New York, United States, March 21, 2024 (GLOBE NEWSWIRE) -- Revenue cycle management (RCM) is the process utilized by healthcare systems worldwide to monitor the revenue from patients, from their initial appointment or encounter to the payment of their final balance. It is software used for financial activities such as medical invoices, tracking patients and data, scheduling appointments and registrations, and in some cases tracking final payments and outstanding balances. Revenue cycle management combines the clinical and business aspects of the healthcare industry, integrating administrative data such as insurance provider information, patient name, and personal information with treatment type and other pertinent healthcare data.
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Positive Government Reforms Drive the Global Market
Government reforms are essential for increasing the utilization and adoption of systems like revenue cycle management. For instance, the Affordable Care Act (ACA) focuses on expanding health insurance coverage for low-income individuals in the United States. It is anticipated that expanding insurance coverage will increase the number of reimbursements and denials requiring revenue cycle management.
In addition, numerous government organizations around the globe are implementing initiatives to facilitate the exchange of health data and enhance the effectiveness of healthcare systems. For instance, the NHS Five Year Forward View, released in 2014, emphasizes using technology to improve care delivery and reduce healthcare disparities. In addition, the NHS initiative to ensure a paperless healthcare system by 2020 by increasing the adoption of HIT systems will likely accelerate the market during the forecast period.
Increasing Outsourcing of Revenue Cycle Management Creates Tremendous Opportunities
The outsourcing of healthcare IT services has increased due to factors like the dearth of skilled labor, the scarcity of resources, and the escalating cost of healthcare. Primarily, healthcare organizations outsource coding requirements, key performance monitoring, claim follow-up, and data accuracy assurance. Inaccuracies can occur in medical invoicing and other processes due to the growing healthcare burden and volume of patient data. Therefore, outsourcing can aid in reducing these errors, allowing for the efficient operation of all aspects of revenue cycle management.
Additionally, major advantages of outsourcing revenue cycle management include the availability of competent and trained professionals, cost-effective and efficient services, and adherence to mandated regulations and guidelines. These advantages have resulted in increased adoption of outsourcing services in recent years. According to a 2020 article published in Med USA, approximately two-thirds of healthcare organizations outsource their revenue cycle management requirements. Consequently, this escalating adoption will likely generate market expansion opportunities during the forecast period.
Competitive Players
The key global revenue cycle management (RCM) market players are Allscripts Inc., The SSI Group Inc., Cerner Corporation, Change Healthcare, R1 RCM Inc., NextGen Healthcare Information Solution LLC, Experian Health, Epic Systems Corporation, McKesson Corporation, Quest Diagnostics Inc., and CareCloud Corporation.
Regional Analysis
North America is the most significant global revenue cycle management (RCM) market shareholder and is anticipated to exhibit a CAGR of 10.61% during the forecast period. In this region, factors such as rising healthcare costs, expanding government initiatives to implement RCM systems, and rising adoption of HIT systems will likely stimulate market growth. The U.S. healthcare system has shifted its emphasis from fee-for-service care models to value-based care. Governing bodies have initiated several measures toward this end. For instance, the U.S. Secretary of Health and Human Services (HHS) desires to direct 30% of Medicare payments to alternative payment models by the end of 2016 and 50% of Medicare payments by 2018. This has facilitated the development of Accountable Care Organizations (ACOs), bundled payments, and other methods of enhancing health outcomes while reducing costs which will increase RCM market growth in North America.
Europe is estimated to exhibit a CAGR of 10.3% over the forecast period. The RCM market in Europe is the second largest in the world and is growing profitably due to government policies. For example, the Digital Single Market Strategy of the European Commission makes it easier for consumers and businesses to access online services and goods across the continent, fostering the optimal environment for the growth of digital networks and services and maximizing the potential for economic expansion in Europe. In addition, the EU presented the eHealth action plan for 2014-2020, which comprises eHealth development strategies for Europe. These initiatives are anticipated to accelerate the healthcare IT market in Europe, thereby fostering the expansion of the RCM market. The increasing volume of patient data, technological advances, and rising demand for efficient and fast healthcare processes will also favor market growth.
Key Highlights
- Based on the product, the global revenue cycle management (RCM) market is bifurcated into software and services. The software segment is the most significant contributor to the market share and is anticipated to exhibit a CAGR of 11.1% over the forecast period.
- Based on type, the global revenue cycle management (RCM) market is divided into standalone and integrated. The integrated segment dominates the global market and is estimated to exhibit a CAGR of 11.7% over the forecast period.
- Based on delivery mode, the global revenue cycle management (RCM) market is bifurcated into web-based, cloud-based, and on-premise. The web-based segment is the highest contributor to the market share and is anticipated to exhibit a CAGR of 11.2% over the forecast period.
- Based on end-user, the global revenue cycle management (RCM) market is segmented into diagnostics laboratories, physician offices, hospitals, and others. The physician offices segment owns the highest market share and is anticipated to exhibit a CAGR of 10.7% during the forecast period.
- North America is the most significant global revenue cycle management (RCM) market shareholder and is anticipated to exhibit a CAGR of 10.61% during the forecast period.
Market News
- In May 2023, Aspirion, a prominent technology-enabled healthcare revenue cycle management ("RCM") supplier for complex claims and revenue integrity, announced the acquisition of FIRM Revenue Cycle Management Services, Inc. ("FIRM RCM"), a dependable partner for hospital systems in the recovery of denied, unpaid, and inadequately paid medical insurance claims.
- In March 2023, eClinicalWorks®, the largest ambulatory cloud EHR, announced that Satori Healing, LLC had chosen eClinicalWorks and healow to enhance patient satisfaction and Revenue Cycle Management (RCM) services.
Global Revenue Cycle Management (RCM) Market: Segmentation
By Product
- Software
- Services
By Type
- Integrated
- Standalone
By Delivery Mode
- On-Premises
- Web-Based
- Cloud-Based
By End-User
- Physician Offices
- Hospitals
- Diagnostic Laboratories
- Others
By Regions
- North America
- Europe
- Asia-Pacific
- Latin America
- The Middle East and Africa
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