The global revenue cycle management market is expected to grow at a CAGR of around 12.3% from 2020 to 2027 and expected to reach the market value of around US$ 97.2 Bn by 2027.
The administration of financial transactions resulting from medical encounters between a patient and a provider, facility, and/or supplier is known as revenue cycle management (RCM). Billing, collections, payer contracting, provider enrollment, coding, data analytics, management, and compliance are examples of these transactions.
Market Dynamics
Technology and payment trends are reshaping the global revenue cycle management market
Pricing pressures and rising claims processing workloads will continue to plague industries. With limited funding to hire more people, the RCM team will be forced to rely more on technology to replace highly manual processes and to make better use of available data and analytics. The team's effectiveness and efficiency can be improved by leveraging digital tools and automating activities. In finance, for example, it is estimated that activities that currently consume approximately 43 percent of employees' time (e.g., mortgage application processing, financial data verification, and market trend analysis) could be automated. Furthermore, some of the more intriguing (and currently available) advances include software that can predict clinical codes based on clinical documentation, voice recognition software to reduce reliance on manual data entry, machine learning to automate bill scrubbing and modifier usage and software that can automate simple appeals with remittance data. Because capacity can be created more easily by leveraging digital tools and automating activities, many providers are turning to advanced analytics to improve decision making and resource management.
Process improvement, customer engagement, and measurement and analytics acts as strong pillars of the global revenue cycle management market
The establishment of shared service departments allows for the standardization of best-in-class processes for key revenue cycle functions. As a result of increased specialization and reduced handoffs and miscommunication, efficiency is increased. Furthermore, it boosts productivity while lowering costs, resulting in a more transparent and consistent patient experience. Implementing strategically balanced improvements across these domains can improve revenue cycle integration, resulting in improved service quality and financial performance. The revenue cycle function has the most interactions with patients – possibly more than any other function in a health care organization. Revenue cycle operations have a significant impact on patient experience and, as a result, customer engagement from the first time a patient calls to schedule an appointment to the time the patient's last bill is paid.
Favorable regulatory compliance bolsters the growth of global revenue cycle management market
The RCM is heavily influenced by government regulations. HIPAA, or the Healthcare Insurance Portability and Accountability Act, has some of this effect. One of the most complex and broad areas of government regulations relating to RCM is how it affects patient collections, specifically how medical debt can be collected. A number of these changes have been spearheaded by the Consumer Financial Protection Bureau (CFPB). Furthermore, the Healthcare Financial Management Association (HFMA) and the Association of Credit and Collection Professionals (ACA International) published a joint report on best practices for medical billing and found the following steps to be beneficial, all of which can be integrated into the RCM cycle to simplify patient billing and collections.
Market Segmentation
The global revenue cycle management market is segmented based on product, type, delivery mode, and end-user. By product, the market is bifurcated into software and services. By type, the market is classified as integrated and standalone. By delivery mode, the market is segmented as on-premise, web-based, and cloud based. Further, by end-user, the market is segmented as physician offices, hospitals, diagnostic laboratories, and others.
By product, the software segment is expected to dominate the revenue cycle management market. The increased amount of data in recent years as a result of digitalization of processes and streamlining for better patient care has resulted in the adoption of solutions, so healthcare analytical software solutions are gaining traction. Based on type, the integrated segment is expected to dominate the global revenue cycle management market. The growth can be attributed to a variety of changes, including a preference for volume-based payments over value-based payments, which is one of the major factors contributing to market growth. By delivery mode, the web-based segment is expected to dominate the global revenue cycle management market. The growing adoption of web-based solutions is expected to drive overall market growth in the coming years. The physician back-office segment will dominate the global revenue cycle management market in terms of end-user. The increasing focus on various healthcare infrastructure and organizations toward the implementation of these systems, as well as the growing number of physicians, drive the global revenue cycle management market.
Regional Overview
North America will continue to dominate the global revenue cycle management market in the coming years. The global revenue cycle management market is growing as a result of government initiatives to increase the adoption of RCM solutions and enhancements in healthcare organizations. Furthermore, rising demand for cloud-based RCM solutions, as well as increased consolidation among vendors offering end-to-end solutions, are propelling the global revenue cycle management market forward. Furthermore, it has been observed that there are lucrative opportunities for the revenue cycle management market in the provinces of North America. One of the major market drivers is the development of an IT framework for the healthcare industry. Because of favorable regulations, the presence of several large hospitals and health systems, the growing geriatric population, and the increasing need to reduce healthcare costs in the country, the United States represents lucrative opportunities in North America.
Europe, on the other hand, is the second largest RCM market. Government initiatives in this region for eHealth, as well as the need to improve overall efficiency in healthcare organizations, are propelling European market growth. Aside from that, the RCM markets in Asia and the Rest of the World are expanding. Factors such as increased government eHealth initiatives, rising medical tourism, and growing demand for quality healthcare are propelling the RCM market in these regions.
Competitive Landscape
The prominent players of the global revenue cycle management market are The SSI Group, Inc., Allscripts Healthcare, LLC, Experian Information Solutions, Inc., McKesson Corporation, Athenahealth, Epic Systems Corporation, NXGN Management, LLC., CareCloud Corporation, Quest Diagnostics, R1 RCM Inc., and among others
Market Segmentation
Market By Product
Software
Services
Market By Type
Integrated
Standalone
Market By Delivery Mode
On-premise
Web-based
Cloud based
Market By End-use
Physician Offices
Hospitals
Diagnostic Laboratories
Others
Market By Geography
North America
• U.S.
• Canada
Europe
• U.K.
• Germany
• France
• Spain
• Rest of Europe
Asia-Pacific
• China
• Japan
• India
• Australia
• South Korea
• Rest of Asia-Pacific
Latin America
• Brazil
• Mexico
• Rest of Latin America
Middle East & Africa
• GCC
• South Africa
• Rest of Middle East & Africa
CHAPTER 1. Industry Overview of Revenue Cycle Management
1.1. Definition and Scope
1.1.1. Definition of Revenue Cycle Management
1.1.2. Market Segmentation
1.1.3. Years Considered for the Study
1.1.4. Assumptions and Acronyms Used
1.1.4.1. Market Assumptions and Market Forecast
1.1.4.2. Acronyms Used in Global Revenue Cycle Management Market
1.2. Summary
1.2.1. Executive Summary
1.2.2. Revenue Cycle Management Market By Product
1.2.3. Revenue Cycle Management Market By Type
1.2.4. Revenue Cycle Management Market By Delivery Mode
1.2.5. Revenue Cycle Management Market By End-use
1.2.6. Revenue Cycle Management Market by Regions
CHAPTER 2. Research Approach
2.1. Methodology
2.1.1. Research Programs
2.1.2. Market Size Estimation
2.1.3. Market Breakdown and Data Triangulation
2.2. Data Source
2.2.1. Secondary Sources
2.2.2. Primary Sources
CHAPTER 3. Market Dynamics And Competition Analysis
3.1. Market Drivers
3.1.1. Driver 1
3.1.2. Driver 2
3.2. Restraints and Challenges
3.2.1. Restrain 1
3.2.2. Restrain 2
3.3. Growth Opportunities
3.3.1. Opportunity 1
3.3.2. Opportunity 2
3.4. Porter’s Five Forces Analysis
3.4.1. Bargaining Power of Suppliers
3.4.2. Bargaining Power of Buyers
3.4.3. Threat of Substitute
3.4.4. Threat of New Entrants
3.4.5. Degree of Competition
3.5. Regulatory Compliance
3.6. Competitive Landscape, 2019
3.6.1. Player Positioning Analysis
3.6.2. Key Strategies Adopted By Leading Players
CHAPTER 4. Revenue Cycle Management Market By Product
4.1. Introduction
4.2. Revenue Cycle Management Revenue By Product
4.2.1. Revenue Cycle Management Revenue (US$ Mn) and Forecast, By Product, 2016-2027
4.2.2. Software
4.2.2.1. Software Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
4.2.3. Services
4.2.3.1. Services Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
CHAPTER 5. Revenue Cycle Management Market Revenue By Type
5.1. Introduction
5.2. Revenue Cycle Management Revenue (US$ Mn) By Type
5.2.1. Revenue Cycle Management Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
5.2.2. Integrated
5.2.2.1. Integrated Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
5.2.3. Standalone
5.2.3.1. Standalone Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
CHAPTER 6. Revenue Cycle Management Market By Delivery Mode
6.1. Introduction
6.2. Revenue Cycle Management Revenue (US$ Mn) By Delivery Mode
6.2.1. Revenue Cycle Management Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
6.2.2. On-premise
6.2.2.1. On-premise Market Revenue (US$ Mn) and Growth Rate (%), 2016-20276.2.3. Web-based
6.2.3.1. Web-based Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
6.2.4. Cloud based
6.2.4.1. Cloud based Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
CHAPTER 7. Revenue Cycle Management Market By End-use
7.1. Introduction
7.2. Revenue Cycle Management Revenue (US$) By End-use
7.2.1. Revenue Cycle Management Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
7.3. Physician Offices
7.3.1. Physician Offices Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
7.4. Hospitals
7.4.1. Hospitals Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
7.5. Diagnostic Laboratories
7.5.1. Diagnostic Laboratories Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
7.6. Others
7.6.1. Others Market Revenue (US$ Mn) and Growth Rate (%), 2016-2027
CHAPTER 8. North America Revenue Cycle Management Market By Country
8.1. North America Revenue Cycle Management Overview
8.2. U.S.
8.2.1. U.S. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
8.2.2. U.S. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
8.2.3. U.S. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
8.2.4. U.S. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
8.3. Canada
8.3.1. Canada Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
8.3.2. Canada Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
8.3.3. Canada Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
8.3.4. Canada Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
8.4. North America PEST Analysis
CHAPTER 9. Europe Revenue Cycle Management Market By Country
9.1. Europe Revenue Cycle Management Market Overview
9.2. U.K.
9.2.1. U.K. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
9.2.2. U.K. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
9.2.3. U.K. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
9.2.4. U.K. Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
9.3. Germany
9.3.1. Germany Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
9.3.2. Germany Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
9.3.3. Germany Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
9.3.4. Germany Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
9.4. France
9.4.1. France Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
9.4.2. France Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
9.4.3. France Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
9.4.4. France Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
9.5. Spain
9.5.1. Spain Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
9.5.2. Spain Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
9.5.3. Spain Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
9.5.4. Spain Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
9.6. Rest of Europe
9.6.1. Rest of Europe Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016-2027
9.6.2. Rest of Europe Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016-2027
9.6.3. Rest of Europe Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016-2027
9.6.4. Rest of Europe Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016-2027
9.7. Europe PEST Analysis
CHAPTER 10. Asia Pacific Revenue Cycle Management Market By Country
10.1. Asia Pacific Revenue Cycle Management Market Overview
10.2. China
10.2.1. China Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
10.2.2. China Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
10.2.3. China Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
10.2.4. China Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
10.3. Japan
10.3.1. Japan Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
10.3.2. Japan Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
10.3.3. Japan Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
10.3.4. Japan Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
10.4. India
10.4.1. India Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
10.4.2. India Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
10.4.3. India Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
10.4.4. India Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
10.5. Australia
10.5.1. Australia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
10.5.2. Australia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
10.5.3. Australia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
10.5.4. Australia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
10.6. South Korea
10.6.1. South Korea Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
10.6.2. South Korea Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
10.6.3. South Korea Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
10.6.4. South Korea Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
10.7. Rest of Asia-Pacific
10.7.1. Rest of Asia-Pacific Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
10.7.2. Rest of Asia-Pacific Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
10.7.3. Rest of Asia-Pacific Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
10.7.4. Rest of Asia-Pacific Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
10.8. Asia Pacific PEST Analysis
CHAPTER 11. Latin America Revenue Cycle Management Market By Country
11.1. Latin America Revenue Cycle Management Market Overview
11.2. Brazil
11.2.1. Brazil Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
11.2.2. Brazil Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
11.2.3. Brazil Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
11.2.4. Brazil Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
11.3. Mexico
11.3.1. Mexico Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
11.3.2. Mexico Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
11.3.3. Mexico Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
11.3.4. Mexico Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
11.4. Rest of Latin America
11.4.1. Rest of Latin America Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
11.4.2. Rest of Latin America Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
11.4.3. Rest of Latin America Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
11.4.4. Rest of Latin America Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
CHAPTER 12. Middle East & Africa Revenue Cycle Management Market By Country
12.1. Middle East & Africa Revenue Cycle Management Market Overview
12.2. Saudi Arabia
12.2.1. Saudi Arabia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
12.2.2. Saudi Arabia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
12.2.3. Saudi Arabia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
12.2.4. Saudi Arabia Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
12.3. UAE
12.3.1. UAE Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
12.3.2. UAE Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
12.3.3. UAE Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
12.3.4. UAE Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
12.4. Rest of Middle East & Africa
12.4.1. Rest of Middle East & Africa Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Product, 2016 - 2027
12.4.2. Rest of Middle East & Africa Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Type, 2016 - 2027
12.4.3. Rest of Middle East & Africa Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By Delivery Mode, 2016 - 2027
12.4.4. Rest of Middle East & Africa Revenue Cycle Management Market Revenue (US$ Mn) and Forecast By End-use, 2016 - 2027
CHAPTER 13. Player Analysis Of Revenue Cycle Management
13.1. Revenue Cycle Management Market Company Share Analysis
13.2. Competition Matrix
13.2.1. Competitive Benchmarking of key players by price, presence, market share, and R&D investment
13.2.2. New Product Launches and Product Enhancements
13.2.3. Mergers And Acquisition In Global Revenue Cycle Management Market
13.2.4. Partnership, Joint Ventures and Strategic Alliances/ Sales Agreements
CHAPTER 14. Company Profile
14.1. The SSI Group, Inc.
14.1.1. Company Snapshot
14.1.2. Business Overview
14.1.3. Financial Overview
14.1.3.1. Revenue (US$ Mn), 2019
14.1.3.2. The SSI Group, Inc. 2019 Revenue Cycle Management Business Regional Distribution
14.1.4. Product/ Service and Specification
14.1.5. Recent Developments & Business Strategy
14.1.6. Manufacturing Plant Footprint Analysis
14.2. Allscripts Healthcare, LLC Experian Information Solutions, Inc.
14.3. McKesson Corporation
14.4. Athenahealth
14.5. Epic Systems Corporation
14.6. NXGN Management, LLC.
14.7. CareCloud Corporation
14.8. Quest Diagnostics
14.9. R1 RCM Inc.
14.10. Others
