PUBLISHER: The Business Research Company | PRODUCT CODE: 1484795
PUBLISHER: The Business Research Company | PRODUCT CODE: 1484795
Healthcare revenue cycle management entails overseeing financial transactions within the healthcare system, from patient registration to reimbursement, to ensure optimal revenue generation. It integrates a variety of services and technological solutions aimed at enhancing financial performance and compliance within healthcare organizations.
At its core, healthcare revenue cycle management comprises two main components: software and services. Software solutions play a pivotal role in automating and optimizing financial processes, encompassing billing, coding, claims processing, and payment collection. These software applications can be deployed either on-premises or via cloud-based platforms, catering to various functions such as claims and denial management, medical coding, billing eligibility verification, and payment remittance. They serve a diverse array of end users, including hospitals, laboratories, physicians, and other healthcare entities.
The healthcare revenue cycle management market research report is one of a series of new reports from The Business Research Company that provides healthcare revenue cycle management market statistics, including healthcare revenue cycle management industry global market size, regional shares, competitors with a healthcare revenue cycle management market share, detailed healthcare revenue cycle management market segments, market trends and opportunities, and any further data you may need to thrive in the healthcare revenue cycle management industry. This healthcare revenue cycle management market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenario of the industry.
The healthcare revenue cycle management market size has grown rapidly in recent years. It will grow from $60.08 billion in 2023 to $69.38 billion in 2024 at a compound annual growth rate (CAGR) of 15.5%. The expansion witnessed in the historical period can be ascribed to heightened investments in healthcare, the shift towards value-centric care frameworks, compliance obligations, widespread integration of electronic health records (EHR), and a focus on streamlining costs and enhancing operational efficiency.
The healthcare revenue cycle management market size is expected to see rapid growth in the next few years. It will grow to $124.79 billion in 2028 at a compound annual growth rate (CAGR) of 15.8%. The projected expansion in the upcoming period stems from the increasing financial responsibility placed on patients, the availability of scalable revenue cycle management (RCM) solutions tailored for mid-sized hospitals, the rising significance of RCM within value-based care frameworks, collaborative ventures between RCM and electronic health record (EHR) providers to offer comprehensive solutions, and advancements in payment processing capabilities within RCM systems. Key trends anticipated in the forecast period encompass automation and artificial intelligence (AI) integration, a transition towards reimbursement models aligned with value-based care, the integration of RCM systems with telehealth platforms, the utilization of data analytics, and the exploration of outsourcing and partnerships as strategic avenues.
The healthcare revenue cycle management market is poised for growth, largely driven by the increasing adoption of electronic health records (EHR). These EHR systems, serving as digital repositories of patients' medical data, offer comprehensive health information accessible to authorized healthcare providers. The rising adoption of EHR is spurred by various factors, including the demand for enhanced patient care access, its efficacy in healthcare delivery, and its seamless information transfer capabilities. EHR systems streamline revenue cycle management by facilitating accurate documentation, efficient claim processing, and timely reimbursement for medical services rendered. Notably, data from the Office of the National Coordinator for Health Information Technology (ONC) in 2021 revealed significant adoption rates, with approximately 78% of office-based physicians and 96% of non-federal acute care hospitals in the US having embraced certified EHR systems. Therefore, increasing adoption of electronic health records (EHR) drives the healthcare revenue cycle management market.
Key players in the healthcare revenue cycle management sector prioritize innovation, with a focus on developing advanced solutions such as sophisticated revenue management platforms. These platforms are tailored to assist providers in enhancing financial performance, reducing administrative burdens, and elevating patient care quality. An advanced revenue management platform in healthcare denotes sophisticated software solutions aimed at optimizing financial aspects within healthcare organizations, particularly in managing revenue cycles. For instance, FinThrive, a US-based healthcare company, introduced its end-to-end revenue management platform in March 2022. This platform offers seamless revenue management by ensuring flexibility, scalability, and visibility across the revenue cycle, thus enabling accurate billing, regulatory compliance, and efficient financial performance. Such platforms aim to maximize revenue opportunities, minimize administrative costs, boost efficiency, and bolster the financial health of organizations, especially in industries such as healthcare where revenue cycle management is pivotal for sustainability and success.
In January 2024, Veradigm, an integrated data systems and services company based in the US, completed the acquisition of Koha Health for an undisclosed sum. This strategic move aims to augment Veradigm's capabilities in ambulatory services and musculoskeletal care, thereby fortifying its position in the healthcare market and expanding its portfolio of revenue cycle services. Koha Health, a US-based firm specializing in healthcare revenue cycle management, offers a range of services including revenue cycle optimization, strategic advisory services, and patient experience enhancement. This acquisition underscores Veradigm's commitment to enhancing its offerings and market presence, capitalizing on Koha Health's expertise to deliver value-added solutions to its clientele.
Major companies operating in the healthcare revenue cycle management market are McKesson Corporation, 3M Health Information Systems, GE Healthcare, Experian Health, Cerner Corporation, Epic Systems Corporation, Change Healthcare, R1 RCM Inc., Nuance Communications, Conifer Health Solutions, Allscripts Healthcare Solutions, Health Catalyst, Craneware, MEDHOST Inc., NextGen Healthcare, Greenway Health, MedeAnalytics, Source Medical, Patientco, Athenahealth Inc., eClinicalWorks, Optum, nThrive, Waystar, IBM Watson Health, Trizetto Provider Solutions, Quadax, Experity
North America was the largest region in the healthcare revenue cycle management market in 2023. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the healthcare revenue cycle management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.
The countries covered in the healthcare revenue cycle management market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA, Canada, Italy, Spain.
The healthcare revenue cycle management market includes revenues earned by entities by providing services such as eligibility verification, coding and documentation review, claims submission and management, accounts receivable (AR) management, payment posting and reconciliation, denial management, and appeals. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.
The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD, unless otherwise specified).
The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.
Healthcare Revenue Cycle Management Global Market Report 2024 from The Business Research Company provides strategists, marketers and senior management with the critical information they need to assess the market.
This report focuses on healthcare revenue cycle management market which is experiencing strong growth. The report gives a guide to the trends which will be shaping the market over the next ten years and beyond.
Where is the largest and fastest growing market for healthcare revenue cycle management ? How does the market relate to the overall economy, demography and other similar markets? What forces will shape the market going forward? The healthcare revenue cycle management market global report from the Business Research Company answers all these questions and many more.
The report covers market characteristics, size and growth, segmentation, regional and country breakdowns, competitive landscape, market shares, trends and strategies for this market. It traces the market's historic and forecast market growth by geography.
The impact of sanctions, supply chain disruptions, and altered demand for goods and services due to the Russian Ukraine war, impacting various macro-economic factors and parameters in the Eastern European region and its subsequent effect on global markets.
The impact of higher inflation in many countries and the resulting spike in interest rates.
The continued but declining impact of COVID-19 on supply chains and consumption patterns.