Back-end Revenue Cycle Management Market – Growing Importance of Denials Management

PUNE, India, 2021-Apr-07 — /EPR Network/ — The study involved four major activities to estimate the current market size for back-end revenue cycle management. Exhaustive secondary research was done to collect information on the market and its different sub-segments. The next step was to validate these findings, assumptions, and sizing with industry experts across the value chain through primary research.

Secondary Research;

In the secondary research process, various secondary sources such as Hoovers, D&B, Bloomberg Business, and Factiva have been referred to so as to identify and collect information for this study. These secondary sources included annual reports, press releases & investor presentations of companies, white papers, certified publications, articles by recognized authors, gold-standard & silver-standard websites, regulatory bodies, and databases.

According to the new market research report “Back-end Revenue Cycle Management Market by Product and Services (Claim Processing, Denial Management, Payment Integrity), Delivery Mode (On-Premise, Cloud Based), End-User (Payer, Provider (Inpatient, Outpatient)), and Region – Global Forecast” published by MarketsandMarkets™.

Expected Revenue Surge: The back-end revenue cycle management market is projected to reach USD 10.4 billion by 2023 from USD 8.1 billion in 2018, at a CAGR of 5.0%.

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Growth Drivers: Growing importance of denials management;

To reduce costs and maximize profits, insurance companies are increasingly denying claims as well as coverage to patients being treated for chronic or persistent illnesses. This is putting an extra burden on healthcare providers to manage operating costs, and in turn is supporting the adoption of back-end revenue cycle management solutions (with a growing number of healthcare providers focusing on properly analyzing denied claims and appealing them).

Many healthcare providers across the globe still use manual and paper-oriented approaches to manage denials. This results in errors, delayed follow-ups, and miscommunication between healthcare providers and insurance companies. The use of back-end revenue cycle management solutions over manual and paper-oriented approaches can not only help healthcare providers overcome these issues but also help them save significant costs. As a result, the demand for back-end revenue cycle management solutions is expected to increase among end users during the forecast period.

Geographical Scenario in Depth:

Geographically, the back-end revenue cycle management market is divided into North America, Europe, Asia, and the Rest of the World (RoW). North America is expected to account for the largest share in 2018 owing to factors such as growing HCIT investments in the region and the presence of regulatory mandates. North America is followed by Europe and Asia. The market in Asia is relatively nascent; however, it is projected to be the fastest-growing market during the forecast period.

Leading Key-Players:

Athenahealth (US), Cerner Corporation (US), Allscripts Healthcare Solutions, Inc. (US), eClinicalWorks (US), Optum, Inc. (US), McKesson Corporation (US), Conifer Health Solutions (US), GeBBs Healthcare Solutions (US), The SSI Group (US), GE Healthcare (US), nThrive (US), DST Systems (US), Cognizant Technology Solutions (US), and Quest Diagnostics (US) are the key players in the revenue cycle management market.

athenahealth was among the key players in the revenue cycle management market. The company focuses on partnerships and acquisitions to expand its business operations. The company also offers qualitative software tools by adopting advanced technologies. In line with this strategy, athenahealth acquired several healthcare information technology companies to enhance its capabilities and competency in the back-end revenue cycle management market. For instance, in 2017, athenahealth acquired Praxify Technologies, Inc., a Palo Alto-based company. The acquisition was aimed at advancing the company’s platform strategy and mobile capabilities to reduce workflow inefficiencies.

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