U.S. Revenue Cycle Management Market Growth Growth & Trends Trends
he U.S. revenue cycle management market size is projected to reach USD 286.7 billion by 2028, according to a new report by Grand View Research, Inc. This market is expected to expand at a CAGR of 11.2% over the forecast period. An increase in pressure on healthcare providers to implement revenue cycle management (RCM) solutions, the rise in adoption of Consumer-driven Healthcare (CDH) accounts, and growth in the number of collaborations in the market are the major factors driving the industry growth.
he integrated product type segment accounted for the largest revenue share of over 70% in 2020 and is expected to grow at the fastest CAGR over the forecast period. These systems provide seamless access to clinical data from Electronic Health Records (EHRs) and similar databases. For instance, according to a news article published by Cerner Corp. in 2020, fully integrated EHR systems provided by the company are proving to be beneficial and providing improvements in the RCM systems at the San Juan Regional Medical Center. Hence, the rising adoption of integrated systems is likely to fuel the segment growth during the forecast period.
On the basis of delivery mode, the web-based segment accounted for the highest revenue share in 2020. Key factors responsible for this growth included affordability, rapid Return on Investment (RoI), and ease of deployment of these systems. On the other hand, the cloud-based segment is expected to grow at the fastest CAGR over the forecast period. Based on sourcing, the outsourcing segment is expected to register the fastest growth rate over the forecast period. There is a rise in the demand for services outsourcing during the Covid-19 pandemic owing to the rapidly increasing inpatient volume, claim fluctuations and staff productivity.
U.S. Revenue Cycle Management Market Report Highlights
- The market was valued at USD 120.7 billion in 2020 and is anticipated to grow at a CAGR of 11.2% over the forecast period
- In 2020, the services segment is predicted to account for the largest market share growing at the fastest CAGR from 2021 to 2028
- This growth is credited to the increased demand for service outsourcing due to the dearth of skilled labor, shortage of resources, and rising healthcare costs in the U.S.
- The software segment is also projected to witness significant growth over the forecast period owing to the rising adoption and penetration of software-based solutions in the market
- In 2020, the integrated systems product type segment accounted for the largest revenue share owing to the increasing demand for these systems to eliminate human errors and speeding up the administrative functions
- Chapter 1 Methodology and Scope
- 1.1 Market Segmentation and Scope
- 1.2 Research Methodology
- 1.2.1 Information procurement
- 1.3 Information or Data Analysis
- 1.4 Market Formulation & Validation
- 1.5 List of Secondary Sources
- 1.6 List of Primary Sources
- Chapter 2 Executive Summary
- 2.1 Industry Insights
- 2.2 Segment Insight
- 2.3 Competitive Insight
- 2.4 Market Snapshot
- Chapter 3 The U.S. Revenue Cycle Management (RCM) Market Variables, Trends & Scope
- 3.1 Penetration & Growth Prospect Mapping
- 3.2 Regulatory Framework
- 3.2.1 Reimbursement framework
- 3.2.1.1 Regulatory Modifications Influencing Radiology Reimbursement
- 3.2.1.2 Regulatory Modifications Influencing Cardiology Reimbursement
- 3.2.1.3 Preparing for Value-Based Reimbursement in Oncology Practices
- 3.2.2 Standards & Compliances
- 3.3 Market Dynamics
- 3.3.1 Market Driver Analysis
- 3.3.1.1 Technological Advancements
- 3.3.1.2 Increase in Outsourcing of RCM
- 3.3.1.3 Increasing Adoption of mhealth
- 3.3.1.4 Growth of High-deductible Health Plans (HDHPs)
- 3.3.2 Market Restraint Analysis
- 3.3.2.1 Increasing Payer Partnerships
- 3.3.2.2 Lack of Professionals to Handle RCM Processes
- 3.3.3 Market Opportunities
- 3.4 The U.S. Revenue Cycle Management Market Analysis Tools
- 3.4.1 The U.S. Revenue Cycle Management (RCM) Market – PEST Analysis
- 3.4.1.1 Political Landscape
- 3.4.1.2 Economic Landscape
- 3.4.1.3 Social Landscape
- 3.4.1.4 Technology Landscape
- 3.4.2 Industry Analysis – Porter’s
- 3.4.2.1 Bargaining power of suppliers – Moderate
- 3.4.2.2 Bargaining power of buyers – Moderate
- 3.4.2.3 Threat of substitution – Low
- 3.4.2.4 Threat of new entrants – Moderate
- 3.4.2.5 Competitive rivalry – High
- 3.5 Pricing Trends, by Physician Specialty
- 3.6 Product Adoption Patterns Analysis
- 3.7 Technology Trends in the RCM
- 3.8 Covid-19 Impact on the U.S. RCM Market
- Chapter 4 The U.S. Revenue Cycle Management Market: Competitive Analysis
- 4.1 Recent Developments & Impact Analysis, by Key Market Participants
- 4.1.1 Healthcare veteran launched HealthRev Partners
- 4.1.2 Waystar Health launched Hubble
- 4.1.3 R1 RCM, Inc. launched R1 Professional
- 4.1.4 SOC Telemed launched RCM service offering
- 4.1.5 Mastercard launched new unit for healthcare billing and data security
- 4.1.6 Homecare Home-base launched new RCM tool
- 4.1.7 Apprio, Inc. introduced ApprioHealth
- 4.1.8 The SSI Group, Inc. launched a new machine learning capability for predicting payor remittance
- 4.1.9 Healthcare Administrative Partners launched MIPS Measure Assurance Services
- 4.1.10 Patientco launched PatientWalletSM
- 4.2 Vendor Landscape
- 4.2.1 Key company market share analysis, 2020
- 4.2.2 Company market position analysis
- 4.2.3 Market Differentiators
- 4.2.4 Synergy Analysis: Major Deals & Strategic Alliances
- 4.2.4.1 Investment
- 4.2.4.2 Partnership
- 4.2.4.3 Merger & Acquistion
- 4.2.5 List of key emerging companies’ /technology disruptors/innovators
- Chapter 5 The U.S. Revenue Cycle Management (RCM) Market: End-user Estimates & Trend Analysis
- 5.1 The U.S. Revenue Cycle Management (RCM) Market: End-user Movement Analysis, USD Billion, 2020 & 2028
- 5.2 Hospitals
- 5.2.1 The U.S. RCM market revenue estimates and forecasts for hospitals, 2016 - 2028 (USD Billion)
- 5.3 Physician & Clinical Services
- 5.3.1 The U.S. RCM market revenue estimates and forecasts for Physician and Clinical Services, 2016 - 2028 (USD Billion)
- Chapter 6 The U.S. Revenue Cycle Management (RCM) Market: Product Type Estimates & Trend Analysis
- 6.1 The U.S. Revenue Cycle Management (RCM) Market: Product Type Movement Analysis, USD Billion, 2020 & 2028
- 6.2 Integrated System
- 6.2.1 The U.S. integrated RCM system market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- 6.3 Standalone System
- 6.3.1 The U.S. standalone RCM system market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- Chapter 7 The U.S. Revenue Cycle Management (RCM) Market: Component Estimates & Trend Analysis
- 7.1 The U.S. Revenue Cycle Management (RCM) Market: Component Movement Analysis, USD Billion, 2020 & 2028
- 7.2 Software Solution
- 7.2.1 The U.S. RCM Software Solution market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- 7.3 Services
- 7.3.1 The U.S. RCM Services market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- Chapter 8 The U.S. Revenue Cycle Management (RCM) Market: Delivery Mode Estimates & Trend Analysis
- 8.1 The U.S. Revenue Cycle Management (RCM) Market: Delivery Mode Movement Analysis, USD Billion, 2020 & 2028
- 8.2 On-premise
- 8.2.1 The U.S. On-premise RCM market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- 8.3 Web-based
- 8.3.1 The U.S. web-based RCM market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- 8.4 Cloud-based
- 8.4.1 The U.S. Cloud-based RCM market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- Chapter 9 The U.S. Revenue Cycle Management (RCM) Market: Physician Specialty Estimates & Trend Analysis
- 9.1 The U.S. Revenue Cycle Management (RCM) Market: Physician specialty Movement Analysis, USD Billion, 2020 & 2028
- 9.2 Oncology
- 9.2.1 The U.S. RCM market revenue estimates and forecasts for oncology, 2016 - 2028 (USD Billion)
- 9.3 Cardiology
- 9.3.1 The U.S. RCM market revenue estimates and forecasts for Cardiology, 2016 - 2028 (USD Billion)
- 9.4 Anesthesia
- 9.4.1 The U.S. RCM market revenue estimates and forecasts for Anesthesia, 2016 - 2028 (USD Billion)
- 9.5 Radiology
- 9.5.1 The U.S. RCM market revenue estimates and forecasts for Radiology, 2016 - 2028 (USD Billion)
- 9.6 Pathology
- 9.6.1 The U.S. RCM market revenue estimates and forecasts for Pathology, 2016 - 2028 (USD Billion)
- 9.7 Pain Management
- 9.7.1 The U.S. RCM market revenue estimates and forecasts for pain Management, 2016 - 2028 (USD Billion)
- 9.8 Emergency Services
- 9.8.1 The U.S. RCM market revenue estimates and forecasts for Emergency Services, 2016 - 2028 (USD Billion)
- 9.9 Others
- 9.9.1 The U.S. RCM market revenue estimates and forecasts for Others, 2016 - 2028 (USD Billion)
- Chapter 10 The U.S. Revenue Cycle Management (RCM) Market: Sourcing Estimates & Trend Analysis
- 10.1 The U.S. Revenue Cycle Management (RCM) Market: Sourcing Movement Analysis, USD Billion, 2020 & 2028
- 10.2 In-house
- 10.2.1 The U.S. In-house RCM market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- 10.3 External RCM Apps/Software
- 10.3.1 The U.S. External RCM Apps/SoftwarE market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- 10.4 Outsourced RCM Services
- 10.4.1 The U.S. Outsourced RCM Services market revenue estimates and forecasts, 2016 - 2028 (USD Billion)
- Chapter 11 The U.S. Revenue Cycle Management (RCM) Market: Functions Estimates & Trend Analysis
- 11.1 The U.S. Revenue Cycle Management (RCM) Market: Functions Movement Analysis, USD Billion, 2020 & 2028
- 11.2 Product Development
- 11.2.1 The U.S. RCM market revenue estimates and forecasts for Product development, 2016 - 2028 (USD Billion)
- 11.3 Member Engagement
- 11.3.1 The U.S. RCM market revenue estimates and forecasts for member Engagement, 2016 - 2028 (USD Billion)
- 11.4 Network Management
- 11.4.1 The U.S. RCM market revenue estimates and forecasts for Network Management, 2016 - 2028 (USD Billion)
- 11.5 Care Management
- 11.5.1 The U.S. RCM market revenue estimates and forecasts for Care Management, 2016 - 2028 (USD Billion)
- 11.6 Claim Management
- 11.6.1 The U.S. RCM market revenue estimates and forecasts for Claim Management, 2016 - 2028 (USD Billion)
- 11.7 Risk and Compliance
- 11.7.1 The U.S. RCM market revenue estimates and forecasts for risk and compliance, 2016 - 2028 (USD Billion)
- Chapter 12 Company Profiles
- 12.1 The SSI Group, Inc.
- 12.1.1 Company Overview
- 12.1.2 Financial Performance
- 12.1.3 Product Benchmarking
- 12.1.4 Strategic Initiatives
- 12.2 Allscripts Healthcare, LLC
- 12.2.1 Company Overview
- 12.2.2 Financial Performance
- 12.2.3 Product Benchmarking
- 12.3 Cerner Corporation
- 12.3.1 Company Overview
- 12.3.2 Financial Performance
- 12.3.2.1 Product Benchmarking
- 12.4 Mckesson Corporation
- 12.4.1 Company Overview
- 12.4.2 Financial Performance
- 12.4.3 Product Benchmarking
- 12.5 Athenahealth, Inc. (Veritas Capital Fund Management, L.L.C. and Evergreen Coast Capital)
- 12.5.1 Company Overview
- 12.5.1.1 Financial Performance
- 12.5.1.2 Product Benchmarking
- 12.5.1.3 Strategic Iniatiatives
- 12.6 Oncospark, Inc.
- 12.6.1 Company Overview
- 12.6.2 Financial Performance
- 12.6.3 Product Benchmarking
- 12.7 R1 RCM, Inc.
- 12.7.1 Company Overview
- 12.7.2 Financial Performance
- 12.7.3 Product Benchmarking
- 12.7.3.1 Strategic Initiatives
- 12.8 Epic Systems Corporation
- 12.8.1 Company Overview
- 12.8.2 Financial Performance
- 12.8.3 Product Benchmarking
- 12.9 Eclinicalworks
- 12.9.1 Company Overview
- 12.9.2 Financial Performance
- 12.9.3 Product Benchmarking
- 12.9.4 Strategic Initiatives
- 12.10 NXGN Management, Llc
- 12.10.1 Company Overview
- 12.10.2 Financial Performance
- 12.10.3 Product Benchmarking
- 12.10.4 Strategic Initiatives
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