Overview and Scope
Healthcare revenue cycle management is the process of overseeing financial transactions in the healthcare system, from patient registration to reimbursement, ensuring efficient billing, coding, and collections to optimize revenue. It involves a combination of services and technology solutions aimed at maximizing financial performance and compliance within healthcare organizations.
Sizing and Forecast
The healthcare revenue cycle management market size has grown rapidly in recent years. It will grow from $60.08 billion in 2023 to $69.38 billion in 2024 at a compound annual growth rate (CAGR) of 15.5%. The growth in the historic period can be attributed to increasing healthcare expenditure, transition to value-based care models, regulatory compliance requirements, growing adoption of electronic health records (EHR) and emphasis on cost reduction and efficiency.
The healthcare revenue cycle management market size is expected to see rapid growth in the next few years. It will grow to $124.79 billion in 2028 at a compound annual growth rate (CAGR) of 15.8%. The growth in the forecast period can be attributed to growing patient financial responsibility, scalable revenue cycle management solutions for mid-sized hospitals, value-based care models driving importance of RCM, partnerships between RCM and EHR providers for comprehensive solutions, payment processing enhancements in RCM systems. Major trends in the forecast period include automation and artificial intelligence (AI), shift towards value-based care reimbursement models, integration of RCM systems with telehealth platforms, data analytics, outsourcing and partnerships.
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Segmentation & Regional Insights
The healthcare revenue cycle management market covered in this report is segmented –
1) By Component: Software, Service
2) By Deployment Mode: On-Premises, Cloud Or Web Based
3) By Function: Claims And Denial Management, Medical Coding And Billing Eligibility Verification, Payment Remittance, Other Functions
4) By End-Use: Hospitals, Laboratories, Physicians, Other End-Users
North America was the largest region in the healthcare revenue cycle management market in 2023. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the healthcare revenue cycle management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.
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Major Driver Impacting Market Growth
The growing adoption of electronic health records (EHR) is expected to propel the growth of the healthcare revenue cycle management market going forward. Electronic health records (EHR) are digital versions of patients’ medical records, containing comprehensive health information accessible to authorized healthcare providers. Electronic health records (EHR) adoption is on the rise due to several factors, including the demand for improved access to patient care, its efficiency and effectiveness in healthcare delivery, and its ability to transfer information seamlessly. Electronic health records (EHR) streamline healthcare revenue cycle management by facilitating accurate documentation, efficient claim processing, and timely reimbursement for medical services rendered. For instance, according to the Office of the National Coordinator for Health Information Technology (ONC), a US-based government agency, as of 2021, nearly 4 in 5 office-based physicians (78%) and almost all non-federal acute care hospitals (96%) have adopted a certified electronic health record (EHR). Therefore, the growing adoption of electronic health records is driving the growth of the healthcare revenue cycle management market.
Key Industry Players
Major companies operating in the healthcare revenue cycle management market are McKesson Corporation, 3M Health Information Systems, GE Healthcare, Experian Health, Cerner Corporation, Epic Systems Corporation, Change Healthcare, R1 RCM Inc., Nuance Communications, Conifer Health Solutions, Allscripts Healthcare Solutions, Health Catalyst, Craneware, MEDHOST Inc., NextGen Healthcare, Greenway Health, MedeAnalytics, Source Medical, Patientco, Athenahealth Inc., eClinicalWorks, Optum, nThrive, Waystar, IBM Watson Health, Trizetto Provider Solutions, Quadax, Experity
The healthcare revenue cycle management market report table of contents includes:
1. Executive Summary
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