Healthcare Revenue Cycle Management Market Size By Product (Integrated, Standalone), By Function (Claims & Denial Management, Medical Coding & Billing, Eligibility Verification, Payment Remittance), By Deployment (On-Premise, Cloud Based), By End-use (Hospitals, Physicians, Diagnostic & Ambulatory Surgical Centers), Industry Analysis Report, Regional Outlook (U.S., Canada, UK, Germany, France, Spain, Italy, Russia, Japan, China, India, Australia, South Korea, Brazil, Mexico, Argentina, South Africa, Saudi Arabia, UAE) Application Potential, Competitive Market Share & Forecast, 2018 - 2024
Healthcare revenue cycle management (HRCM) will exceed USD 100 billion by 2024; as per a new research report.
Increase in healthcare expenditure and rapidly growing geriatric population are the major impact rendering factors for healthcare revenue management industry growth. As per World Bank Data 2015, the estimated healthcare expenditure in U.S. was 16.9% of GDP that is comparatively higher than other countries. Increasing healthcare expenditure ultimately increases the need of revenue management systems to manage these expenditures thereby stimulating HRCM business growth.
Rising demand for health insurance will drive the healthcare revenue management market growth in upcoming years. Healthcare providers typically carry large balances and struggle to receive timely and accurate reimbursement from government programs such as Medicare and Medicaid as well as commercial insurance payors. As per Centers for Medicare & Medicaid Services (CDC) Actuary Releases 2017, the private health insurance spending is projected to average 4.7% over 2017-2026. Increase in demand for healthcare insurance is set to drive the adoption of HRCM solutions.
Integrated revenue cycle management system segment was valued at USD 40,843.4 million in 2017 and is projected to grow significantly over the forecast timeframe. Integrated systems provide efficient tracking management capabilities that helps to reduce cost of auditing. The integrated systems comprising of AR management Denials management and business analytics technology helps to identify and address the key issues driving denials. These integrated software help in optimizing operational performance and subsequent financial results that will help in favoring growth of healthcare revenue management industry over the coming years.
Medical coding and billing segments are anticipated to show lucrative market growth of 11.3% during the forecast timeframe. The growth of the segment is attributed to rising incidence of insurance issues related with misinterpretation of medical documents. In addition, rising adoption of coding and billing procedures in hospitals, is expected to generate growth opportunities during the projected timeframe.
On premise deployment segment accounted for 23.6% revenue share in 2017 due to its wide applicability and several advantages. On premise revenue cycle management solutions offers better security compared to cloud based as servers installed on premise and can be protected by preventing unauthorized access. Increasing use of these on-premise revenue cycle management solutions thereby, stimulating HRCM business growth.
Hospital end-user segment will witness 11.6% CAGR during the forecast timeframe and is expected to witness robust growth during the projected timeframe. The growth of the segment is attributed to increasing patient base as well as cash flow in hospitals. The number of patients that are unwilling or unable to pay is growing, that again compels healthcare providers to implement efficient revenue cycle management system to collect from patient at all points of service. Hospital revenue cycle management consists of generation, management and collection of patient care revenue.
U.S. healthcare revenue management market contributed 90.7% of total North America industry revenue in 2017. U.S. healthcare has experienced significant changes in regulations that have largely affected the finances, organization, and delivery of healthcare services. Various changes in laws and regulations including introduction of the Affordable Care Act (ACA) and a transition in coding system will augment country growth in forthcoming years.
China healthcare revenue management market was valued at USD 2,490.6 million in 2017 owing to rapidly increasing healthcare spending, increased government initiatives on healthcare sector and developments in healthcare IT. Moreover, emerging technologies in Healthcare IT like mobility, cloud, analytics/ big data and social business create efficiency and sustainability in healthcare sector thereby contributing healthcare revenue management business expansion.
Some of the prominent competitors operating in healthcare revenue management business include Allscripts Healthcare Solutions, AGS health, Athenahealth, Accretive Health, Cognizant Technology Solutions, Cerner, Carecloud Corporation, Conifer Health Solutions, Dell, Emdeon, Etransmedia and Experian. Industry competitors are mainly focusing on inorganic strategies such as partnership, merger and acquisitions to garner higher revenue share in the industry.