$931.6 million is the projected market size for healthcare reimbursement optimization by 2036, up from $510.5 million in 2026 as providers invest to cut preventable denials and speed reimbursement.
6.55% of Medicare Fee-for-Service payments—$28.83 billion—were flagged as improper in fiscal 2025, the report said, highlighting documentation gaps that boost demand for claims, eligibility and denial-management tools.
Claims management is forecast to hold a 39.6% share in 2026, while cloud-based deployments take 43.9%, reflecting demand for earlier error detection, centralized rule updates and payer connectivity.
Hospitals are expected to account for 41.1% of 2026 spending and eligibility verification 38.3%, as large provider systems seek enterprise-wide visibility across complex reimbursement workflows.
Country growth is uneven despite the broader uptrend, with Japan leading the profiled markets at 7.5% CAGR, ahead of the UK at 7.2% and the US at 6.6% through 2036.