Revenue Cycle Management Market

The global revenue cycle management market size was valued at USD 261.5 billion in 2020 and is projected to reach USD 633.2 billion by 2028, expanding at a CAGR of 11.2 % during the forecast period, 2021–2028. The growth of the market is attributed to the growing innovation in synchronized management software and systems.

Revenue cycle management (RCM) can be defined as the management of all clinical and administrative procedures that lead to patient service adds indirectly or directly to revenue in order to maximize profits. By processing claims, the RCM process allows health providers to maximize income. Management of the revenue cycle offers several processes, such as patient registration, insurance eligibility and verification, medical coding, claim processing, and payment & account receivable management. Patients, health-care providers, billing businesses, and insurance payers are the four most important RCM components.

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The COVID-19 pandemic outbreak had negative impact on the market. Due to the pandemic, there were unpredictable claim volumes and inconsistent patient volume, which resulted in rise in RCM complexities and companies opted for outsourcing. The market is expected to recover an uptrend operation soon owing to subsiding the COVID cases significantly across the globe.

Market Trends, Drivers, Restraints, and Opportunities

• Growing need to manage unstructured healthcare data is one of the key factors driving the market growth.
• Availability for advanced technological innovations in RCM is expected to boost the market growth in the coming years.
• High deployment cost of RCM solutions and the associated infrastructure presents a major challenge. This is likely to hinder the market growth during the forecast period.
• Lack of skilled medical professionals in developing regions is expected to hamper the market growth during the projected timeline.
• Rising demand for Artificial Intelligence & cloud-based deployment is projected to create significant growth opportunities for the market in the near future.

Scope of Revenue Cycle Management Market Report

The report on the global revenue cycle management market includes an assessment of the market, trends, segments, and regional markets. Overview and dynamics have also been included in the report.

Revenue Cycle Management Market Segment Insights

Web-based segment to grow at a rapid pace

Based on delivery mode, the global revenue cycle management market is segmented into web-based, on-premise, and cloud-based. The web-based segment is expected to grow at a rapid pace during the forecast period owing to increasing adoption of the solution globally. However, the cloud-based segment is anticipated to hold a key share of the market in the coming years due to the factors, such as stable internet access and readily available information, which can be accessed even from remote locations, one-time update, and faster processing & higher reliability across all domains.

Software segment to expand at a considerable CAGR

On the basis of products, the market is bifurcated into services and software. The software segment is projected to expand at a considerable CAGR during the forecast period attributed to the digitalization of processes and streamlining for better patient care, which resulted in rising amount of data. On the other hand, the services segment is anticipated to account for a major market share during the forecast period due to the growing number of market participants offering outsourcing services to healthcare facilities.

Integrated segment to hold significant market share

In terms of types, the global revenue cycle management market is bifurcated into standalone and integrated. The integrated segment is anticipated to hold significant market share in the coming years owing to numerous changes, such as the preference for volume-based payments instead of value-based payments. Moreover, it offers a centralized and streamlined framework for a variety of financial activities through a single platform, resulting in a consistent data collection and processing procedure. This is driving the segment growth further. However, the standalone segment is expected to register a considerable CAGR during the forecast period due to the benefits, such as speeding up administrative functions and elimination of human errors.

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Physician offices to expand at robust growth rate

On the basis of end-users, the market is segregated into hospitals, physician offices, diagnostic laboratories, and others. The physician offices segment is estimated to expand at robust growth rate during the forecast period attributed to the rising number of physicians and increasing the attention on several healthcare institutions and organizations on the implementation of these systems. On the other hand, the hospitals segment is expected to grow at a significant rate due to the increase in scrutiny related to patient safety by regulatory authorities.

North America to constitute a key market share

In terms of regions, the global revenue cycle management market is classified as Asia Pacific, North America, Latin America, Europe, and Middle East & Africa. North America is expected to constitute a key share of the market during the projected period owing to the presence of numerous physicians’ offices across the region. Additionally, numerous factors, such as the presence of advantageous regulations, healthcare infrastructures & established hospitals, and a growing demand to cut healthcare costs is projected to drive the regional growth further. However, the market of Asia Pacific is anticipated to expand at a rapid pace during the forecast period attributed to the factors, such as governments initiative to improve the quality of healthcare delivery through the use of health information technology systems, expanding healthcare spending, and rising unmet healthcare needs in the region.

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Segments

The global revenue cycle management market has been segmented on the basis of

Delivery Mode

• Web-based
• On-premise
• Cloud-based

Products

• Services
• Software

Types

• Standalone
• Integrated

End-users

• Hospitals
• Physician Offices
• Diagnostic Laboratories
• Others

Regions

• Asia Pacific
• North America
• Latin America
• Europe
• Middle East & Africa

Key Players

• R1 RCM Inc.
• Quest Diagnostics, Inc.
• The SSI Group, LLC
• Allscripts Healthcare Solutions, Inc.
• Experian Health, Inc.
• athenahealth, Inc.
• Epic Systems Corp.
• NXGN Management, LLC
• CareCloud Corp.
• McKesson Corp.

Competitive Landscape

Key players competing in the global revenue cycle management market are R1 RCM Inc.; Quest Diagnostics, Inc.; The SSI Group, LLC; Allscripts Healthcare Solutions, Inc.; Experian Health, Inc.; athenahealth, Inc.; Epic Systems Corp.; NXGN Management, LLC; CareCloud Corp.; and McKesson Corp. As part of their efforts to expand their client base and acquire a competitive advantage over competitors, manufacturers operating in the market have adopted various strategic initiatives, such as partnerships, collaborations, and mergers & acquisitions. Moreover, companies are focusing on investment in R&D for development and launching of new products to maintain their competitive positions in the market.

For instance, in October 2019, Medidal, a provider of payer search, transfer DRG, and pharmacy reimbursement solutions, were bought by eSolution, a healthcare technology business. The acquisition was to maintain its commitment to provide revenue cycle management technologies to increase workflow efficiency and save customers' time and money. In January 2020, R1 RCM launched R1 Professional, a physician revenue cycle management solution aimed for large hospital-owned medical groups and independent clinics. This aided in the development of a consistent revenue cycle management approach and reimbursement models.