The U.S. revenue cycle management market size is expected to reach USD 308.2 billion by 2030, according to a new report by Grand View Research, Inc. It is expected to expand at a CAGR of 10.3% from 2022 to 2030. Growing data siloes emerging from multiple healthcare functionalities and departments are driving the need to consolidate and streamline unorganized workflows to boost efficiency and productivity in healthcare organizations. Furthermore, the growing trend of digital health and widespread adoption of healthcare IT solutions are anticipated to accelerate market growth. The market growth in the U.S. can also be attributed to the increasing healthcare IT spending and the growing trend of outsourcing RCM systems and services.
U.S. Revenue Cycle Management Market Report Highlights
- The services component segment dominated the market in 2021 owing to the outsourcing of RCM services from third-party vendors with adequate skill set and workforce
- By product type, integrated system spearheaded the market in 2021 owing to the growing demand from healthcare organizations for a synchronized single platform to manage financial activities
- The web-based delivery mode segment dominated the market in 2021 owing to the cost-effectiveness and rapid deployment associated with these solutions
- The hospitals end-user segment led the market in 2021 owing to the presence of well-established hospitals and growing healthcare IT infrastructure
- The others physician specialty segment dominated the market in 2021 owing to the increase in insurance coverage policies for other healthcare services
- The in-house sourcing segment held the largest revenue share in 2021 owing to the advantages offered such as patient information confidentiality and entire control of coding operations
- Based on function, the claims management segment led the market in 2021 owing to the increasing patient volume and the presence of ineffective claim management systems
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Revenue cycle management (RCM) is the financial management process that helps track, identify, collect, and manage incoming payments. Incorporates these core functions and consists of the methodologies and tools, utilizing medical billing software, that healthcare facilities use to track patient care. Services presented to healthcare organizations include medical coding, medical billing, and patient management solutions. It includes the entire revenue cycle from the time of an appointment all the way through the time the patient’s bill is paid in full. The software segment is expected to grow steadily due to the increasing demand to digitize and streamline operational workflows to improve patient care.
Healthcare systems in the U.S. are undergoing significant transformations and readily adopting electronic processes for claims and reimbursement management. The presence of numerous renowned healthcare facilities, increasing healthcare awareness and spending, and the growing digital literacy are expected to support the growth of the market. Favorable regulatory reforms from government agencies and regular technological advancements by market players are expected to boost market growth over the forthcoming years. The growing need for regular technological advancements is driving market players to revise their product development strategies to improve provider-patient relationship in healthcare facilities. Key participants are focusing on collaborations and strategic partnerships with other market players to combine expertise and grow their business footprint.
For instance, in 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. As per the agreement, the platform by R1 RCM would be integrated with RUSH’s Epic EMR workflow, which uses enterprise-wide performance analytics and intelligent automation to improve the company’s current revenue cycle operations. In addition, the collaboration would aid R1 RCM to launch its innovation lab, which focuses on value-based care and incorporates advanced analytics to educate other healthcare institutions in preparing for the future healthcare workforce. This partnership is expected to enable significant improvements in serving patients and financial results in the Chicago metropolitan area.
Market players are introducing innovative product solutions to expand their product portfolio and grow their clientele. For instance, in June 2019, Homecare Homebase (HCHB) introduced a new RCM tool that would reduce the burden related to staffing and time-consuming administrative functions, which often restrict the home health agencies from spending more quality time with patients. Moreover, this new tool offers greater transparency into the murky RCM process that is suitable for agency management, by making use of HCHB dashboards and analytical systems. This new tool makes use of extensive knowledge of the billing process, which aids in achieving and maintaining high collection days and reducing outstanding days in accounts receivable (AR), enabling more time with patients.
COVID-19 Impacts On U.S. Revenue Cycle Management Market
The pandemic increased the focus on patient financial responsibility and the implementation of America’s Health Insurance Plans (AHIP) to minimize out-of-pocket healthcare expenses for Covid-19 patients. Outsourcing of RCM systems witness significant growth due to the surge in inpatient volumes and rising healthcare costs, a significant surge in claims volume, and constantly changing reimbursement codes and policies. Healthcare payers are capitalizing on future growth opportunities by investing in preventive healthcare solutions such as telehealth and early screenings.
Competitive Analysis By Major Companies
The key players in the U.S. market are focusing on devising numerous business strategies such as innovative product development, geographic expansions, technological collaboration, partnerships, and mergers & acquisitions. Some prominent players in the U.S. revenue cycle management include:
- NXGN Management, LLC
- athenahealth, Inc.
- McKesson Corporation
- OncoSpark, Inc.
- Epic Systems Corporation
- The SSI Group, Inc.
- AllScripts Healthcare LLC
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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)
- S. Revenue Cycle Management Product Type Outlook (Revenue, USD Billion, 2016 – 2030)
- S. Revenue Cycle Management Component Outlook (Revenue, USD Billion, 2016 – 2030)
- S. Revenue Cycle Management Delivery Mode Outlook (Revenue, USD Billion, 2016 – 2030)
- S. Revenue Cycle Management Physician Specialty Outlook (Revenue, USD Billion, 2016 – 2030)
- S. Revenue Cycle Management Sourcing Outlook (Revenue, USD Billion, 2016 – 2030)
- S. Revenue Cycle Management Function Outlook (Revenue, USD Billion, 2016 – 2030)
- List of Key Players of U.S. Revenue Cycle Management Market
Research Methodology
We employ a comprehensive and iterative research methodology focused on minimizing deviance in order to provide the most accurate estimates and forecasts possible. We utilize a combination of bottom-up and top-down approaches for segmenting and estimating quantitative aspects of the market. Data is continuously filtered to ensure that only validated and authenticated sources are considered. In addition, data is also mined from a host of reports in our repository, as well as a number of reputed paid databases. Our market estimates and forecasts are derived through simulation models. A unique model is created and customized for each study. Gathered information for market dynamics, technology landscape, application development, and pricing trends are fed into the model and analyzed simultaneously.
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About Grand View Research
Grand View Research provides syndicated as well as customized research reports and consulting services on 46 industries across 25 major countries worldwide. This U.S. based market research and consulting company is registered in California and headquartered in San Francisco. Comprising over 425 analysts and consultants, the company adds 1200+ market research reports to its extensive database each year. Supported by an interactive market intelligence platform, the team at Grand View Research guides Fortune 500 companies and prominent academic institutes in comprehending the global and regional business environment and carefully identifying future opportunities.
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