Explore Top Players of U.S. Revenue Cycle Management Market

Posted on 2022-05-12 by researchinsights in Technology // 0 Comments

San Francisco, California , USA, May 12, 2022 — /EPR Network/ —

U.S. Revenue Cycle Management Industry Overview

The U.S. revenue cycle management market size was valued at USD 126.1 billion in 2021 and is expected to expand at a compound annual growth rate (CAGR) of 10.3% from 2022 to 2030.

The rapidly transforming healthcare system and adoption of digitalization are paving a path for implementing healthcare IT services such as revenue cycle management (RCM) systems to organize and streamline workflows of healthcare organizations using synchronized management software solutions. RCM solutions are an integration of payment models, reimbursement guidelines, codes, and third-party payers. Medical services are facing complex challenges in billing and precise payment, which is anticipated to drive the demand for innovative RCM solutions. The availability of advanced innovative RCM solutions offered by renowned third-party service providers enables the healthcare industry to leverage the economic value and efficacy of these RCM solutions while simultaneously focusing on improving patient care.

Gather more insights about the market drivers, restrains and growth of the U.S. Revenue Cycle Management Market

The growing trend for outsourcing healthcare RCM solutions is majorly driven by value addition, business prospects, and finances. The healthcare industry is rapidly growing and evolving in the U.S. owing to the growing healthcare expenditure, rising number of well-established healthcare facilities, increasing healthcare IT spending, advancing healthcare IT infrastructure, and increasing emphasis on the patient-provider relationship. According to Centers for Medicare and Medicaid Services estimates in 2020, U.S. healthcare spending was recorded at USD 12,350 per capita and accounted for 19.7% of the country’s GDP.

Healthcare systems are implementing digital processing for reimbursements, codes, and claims management, which is driving market stakeholders to accommodate factors such as growth in risk-sharing, execution cost limits, and value-centric reimbursement structures. Healthcare organizations are demanding workflow optimization solutions, which, in turn, is expected to accelerate the market growth. Growing favorable government support and regulatory reforms are anticipated to support growth.

Outsourcing of revenue cycle management systems and services is driving the adoption rate of these solutions. Furthermore, the advantages associated with outsourcing RCM services are cost-effectiveness, adherence to existing regulations and guidelines, planning and staffing, training, and maintenance. Since the implementation of RCM systems and services requires certain skill sets and resources, healthcare facilities are readily outsourcing these services from third-party vendors. Moreover, the RCM market is undergoing regular advancements with value-added features such as data analytics and integration of artificial intelligence and machine learning algorithms in the existing product offerings. For example, predictive analytics will present unique data analysis and understanding. For instance, it is possible to understand a patient’s ability to pay the bill on a particular day if an email is sent at a predefined time. In addition, it is possible to predict reimbursement trends depending on past trends. It is possible to depend on analytical tools to determine RCM workflow, which can help the staff prioritize claims and generate good returns.

Moreover, market players are focusing on strengthening revenue cycle platforms through cloud-deployed models. The growing adoption of telemedicine and homecare offering value-based care is expected to support market growth. For instance, in February 2020, a veteran healthcare employee announced the launch of HealthRev Partners, which is completely focused on consultative-style revenue cycle management for hospice and home health agencies across the U.S. The company seeks to advance traditional RCM practices by offering a more consultative, modern approach by directly managing complex, daily billing, and coding processes by closely working with clients for improving operational efficiency. These improvements have a direct impact on security and financial success, with no high costs related to consulting services.

The U.S. healthcare industry is constantly progressing and adopting advanced technological solutions. Healthcare organizations’ revenue cycle managers need to identify opportunities to improve productivity, efficiency, patient fulfillment, and enhance financial and operational outcomes of the organization. Some of the identified opportunities to improve effectiveness include the creation and implementation of high-quality care practices, improved profit collection rates, minimized organizational overhead and vendor supervision time, enhanced patient satisfaction, and better account receivable outstanding timeline. The adoption and implementation of RCM solutions face a major restrain in the availability of skilled IT professionals. Some other challenges hindering adoption are rising costs, insurance claims management, and adequate resource allotment and management. Moreover, the Covid-19 pandemic created instabilities and uncertainties in workforce requirements for different RCM functions. The existing healthcare systems and current staffing model were disrupted due to the pandemic and remote working.

The ongoing pandemic had a dramatic impact on several sectors of the healthcare industry and caused disruptions in the normal functioning of the existing healthcare systems. Healthcare organizations’ sustainability was challenged due to a decline in revenue earnings. Due to the sharp increase in patient volume, there was a significant impact on healthcare expenses and medical billing complexities, which directly contributed to a surge in demand for outsourced revenue cycle management solutions across the U.S. The growing demand for RCM systems and services drove market players to integrate value-added features such as remote coding services, payer connect, reporting, audit, and analytics to serve the growing demand.

Browse through Grand View Research’s Healthcare IT Industry Research Reports.

Telemedicine Market – The telemedicine market size was valued at USD 70.4 billion in 2021 and is estimated to grow at a compound annual growth rate (CAGR) of 19.5% from 2022 to 2030.
Revenue Cycle Management Market – The global revenue cycle management market size was valued at USD 243.1 billion in 2021 and is projected to expand at a compound annual growth rate (CAGR) of 11.6% from 2022 to 2030.

U.S. Revenue Cycle Management Market Segmentation

Grand View Research, Inc. has segmented the U.S. revenue cycle management market on the basis of end user, product type, component, delivery mode, physician specialty, sourcing, and function:

S. Revenue Cycle Management End-user Outlook (Revenue, USD Billion, 2016 – 2030)
- Hospitals
- Physician & Clinical Services
S. Revenue Cycle Management Product Type Outlook (Revenue, USD Billion, 2016 – 2030)
- Contract Integrated System
- Standalone System
S. Revenue Cycle Management Component Outlook (Revenue, USD Billion, 2016 – 2030)
- Software Solution
- Services
S. Revenue Cycle Management Delivery Mode Outlook (Revenue, USD Billion, 2016 – 2030)
- On-premise
- Web-based
- Cloud-based
S. Revenue Cycle Management Physician Specialty Outlook (Revenue, USD Billion, 2016 – 2030)
- Oncology
- Cardiology
- Anesthesia
- Radiology
- Pathology
- Pain Management
- Emergency Service
- Others
S. Revenue Cycle Management Sourcing Outlook (Revenue, USD Billion, 2016 – 2030)
- In-house
- External RCM Apps/ Software
- Outsourced RCM Services
S. Revenue Cycle Management Function Outlook (Revenue, USD Billion, 2016 – 2030)
- Product Development
- Member Engagement
- Network Management
- Care Management
- Claim Management
- Risk and Compliances

Market Share Insights

February 2020: Waystar Health launched Hubble, an AI/RPA integrated platform used for revenue cycle process automation. Through this platform, revenue capture is increasing using predictive analytics and advanced machine learning algorithms.
January 2020: R1 RCM, Inc. entered into a strategic partnership with Rush University System for Health (RUSH) to achieve revenue cycle performance excellence and boost innovation in healthcare.

Key Companies profiled:

Some prominent players in the U.S. Revenue Cycle Management market include

Boehringer NXGN Management, LLC
athenahealth, Inc.
McKesson Corporation
OncoSpark, Inc.
Epic Systems Corporation
The SSI Group, Inc.
AllScripts Healthcare LLC
eClinicalWorks

Order a free sample PDF of the U.S. Revenue Cycle Management Market Intelligence Study, published by Grand View Research.

About Grand View Research

Grand View Research, U.S.-based market research and consulting company, provides syndicated as well as customized research reports and consulting services. Registered in California and headquartered in San Francisco, the company comprises over 425 analysts and consultants, adding more than 1200 market research reports to its vast database each year. These reports offer in-depth analysis on 46 industries across 25 major countries worldwide. With the help of an interactive market intelligence platform, Grand View Research Helps Fortune 500 companies and renowned academic institutes understand the global and regional business environment and gauge the opportunities that lie ahead.

Matched content

Editor’s pick