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Back-end Revenue Cycle Management Market

Back-end Revenue Cycle Management Market Size, Share, Competitive Landscape and Trend Analysis Report by Product and Services, by Delivery Mode and by End User : Global Opportunity Analysis and Industry Forecast, 2023-2032

LS : Healthcare IT

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Author's: | Roshan Deshmukh
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Back-end Revenue Cycle Management Market Outlook – 2027

Back-end Revenue Cycle Management is a management and collection of income received from the backend office. The back-end revenue cycle initiates following the providers have conducted a visit with the patients, coding responsibilities, and performing clinical documentation. Revenue cycle management staff works on various segments like medical billing, claims management, and the final financial responsibility of the patients and their collections.

Back-end Revenue Cycle Management Market

Back-end employees carry out various responsibilities related to the charge capturing. Charge capturing is the operation of translating physician time and services through the billable charges.

Healthcare organizations utilize charge masters that links clinical codes to a price. Nevertheless, insufficient clinical documentation can affect in the imprecise capturing of charge and leakage of the revenue. Various organizations have been continually hiring members in the staff to work on the charge capture issues charges rework. Healthcare revenue cycles are very complicated in the process of revenue management as it moves all over the organization.                                      

COVID-19 scenario analysis:

With the outbreak of COVID-19 globally and the stipulated lockout, there is an ongoing downturn in the healthcare market. Aside from communities, COVID-19 was equally disastrous for major world economies, especially the healthcare sector. Prominent stakeholders are continuing to adapt their strategy to the rapidly changing situation. COVID-19 is projected to have significant long-term impacts on the healthcare industry. Countries and major players would have to undertake critical healthcare changes until the crisis takes a back seat.

Technological progress, cost containment, and increased access will in the near future be an integral part of healthcare reforms. Digital health and telehealth have taken a front seat in the ongoing outbreak. COVID-19 re-emphasized the importance of remote diagnosis, care, and consultation. Over the past few years, regulatory and behavioral barriers have slowed Telehealth growth. However, since many healthcare providers are currently working on video conferencing and telephone calls, this segment's growth will increase several folds over the next two years. The social distancing measures also mandated online consultation of patients with moderate symptoms. In addition, it greatly reduces the burden on hospitals already swamped by counts of COVID-19 patients. Medical IoT devices that live at home with patients are now being used for optimizing outpatient treatment and minimizing repeat visits, and these devices can be further used in a crisis situation. The pandemic led to severe resource constraints. This is expected to result in the development of competitive pricing and value-based pricing models, which will accelerate the back-end revenue cycle management market growth in the future.

Owing to such factors, COVID 19 is expected to have a significant impact on the Back-end Revenue Cycle Management market.

Top impacting factors: Market Scenario Analysis, Trends, Drivers and Impact Analysis:

The importance of denials management growth, the growing volume of patients, improvements in healthcare organization processes, and reimbursement rates are declining are the major factors propelling the back-end revenue cycle management market.

While trying to reduce the cost and getting maximum profits, insurance companies are opposing the claims and coverage given to the persistent and chronic illnesses suffering patients’ treatment. This is facing the healthcare sector to reduce the operating costs to minimal, which is encouraging them to use the back-end revenue cycle management solutions. Many healthcare facilities all over the world are using the traditional methods of pen and paper to manage their financial account. The calculational errors, miscommunication between the clients, insurance companies, and the healthcare facilities and delayed follow-ups, and are been solved by the use of the back end revenue cycle management solutions.

If the purchase cost of the back end revenue cycle management software prices are considered they are generally on the higher side and the update and maintenance are even higher. Additionally, there has been a lack of IT expertise when the healthcare facilities staff members are taken into consideration which makes it mandatory to train the employees to improve the efficiency of the employees as well as the software.

Generally, hospitals show interest in investing in the core technologies which directly plays a role in the patients care rather than technologies for their other departments. Therefore the high cost and other charges are hampering the growth of back-end revenue cycle management solutions in hospitals and other healthcare organizations.

New product launches and acquisitions to flourish the market:

On January 28th, 2019, Change Healthcare and Experian Health entered into a partnership that helped them solve the concerns related to the identification and duplication of patients' information in the identity management solutions.

On February 7th, 2019, Zotec Partners launched a medical revenue cycle management PAYperless which allows the patients in making payments via the online method and also send notifications about their medical status and information authentication.

Surge in usage in healthcare sector applications:

Healthcare payers and providers are the major consumers of the back endrevenue cycle management market. Healthcare payers hold a stronger position when it comes to the consumption of the solutions.Insurance providers stick to the back end revenue cycle management solutions to stay in the limits of regulations and to decrease the punishments and penalties for breaking the rules.              

Key benefits of the report:

  • This study presents the analytical depiction of the global Back-end Revenue Cycle Management industry along with the current trends and future estimations to determine the imminent investment pockets.
  • The report presents information related to key drivers, restraints, and opportunities along with detailed analysis of the global Back-end Revenue Cycle Management market share.
  • The current market is quantitatively analyzed to highlight the global market growth scenario.
  • Porter’s five forces analysis illustrates the potency of buyers & suppliers in the market.
  • The report provides a detailed global Back-end Revenue Cycle Management market analysis based on competitive intensity and how the competition will take shape in coming years.

Questions answered in the Back-end Revenue Cycle Management Market research report:

  • What are the leading market players active in the Back-end Revenue Cycle Management market?
  • What the current trends will influence the market in the next few years?
  • What are the driving factors, restraints, and opportunities in the market?
  • What are the projections for the future that would help in taking further strategic steps?

Back-end Revenue Cycle Management Market Report Highlights

Aspects Details
By Product and Services
  • Services
  • Software
    • Integrated Software
    • Standalone Software
      • Claims Processing Software
      • Denial Management Software
      • Coding & Auditing Software
      • Billing/Billing Review Software
      • Payment Integrity Software
By Delivery Mode
  • On-premise Delivery Mode
  • Cloud-based Delivery Mode
By End User
  • Healthcare Payers
  • Healthcare Providers
    • Inpatient Facilities
    • Outpatient Facilities and Physician Clinics
By Region
  • North America  (U.S., Canada, Mexico)
  • Europe  (France, Germany, Italy, Spain, UK, Rest of Europe)
  • Asia-Pacific  (China, Japan, India, South Korea, Australia, Rest of Asia-Pacific)
  • LAMEA  (Brazil, South Africa, Saudi Arabia, Rest of LAMEA)
Key Market Players

Conifer Health Solutions, GE Healthcare, Allscripts Healthcare Solutions, Inc., Optum, Inc., eClinicalWorks, Cerner Corporation, GeBBs Healthcare Solutions, The SSI Group, McKesson Corporation, Athenahealth

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Back-end Revenue Cycle Management Market

Global Opportunity Analysis and Industry Forecast, 2023-2032