London, Jan. 29, 2021 (GLOBE NEWSWIRE) -- According to a new market research report, titled “Mid-revenue Cycle Management/Clinical Documentation Improvement Market by Product & Service [Solutions (Coding, Charge Capture, DRG Group, Pre-Bill Review), Consulting Services], End User (Providers, Payers), and Geography - Global Forecast to 2027”, published by Meticulous Research®, the mid-revenue cycle management/clinical documentation improvement market is expected to grow at a CAGR of 6.6% from 2020 to reach $4.55 billion by 2027.
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Mid-revenue cycle management involves all processes associated with clinical and financial coverage. The mid-revenue cycle management/clinical documentation improvement market covers solutions and consulting services that improve financial and quality outcomes. With the shift towards value-based and pay-for-performance models, prioritizing clinical documentation improvement and coding, mid-revenue cycle management has become a focal point in healthcare. The growth of this market is mainly attributed to the alterations in revenue due to medical billing errors, increasing healthcare expenditure, and the growing need to manage unstructured healthcare data. The integration of AI with healthcare revenue cycle management and changing scenarios in developing economies are expected to boost the adoption of healthcare IT solutions and create opportunities for the growth of this market during the forecast period.
However, the limitations in the IT infrastructure of developing economies limit the growth of this market. Moreover, data security concerns also hinder the market’s growth to some extent.
Impact of COVID-19 on the Mid-Revenue Cycle Management/Clinical Documentation Improvement Market
Hospitals and health systems across the world have ramped up meeting the challenges of COVID-19. The global COVID-19 pandemic has affected 219 countries and territories around the globe. To combat the challenges faced during the outbreak of COVID -19, hospitals worldwide ramped up the testing and increased efforts to provide access to suitable treatment options to minimize the spread of infection.
Hospitals faced tremendous financial pressures, which presented a challenge for healthcare systems. Some of the financing implications faced by hospitals amid the COVID-19 pandemic are:
- The cost of care of the treatment of COVID-19 increased substantially, increasing healthcare spending
- Purchase of new essential medical supplies requiring investments in purchasing new equipment and PPE kits
- Revenue shortfalls due to cancellation of elective surgeries
- Compensation for the services provided by the non-contracted acute care facilities
- Shut down or layoffs within outpatient surgery centers, physician offices
These financial challenges have reduced budgets for implementation or upgradation of digital health solutions, negatively influencing the market growth.
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The COVID-19 pandemic is also projected to positively impact the market growth. For instance, after the reopening of outpatient surgery centers, the previously canceled elective surgeries were operated through outpatient surgery centers. The physicians and patients preferred outpatient surgery centers due to the COVID-19 pandemic's safety concerns. This resulted in gradually growing cash flows in the outpatient surgery centers, requiring solutions like mid revenue cycle management. Further, the ambulatory surgery centers, to safeguard their staff, began outsourcing medical billing and coding and claim processing, positively influencing outsourcing revenue cycle operations. Additionally, in the U.S., the coding practices are altered under several instances like increasing reimbursement rates, the announcement of new CPT codes for reporting antigen testing of patients. Thus, alterations in coding practices is expected to drive the adoption of outsourced mid revenue cycle solutions, positively influencing the market growth.
The mid-revenue cycle management/clinical documentation improvement market study presents historical market data in terms of values (2018 and 2019), estimated current data (2020), and forecasts for 2027 by product & service [solutions (clinical coding, clinical documentation improvement, charge capture, clinical documentation, diagnosis-related grouping, pre-bill review), consulting services], end user [healthcare providers (inpatient settings, outpatient settings), healthcare payers] and geography. The study also evaluates industry competitors and analyses the market at regional and country levels.
In 2020, based on product & service, the solutions segment commanded the largest share of the overall mid-revenue cycle management/clinical documentation improvement market due to the increasing need for improving revenue cycle productivity by eliminating coding errors allied with manual coding practices and streamlining medical workflow.
In 2020, based on end user, the healthcare provider segment commanded the largest share of the overall mid-revenue cycle management/clinical documentation improvement market due to the growing adoption of revenue cycle solutions by the organizations for its ability to preserve and manage patient billing records, simplify billing collection cycles, and establish communication between EHRs and accounting systems.
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In 2020, geographically, North America dominated the global mid-revenue cycle management/clinical documentation improvement market, followed by Europe and Asia-Pacific. Increasing utilization of mid revenue cycle management solutions in the region to reduce healthcare costs, the growing need to reduce the loss of revenue due to medical billing & coding errors, and shift towards value-based care are some of the key factors driving the growth of this segment.
The report also includes an extensive assessment of the product portfolio, end-user analysis, geographic analysis, and key strategic developments adopted by the leading market participants in the industry over the past four years. The mid-revenue cycle management/clinical documentation improvement market has witnessed numerous new product & service launches; agreements, collaborations, & partnerships; and acquisitions & mergers.
The key players operating in the global mid-revenue cycle management/clinical documentation improvement market are nThrive, Inc. (U.S.), Dolbey Systems, Inc. (U.S.), 3M Company (U.S.), UnitedHealth Group Incorporated (U.S.), Streamline Healthcare Solutions, LLC (U.S.), Vitalware, LLC (U.S.), Iodine Software LLC (U.S.), Craneware plc (U.K.), Epic Systems Corporation (U.S.), ChartWise Medical Systems, Inc. (U.S.), Nuance Communications, Inc (U.S.), and Cerner Corporation (U.S.) among others.
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Scope of the Report:
Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, by Product
- Solutions
- Clinical Coding
- Clinical Documentation Improvement
- Charge Capture
- Clinical Documentation
- Diagnosis-Related Grouping
- Pre-Bill Review
- Consulting Services
Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, by End User
- Healthcare Providers
- Inpatient Settings
- Outpatient Settings
- Healthcare payers
Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, by Geography
- North America
- U.S.
- Canada
- Mexico
- Europe
- Germany
- France
- U.K.
- Italy
- Spain
- Rest of Europe (RoE)
- Asia Pacific
- India
- China
- Indonesia
- Australia & New Zealand
- Japan
- Rest of Asia-Pacific (APAC)
- Latin America
- Brazil
- Argentina
- Chile
- Rest of Latin America
- Middle East & Africa
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