New York, Aug. 02, 2023 (GLOBE NEWSWIRE) -- The global revenue cycle management market size is slated to expand at ~13.60% CAGR between 2023 and 2035. The market is poised to garner a revenue of USD 214 billion by the end of 2035, up from a revenue of ~USD 46 billion in the year 2022.The growth of the market is attributed to the rising need for structured healthcare services along with the introduction of such systems that integrate administrative data such as patient identity, insurance plan and others to enable rapid value-based reimbursement due to the growing patient population in the world. For example, according to the latest updates, more than 200,700 patients were admitted to general hospitals in Norway in 2022.
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Furthermore, among the factors driving revenue cycle management market growth is the increase in healthcare spending worldwide which is responsible for the growing need to unify the entire healthcare system through the active use of various IT solutions, such as: RCM, which enables healthcare facilities to track patient treatment stages from registration and scheduling to final balance payment. According to World Bank statistics, current global health expenditure as a percentage of GDP increased from 8.63% in 2000 to 84% in 2019. Therefore, the increasing influx of patients into hospitals due to the prevalence of various types of chronic diseases worldwide and the high spending in the forecast period are expected to offer potential for market expansion.
Revenue Cycle Management Market: Key Takeaways
- Market in North America to propel highest growth
- The cloud-based segment to garner the highest growth
- Market in Asia Pacific to grow at a highest rate
Increasing Opportunities for Medical Billing Software & Medical Billing across the Globe to Boost Market Growth
The growing need for healthcare providers to make workflows more efficient, as well as the adoption of practices that save healthcare facilities time and money, reduce fewer claim denials, and allow patients to make payments online are fueling adoption. of these advanced RCM systems. There are currently nearly 300 medical billing companies operating in the United States alone. As healthcare providers strive to improve the patient experience by providing quality care and lower costs, most other processes are now outsourced.
Additionally, according to the results, the average error rate for self-generated claims is nearly 30%, but this number is expected to drop to less than 1% when medical billing is outsourced to a reputable company. Therefore, it is expected that this will boost the market growth in the coming years. For example, according to the data, about 60 million people, or 18.2% of the US population, enrolled in Medicare in 2021, while many people were covered by private health insurance. The growing number of insured patients, medical records, and increased use of codes are helping the insurance company determine coverage, and the medical necessity of services is expected to drive the adoption of systems such as revenue cycle, patient involvement, and care coordination service.
Revenue Cycle Management Market: Regional Overview
The market is segmented into five major regions including North America, Europe, Asia Pacific, Latin America, and the Middle East and Africa region.
Expanding Healthcare Industry to Drive the Market Growth in North America Region
The revenue cycle management market in North America region is estimated to garner the largest revenue by the end of 2035. The North American healthcare industry has witnessed an increased demand for services due to factors such as an aging population, the prevalence of chronic diseases, and advancements in medical treatments. The healthcare reimbursement landscape in North America is highly complex, with numerous regulations and policies that healthcare providers must navigate. The implementation of value-based care models, Medicare and Medicaid requirements, and commercial payer policies has increased the need for efficient revenue cycle management solutions.
Healthcare organizations are under pressure to reduce costs while optimizing revenue streams to remain financially sustainable. Revenue cycle management solutions can help identify areas of improvement, streamline billing processes, reduce denials, and enhance overall revenue performance. The growth of the market is mainly due to the increasing digital transformation in the healthcare industry as well as increasing spending on healthcare IT as well as the increasing adoption of the latest IT solutions, such as e.g., B. IT systems attributed. of revenue cycle management in healthcare to improve efficiency and increase value-based care reimbursement. According to a survey, in the United States alone, 75% of hospitals and healthcare systems implemented Revenue Cycle Management (RCM) technology during the COVID-19 pandemic. as well as favorable regulations for important market participants in the region will create lucrative growth opportunities for the market region.
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Growing investment in healthcare IT solutions to Propel the Growth in the Asia Pacific Region
The Asia Pacific revenue cycle management market is estimated to garner the highest CAGR by the end of 2035. Healthcare expenditure in the Asia Pacific region has been rising steadily due to factors such as population growth, increasing income levels, and improved access to healthcare services. According to a report, healthcare spending in the Asia Pacific region is projected to reach USD 4.2 trillion by 2025. Many countries in the Asia Pacific region have been actively investing in healthcare IT solutions, including electronic medical records (EMRs) and hospital information systems (HIS). This increased adoption of technology in healthcare has created opportunities for RCM solutions to optimize revenue processes.
The Asia Pacific region has witnessed a significant expansion of private healthcare services, driven by rising middle-class populations, increased insurance coverage, and growing medical tourism. Private healthcare providers often prioritize efficient revenue cycle management to ensure financial sustainability and profitability. Several countries in the Asia Pacific region have launched initiatives to digitize healthcare systems, including the implementation of electronic health records (EHRs) and telemedicine. These initiatives create a conducive environment for the adoption of RCM solutions that integrate with digital healthcare infrastructure.
Revenue Cycle Management, Segmentation by Deployment Model
- On-Premises
- Cloud-Based
Amongst these two segments, the cloud based segment in revenue cycle management market is anticipated to hold the largest share over the forecast period. Cloud-based RCM solutions offer scalability and flexibility to healthcare organizations, allowing them to adapt to changing needs and scale their operations seamlessly. According to a survey, 83% of healthcare organizations using cloud-based RCM solutions reported scalability as a significant benefit. Scalable solutions enable healthcare providers to handle increased volumes of patient data, claims, and billing processes without major infrastructure investments. Cloud-based RCM solutions offer cost advantages over on-premises systems, eliminating the need for extensive hardware infrastructure and reducing maintenance costs.
Cloud-based solutions also eliminate the need for manual software updates, as updates and maintenance are handled by the service provider, further reducing costs. Cloud-based RCM solutions enable healthcare providers to access and manage their revenue cycle processes remotely, facilitating collaboration across multiple locations or remote teams. This is especially valuable in scenarios such as telehealth and distributed healthcare settings.
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Revenue Cycle Management, Segmentation by End User
- Hospitals
- Specialty Clinics
- Laboratories
- Others
Amongst these four segments, the hospitals segment in revenue cycle management market is anticipated to hold a significant share over the forecast period. Hospitals face unique challenges in managing their revenue cycles due to the complexity of billing and reimbursement processes. According to a survey, 70% of hospital finance leaders in the United States reported that managing the revenue cycle has become more challenging in recent years. Hospitals require robust RCM solutions to streamline processes, reduce billing errors, and improve revenue collection. Hospitals are under increasing financial pressure due to rising healthcare costs, regulatory changes, and reduced reimbursements from payers. Hospitals strive to improve operational efficiency and reduce costs to deliver high-quality care while maintaining financial viability.
RCM solutions automate processes, optimize coding and billing, and provide analytics to identify areas for improvement, helping hospitals achieve operational efficiency and cost reduction goals. The shift from fee-for-service to value-based care models requires hospitals to focus on quality outcomes and cost-effective care delivery. Value-based care models emphasize accurate coding, proper documentation, and efficient claims management, all of which are facilitated by RCM solutions.
Revenue Cycle Management, Segmentation by Service
- Claims and Denial Management
- Medical Coding and Billing
- Electronic Health Records (EHR)
- Clinical Documentation Improvement (CDI)
- Insurance
- Others
Few of the well-known market leaders in the revenue cycle management market that are profiled by Research Nester are R1 RCM Inc., Experian Information Solutions, Inc., athenahealth, Inc., AllScripts Healthcare, LLC, Epic Systems Corporation, and other key market players
Recent Development in the Revenue Cycle Management Market
- SSI Group, LLC, a leading provider of financial performance solutions for providers and payers, announced its partnership with RCxRules, a leading provider of automated billing solutions for the population health and revenue cycle of healthcare organizations.
- R1 RCM Inc., a leading provider of technology-enabled revenue cycle management (RCM) services for healthcare providers, announced that Rush University System for Health (RUSH), an academic healthcare system, has entered into a strategic partnership to achieve superior revenue cycle performance and Accelerating Healthcare Innovation.
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