than ever.
Credentialing plays a fundamental role in verifying
the qualifications, licenses, and compliance status of healthcare providers,
directly impacting patient safety, risk management, and regulatory adherence. In
2022, the United States had approximately 760,000 physicians, reflecting a 22%
increase over the past decade. During the same period, hospital employment grew
by 33%, while private medical practices expanded by 17%. Currently, 55% of
physicians are employed in private practice down 3 percentage points from ten
years ago while 27% are employed by hospitals, representing a modest increase
from 25% a decade earlier. With the growing number of physicians,
specialists, and allied health professionals entering the workforce, healthcare
organizations are turning to advanced credentialing software to streamline
operations, reduce administrative burden, and ensure real-time accuracy.
Surge
in Technological Advancements
The United States credentialing software and services
market in healthcare is witnessing strong growth, largely fueled by a surge in
technological advancements. As healthcare systems become increasingly complex,
providers are turning to advanced credentialing solutions to streamline
operations, ensure regulatory compliance, and maintain high standards of
patient safety. Modern credentialing platforms now integrate cloud-based
architecture, artificial intelligence (AI), machine learning, and blockchain
technologies to automate and enhance the accuracy of provider verification,
license tracking, and compliance monitoring.
Pearson, a global leader in assessment and learning,
offers workforce planning and talent management solutions to help organizations
address evolving skills gaps. As a part of Pearson, Cradley is the world’s
leading digital credentialing platform, recognized for its trusted approach to
validating and showcasing skills. These innovations significantly reduce administrative
burden, minimize errors, and accelerate the onboarding process for healthcare
professionals.
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Key Market Challenges
Data
Integrity and Compliance Risks
One of the primary challenges facing the
United States credentialing software and services market in healthcare is
ensuring data integrity and managing compliance risks. Credentialing processes
involve the collection, verification, and maintenance of sensitive and
extensive provider information, including licensure, certifications, work
history, and disciplinary records. Maintaining the accuracy, completeness, and
security of this data is critical, as any discrepancies or breaches can lead to
significant regulatory penalties, reputational damage, and potential risks to
patient safety.
Given the highly regulated nature of
healthcare, credentialing systems must adhere to stringent standards set forth
by federal and state agencies, as well as accreditation bodies such as The
Joint Commission and CMS. Failure to comply with these requirements can result
in costly audits, fines, and even loss of accreditation or reimbursement
eligibility for healthcare organizations.
Key Market Trends
Growth
in Telehealth
The rapid expansion of telehealth
services in the United States is emerging as a significant trend influencing
the credentialing software and services market. As of December 2020, the
Centers for Medicare & Medicaid Services (CMS) permanently expanded the
range of telehealth services available to Medicare beneficiaries and enrollees,
as outlined in the FY2021 Medicare Physician Fee Schedule Final Rule. The
widespread adoption of virtual care, accelerated by technological advancements
and shifts in patient preferences, has transformed how healthcare providers
deliver services, creating new complexities in provider credentialing and
compliance management.
Telehealth enables healthcare
professionals to offer care across state lines and diverse geographic regions,
which increases the demand for sophisticated credentialing systems capable of
managing multi-jurisdictional licensure verification and ensuring adherence to
varying regulatory requirements. This trend necessitates credentialing software
that can streamline remote provider onboarding, real-time license tracking, and
efficient management of provider data.
Segmental Insights
Component
Insights
Based on Component, Software have
emerged as the fastest growing segment in the United States Credentialing
Software And Services In Healthcare Market in 2024. The increasing demand for
cloud-based, scalable, and user-friendly software platforms is driving rapid
adoption across hospitals, clinics, and large healthcare networks. Advanced
features such as real-time license verification, automated compliance tracking,
and seamless integration with existing electronic health records (EHR) systems
further enhance the appeal of software-based credentialing.
End
Use Insights
Based on End Use, Hospitals &
Clinics have emerged as the fastest growing segment in the United States Credentialing
Software And Services In Healthcare Market during the forecast period. This is due
to several strategic and operational factors. These healthcare providers face
increasing regulatory scrutiny and stringent compliance requirements, driving
the urgent need for efficient, reliable credentialing solutions that can
streamline the complex process of verifying the qualifications and licenses of
a growing pool of medical staff.
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Regional Insights
Based on Region, Midwest have emerged as
the dominating region in the United States Credentialing Software And Services
In Healthcare Market in 2024. The region is home to a large number of
healthcare providers, including major hospital systems, clinics, and specialty
care centers, which drives significant demand for efficient credentialing
solutions. These providers face increasing regulatory pressures and operational
complexities, prompting widespread adoption of advanced credentialing software
and services. Additionally, the Midwest benefits from a strong concentration of
technology firms and startups specializing in healthcare IT, fostering
innovation and the development of tailored credentialing platforms that meet
the unique needs of local healthcare organizations.
Recent Development
- In August 2025, Fluent, a leader in
agentic AI-powered dental analytics, announced the launch of its Fluent
Credentialing SaaS platform an advanced, end-to-end solution designed to
modernize and expedite credentialing within the dental ecosystem. Positioned as
a revenue acceleration tool for payers, DSOs, and providers, the platform
utilizes AI and intelligent workflow automation to deliver a more efficient,
accurate, and streamlined credentialing process. This platform serves as a key
component of the broader Fluent Credentialing Suite, which also offers
NCQA-accredited delegated credentialing services, payer enrollment support, and
comprehensive CVO solutions.
Key Market Players
- symplr
Software LLC
- Simplify
Healthcare Technology
- Global
Healthcare Exchange, LLC
- HealthStream,
Inc.
- Bizmatics,
Inc.
- Applied
Statistics & Management, Inc.
- HCA
Management Services, L.P.
- CureMD
Healthcare
- Global
Healthcare Exchange, LLC.
- Verisys
Corporation
|
By Component
|
By End Use
|
By Region
|
|
|
- Hospitals & Clinics
- Healthcare Payers
- Others
|
- Northeast
- Midwest
- South
- West
|
Report Scope
In this report, the United States Credentialing
Software And Services In Healthcare Market has been segmented into the
following categories, in addition to the industry trends which have also been
detailed below:
- United States Credentialing
Software And Services In Healthcare Market, By Component:
o Software
o Services
- United States Credentialing
Software And Services In Healthcare Market, By End Use:
o Hospitals & Clinics
o Healthcare Payers
o Others
- United States Credentialing
Software And Services In Healthcare Market, By Region:
o Northeast
o Midwest
o South
o West
Competitive Landscape
Company Profiles: Detailed analysis of the major companies
present in the United States Credentialing Software And Services In Healthcare
Market.
Available Customizations:
United States Credentialing Software And Services
In Healthcare Market report with the given market data, Tech Sci Research
offers customizations according to a company's specific needs. The following
customization options are available for the report:
Company Information
- Detailed analysis and
profiling of additional market players (up to five).
United States Credentialing
Software And Services In Healthcare Market is an upcoming report to be released
soon. If you wish an early delivery of this report or want to confirm the date
of release, please contact us at [email protected]