Medicare Consulting Service Market Size Worth $11.31 Billion by 2029 - Exclusive Report by The Business Research Company

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The Business Research Company’s Medicare Consulting Service Global Market Report 2025 - Market Size, Trends, And Global Forecast 2025-2034

LONDON, GREATER LONDON, UNITED KINGDOM, September 12, 2025 /EINPresswire.com/ -- Get 30% Off All Global Market Reports With Code ONLINE30 – Stay Ahead Of Trade Shifts, Macroeconomic Trends, And Industry Disruptors

How Much Is The Medicare Consulting Service Market Worth?
The size of the medicare consulting service market has experienced substantial growth in the past couple of years. The expansion will advance from $7.81 billion in 2024 to $8.43 billion in 2025, at a compound annual growth rate (CAGR) of 8.0%. Factors such as a growing elderly population, enhancing Medicare registration rates, an increased need for plan advice, heightened awareness of healthcare costs, and the escalating complexity in coverage choices have contributed to the growth experienced in the historical period.

Expectations are high for the medicare consulting service market as it is forecasted to experience robust expansion within the next few years. The market value is anticipated to surge to $11.32 billion by 2029, marking an impressive compound annual growth rate (CAGR) of 7.6%. This projected growth during the forecast period is tied to several factors such as the rising need for aid with compliance, an increasing occurrence of chronic diseases, a booming demand for virtual consulting, escalating retiree health planning necessities, and frequent updates in policy regulation. The forecast period is also expected to see key trends like the enhancement of telehealth consulting platforms, AI integration in plan matching, increased technology use in claims support, advancements in personalized plan analytics, and the emergence of new compliance automation tools.

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What Are The Factors Driving The Medicare Consulting Service Market?
As more value-based care models are adopted, it's anticipated that the growth of the medicare consulting service market will be boosted. Value-based care models are healthcare structures where payments to providers depend on patient health outcomes, with a greater focus on quality, efficacy, and preventive care over the quantity of services. The transition from volume-based to outcome-based reimbursement is fuelling an increase in the adoption of these models, as both providers and payers are striving to enhance patient outcomes while keeping healthcare costs in check. Medicare consulting services champion value-based care by advising healthcare providers on issues such as compliance, reimbursement, and operational strategies. They upgrade patient outcomes and service efficiency by facilitating the introduction of outcome-based practices and the optimisation of healthcare provision. For example, data from America's Health Insurance Plans (AHIP), a health insurance association based in the US, indicated that in 2022, 86.7% of US residents were part of value-based care arrangements, a rise from 77% in 2021. Thus, the growing adoption of these care models is fuelling the growth of the medicare consulting service market.

Who Are The Major Players In The Medicare Consulting Service Market?
Major players in the Medicare Consulting Service Global Market Report 2025 include:

• Accenture plc
• Deloitte Touche Tohmatsu Limited
• PricewaterhouseCoopers International Limited
• Ernst & Young Global Limited
• Klynveld Peat Marwick Goerdeler
• General Electric Healthcare Partners
• IQVIA Holdings Inc.
• McKinsey & Company Inc.
• Boston Consulting Group Inc.
• L.E.K. Consulting LLC

What Are The Future Trends Of The Medicare Consulting Service Market?
Top firms in the medicare consulting service sector are concentrating on the creation of technologically sophisticated solutions like comprehensive risk adjustment workflow solutions to improve the accuracy of reimbursements, adherence to compliance, and quality of care. A full risk adjustment workflow solution is a system that oversees the complete procedure of evaluating, documenting, and encoding the health information of patients to accurately forecast healthcare expenses and maximize reimbursements. For example, Milliman MedInsight Inc., an American healthcare analysis and consultation firm, introduced the Milliman MedInsight risk adjustment platform in March 2025. This inclusive solution is designed to boost the capability of healthcare establishments to efficiently control risk adjustment procedures. The platform incorporates advanced analytics, retrospective chart review, and prospective encounter gap closure tools into one workflow, making operations more efficient and enhancing the precision of patient risk scores for Medicare Advantage and other risk-focused payment models. It's instrumental in securing fair remuneration for the care provided, highlighting the platform's strategic importance.

Which Segment Accounted For The Largest Medicare Consulting Service Market Share?
The medicare consulting service market covered in this report is segmented

1) By Service Type: Enrollment Assistance, Claims Assistance, Plan Selection, Compliance And Regulatory Assistance
2) By Mode Of Delivery: Online, Offline
3) By Application: Individual Medicare Programs, Employer Group Programs
4) By End-User: Individuals, Insurance Companies, Healthcare Providers, Other End-Users

Subsegments:
1) By Enrollment Assistance: Medicare Initial Enrollment Support, Special Enrollment Period Guidance, Part D Enrollment Services, Medicare Advantage Plan Enrollment, Enrollment Education And Workshops
2) By Claims Assistance: Billing Error Resolution Support, Claims Submission Guidance, Denied Claims Appeal Support, Out-Of-Pocket Cost Explanation, Claims Tracking And Updates
3) By Plan Selection: Medicare Advantage Plan Comparison, Medigap Policy Evaluation, Prescription Drug Plan Matching, Cost-Benefit Plan Analysis, Personalized Coverage Recommendations
4) By Compliance And Regulatory Assistance: Health Insurance Portability and Accountability Act of 1996 (HIPAA) Compliance Guidance, Content Management System (CMS) Regulation Updates Support, Audit Preparation And Review, Policy Documentation Assistance, Fraud Prevention Education

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What Are The Regional Trends In The Medicare Consulting Service Market?
In 2024, North America held the highest share in the Medicare consulting service market. Meanwhile, Asia-Pacific is projected to experience the most significant growth during the forecast period. The global market report for Medicare consulting service for 2025 includes regions such as Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, and Africa.

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