Revenue Cycle Management Market is Expected to Reach $67.8 billion | MarketsandMarkets.


Chicago, April 03, 2023 (GLOBE NEWSWIRE) -- The Revenue Cycle Management (RCM) industry is expected to grow significantly over the next few years, as healthcare organizations increasingly adopt digital solutions to manage the complexities of the revenue cycle. As hospitals and physician practices transition to value-based care, they are looking to RCM solutions to help them optimize their revenue and reduce costs. The adoption of new technologies, such as cloud-based solutions, artificial intelligence, and robotic process automation, is also expected to drive the growth of the RCM industry. In addition, the increased demand for remote patient monitoring, telemedicine, and other digital health solutions will likely contribute to the growth of the RCM industry.

Revenue Cycle Management market in terms of revenue was estimated to be worth $40.9 billion in 2021 and is poised to reach $67.8 billion by 2026, growing at a CAGR of 10.6% from 2021 to 2026 according to a latest report published by MarketsandMarkets™. The growth of this market is majorly attributed to the need for increasing patient volumes, and the growing need to manage unstructured healthcare data. Also, growing regulatory requirements & government initiatives are expected to drive demand growth in the revenue cycle management market during the forecast period.

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Revenue Cycle Management Market Scope:

Report Coverage Details
Market Revenue in 2021 $40.9 billion
Estimated Value by 2026 $67.8 billion
Growth Rate Poised to grow at a CAGR of 10.6%
Market Size Available for 2020–2026
Forecast Period 2021–2026
Forecast Units Value (USD Billion)
Report Coverage Revenue Forecast, Competitive Landscape, Growth Factors, and Trends
Segments Covered Product & services, delivery mode, end user and region
Geographies Covered North America, Europe, Asia Pacific, Latin America, and Middle East & Africa
Report Highlights Updated financial information / product portfolio of players
Key Market Opportunity Growing demand for AI & cloud-based deployment
Key Market Drivers Growing need to manage unstructured healthcare data

The revenue cycle management market has been segmented on the basis of product & services, delivery mode, end user, and region. Based on product & services, the revenue cycle management market has been segmented into solutions, and outsourcing services. The outsourcing services segment accounted for the largest share in the revenue cycle management market. The large share and high growth of this segment can be attributed to the lack of IT infrastructure and the shortage of skilled HCIT personnel.

On the basis of delivery mode, the global revenue cycle management market is segmented into on-premises and cloud-based. On-premises accounted for the largest share in the revenue cycle management market. The large share of this segment is attributed to the increasing demand for mobile support systems for better customer (patient) engagement platforms.

On the basis of end user, the global revenue cycle management market is segmented into healthcare providers and healthcare payers. The healthcare providers segment accounted for the largest share in the Revenue cycle management market. The large share of this segment can be attributed to the growing need to automate the process from patient registration to billing and claims processing and provide better transparency that improves the overall financial health of the provider organization.

North America accounted for the largest share of the revenue cycle management market in 2020. The large shares of North America in the global revenue cycle management market can be attributed to factors such as stringent regulations, increasing volume of claims denials, the presence of a high number of private healthcare payers and well-established government payers, and many healthcare IT companies are some of the factors driving the growth of the revenue cycle management market in this region.

Key Market Players:

The major players in the global revenue cycle management market are R1 RCM (US), Cerner Corporation (US), Optum (US). Other prominent players in the market include McKesson Corporation (US), Change Healthcare (US), 3M (US), Experian plc (Ireland), Conifer Health Solutions (US), Allscripts Healthcare Solutions (US), GE Healthcare (US), Cognizant (US), athenahealth (US), SSI Group LLC (US), AdvantEdge Healthcare (US), and Huron Consulting Group (US).

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Hypothetic Challenges of Revenue Cycle Management Market in Near Future:

  • Increased focus on data security and privacy: With the implementation of more stringent data security regulations and the rise of cyber-attacks, the revenue cycle management market will need to focus on providing more secure solutions for protecting patient and financial data.
  • Growing complexity of healthcare regulations: Healthcare regulations are becoming increasingly complex and are subject to frequent changes, making it difficult for revenue cycle management solutions to keep up.
  • Increased focus on patient experience: With the rise of patient-centered healthcare, providers are focusing more on providing a high-quality patient experience. This means that revenue cycle management solutions must be able to provide a seamless patient experience.
  • Expansion of value-based care models: As more providers shift to value-based care models, revenue cycle management solutions must be able to track and optimize performance based on different metrics.
  • Growing demand for AI and machine learning: AI and machine learning technologies are becoming increasingly important for improving the efficiency and accuracy of revenue cycle management solutions.

Top 3 Use Cases of Revenue Cycle Management Market:

  • Automating Claims Management: Automating claims management is essential for streamlining the revenue cycle. Automation can help to reduce manual effort and speed up the process of claims adjudication and payment. Automating claims management can help to reduce errors, eliminate duplicate data entry, and improve accuracy.
  • Enhancing Patient Engagement: Patient engagement is a key component of the revenue cycle management process. Ensuring that patients are well informed about their health insurance coverage, payment options, and other healthcare related information can help to improve the overall customer experience. This can be achieved through patient portals, mobile applications, and other digital tools that allow for direct communication between providers and patients.
  • Streamlining Provider Network Management: Provider network management is a critical component of the revenue cycle management process. It is essential for providers to manage their network of health care providers, including their internal staff, external vendors, and other organizations. Streamlining this process can help to ensure that all providers are following regulations, provide timely services, and maintain the highest quality of care. Additionally, it can help to reduce administrative costs associated with managing the provider network.

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Recent Developments:

  • In 2021, R1 and Mednax entered into an agreement to make R1 the primary provider of enterprise revenue cycle management services for Mednax.
  • In 2021, Vanderbilt collaborated with McKesson to offer VHRxS’ full suite of specialty pharmacy consulting services to McKesson’s health system clients.
  • In 2020, Cerner and Banner signed an agreement to add Cerner’s revenue cycle management solutions to Banner Health’s profile.

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