Revenue Cycle Management Market Share Growth by Top Company Region, Applications Drivers, Trends Forecast to 2025


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Apr 08, 2021, 08:58 EST


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The growth of the revenue cycle management (RCM) market is attributed to the increase in government initiatives to boost the adoption of RCM solutions, increasing revenue loss due to billing errors, and increasing adoption of Electronic Health/Medical Record (EHR/EMR).

Revenue for healthcare providers depends on the accurate processing of medical claims. For improving the financial outcome, a healthcare organization needs to maintain a quality revenue cycle and insurance billing. The revenue cycle management team comprises of accounts receivable (A/R) management and denial management. With mounting pressure on hospitals to reduce cost, most of the care providers are losing revenue due to claim denials and their failure to submit or delay the denied claim. This has given an opportunity for specialty firms that provide revenue cycle management service.

Most hospitals are now dependent on third-party providers for denial management service, as they lack the expert knowledge and the time to manage the reimbursement process. The most common billing errors include failure to verify insurance, filing an incomplete claim, coding errors, lack of specificity, and missing filing deadlines. Many of the care providers are now addressing the challenge by working with third-party medical billing professionals, who are expert in the overall revenue cycle management. Thereby, this factor is expected to drive the market studied over the forecast period.

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Key Market Trends

Cloud-based is the Segment Under Deployment that is Expected to Grow Fastest Over the Forecast Period

The web-based segment held a maximum share as it is installed off-site and is supervised by a third party. It is used over the internet and with a web browser, which does not require any additional storage or hardware. So, the data can be retrieved by various healthcare providers from different geographical locations.

The cloud-based segment is forecasted to show significant growth during the forecast period due to the flexibility and scalability offered by these solutions. The cloud-based delivery model makes the software extremely flexible regarding scalability (pay-as-you-go storage utilization). It simplifies and consolidates storage resources to reduce cost and enhance workflow, by eliminating departmental silos of clinical information. The storage and server power for the organization is hosted off-premise. The cloud vendor provides all the off-premise system support resources. This feature of cloud technology is a key market driver.

North America holds the Largest Market Share of the Revenue Cycle Management Market Currently and is Believed to Follow the Same Trend over the Forecast Period

The North American healthcare revenue cycle management market dominated the global market and is estimated to show a similar trend during the forecast period. This growth is due to factors like significant changes in regulations that have largely affected the finances, organization, and delivery of healthcare services. Most healthcare providers are deploying revenue cycle management (RCM) systems that reduce the time taken for receiving payment after providing a service in the region. The RCM that automates many activities previously done manually is saving time, which is a major factor for the growth of the market.

Competitive Landscape

The RCM market is moderately competitive, and consists of several major players, including Allscripts Healthcare Solutions, Athenahealth, Cerner Corporation, etc. The companies are implementing certain strategic initiatives, such as mergers, new product launches, acquisitions, and partnerships that help them in strengthening their market position.

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1 INTRODUCTION
1.1 Study Deliverables
1.2 Study Assumptions
1.3 Scope of the Study

2 RESEARCH METHODOLOGY

3 EXECUTIVE SUMMARY

4 MARKET DYNAMICS
4.1 Market Overview
4.2 Market Drivers
4.2.1 Government Initiatives to Boost the Adoption of RCM Solutions
4.2.2 Increasing Revenue Loss Due to Billing Errors
4.2.3 Increasing Adoption of EHR/EMR
4.3 Market Restraints
4.3.1 High Pricing and Maintenance of RCM Solutions
4.3.2 Lack of Proper IT infrastructure
4.4 Porter's Five Forces Analysis
4.4.1 Threat of New Entrants
4.4.2 Bargaining Power of Buyers/Consumers
4.4.3 Bargaining Power of Suppliers
4.4.4 Threat of Substitute Products
4.4.5 Intensity of Competitive Rivalry

5 MARKET SEGMENTATION
5.1 By Deployment
5.1.1 Web-based and Cloud-based
5.1.2 On-premise
5.2 By Function
5.2.1 Claims and Denial Management
5.2.2 Medical Coding and Billing
5.2.3 Electronic Health Record (EHR)
5.2.4 Clinical Documentation Improvement (CDI)
5.2.5 Insurance
5.2.6 Other Functions
5.3 By End User
5.3.1 Hospitals
5.3.2 Laboratories
5.3.3 Other End Users
5.4 Geography
5.4.1 North America
5.4.1.1 United States
5.4.1.2 Canada
5.4.1.3 Mexico
5.4.2 Europe
5.4.2.1 Germany
5.4.2.2 United Kingdom
5.4.2.3 France
5.4.2.4 Italy
5.4.2.5 Spain
5.4.2.6 Rest of Europe
5.4.3 Asia-Pacific
5.4.3.1 China
5.4.3.2 Japan
5.4.3.3 India
5.4.3.4 Australia
5.4.3.5 South Korea
5.4.3.6 Rest of Asia-Pacific
5.4.4 Middle-East & Africa
5.4.4.1 GCC
5.4.4.2 South Africa
5.4.4.3 Rest of Middle-East & Africa
5.4.5 South America
5.4.5.1 Brazil
5.4.5.2 Argentina
5.4.5.3 Rest of South America

6 COMPETITIVE LANDSCAPE
6.1 Company Profiles
6.1.1 Allscripts Healthcare Solutions
6.1.2 athenahealth, Inc.
6.1.3 Cerner Corporation
6.1.4 Conifer Health Solutions, LLC
6.1.5 Constellation Software
6.1.6 eClinicalWorks
6.1.7 Epic Systems Corporation
6.1.8 GE Healthcare
6.1.9 GeBBs Healthcare Solutions, Inc.
6.1.10 Mckesson Corporation

7 MARKET OPPORTUNITIES AND FUTURE TRENDS

 

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