Allied Market Research

2024

Healthcare Revenue Cycle Management Market

Healthcare Revenue Cycle Management Market Size, Share, Competitive Landscape and Trend Analysis Report by Product (Integrated, Standalone), by Presence (On-premises, On-cloud, Web-based services), by Application (Collection and storing of clinical data, Medical coding and billing, Claims and denial management, Others) and by End user (Diagnostic and research centers, Hospitals, Physicians, Others): Global Opportunity Analysis and Industry Forecast, 2023-2032

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Author's: | Roshan Deshmukh
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Revenue cycle management (RCM) is the financial process with a number of steps right from utilizing medical billing software that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. Revenue Cycle Management (RCM) in simpler words refers to the process of recognizing, collecting and managing the monetary funds or revenue obtained from the services provided to the payers. A successful RCM process is essential for a healthcare practice to earn profits, maintain financial viability and continue to provide quality treatment for their patients. Intensification of healthcare services and more holistic patient care approach on a large scale has pushed healthcare service providers to assess and upgrade their revenue cycle management.  RCM works at the functional core of a healthcare organization and is a backbone in ensuring profitability whether it is a small practice or a large hospital. Poor billing practices can result in financial losses and potentially put at risk the ability to deliver quality care. Without healthcare revenue cycle management, that is a key financial process, healthcare organizations would find it difficult to sustain and at the same time keep their doors open to treat patients. It is the strategy that healthcare organizations use to earn revenue for their offered services.

Healthcare-revenue-cycle-management

COVID – 19 scenario analysis:

  • The COVID-19 pandemic has emerged as a humanitarian as well as economic crisis, creating strain on the society and affecting millions of people and businesses
  • Industry closures and people are asked to stay in their homes which has cause taken a huge toll in terms of money and economic growth
  • Over 4 million people affected globally, with 300 thousand losing their lives due to novel coronavirus
  • Healthcare organizations are already working in battle mode, preparing new plans to respond growing COVID-19 patients, right from sourcing rapid diagnosing kits to sufficient PPE kits for workers, and now they have to face another set of challenges i.e. to maintain their revenue cycles
  • Various governments have brought down the treatment costs for COVID-19, as the hospitals and diagnostic centers are flooding with huge in flow of patients
  • In order to distress the healthcare providers, governments are thinking of initiating a disaster management and control plan via which the government would pay hospitals for their healthcare services

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

Healthcare providers currently, are facing drastic challenges due to increasing number of patients, need for well-equipped hospitals, increasing complexity and rising treatment costs. These factors are causing enormous strain on the healthcare authorities. Healthcare revenue cycle management (HRCM) comes in handy in such situations. Presence of upgraded software reduces humanitarian errors, duplication of work and minimizes confusion while handling tons of data. Major players are trying to focus on developing innovative HRCM software that would serve as one of the most important components in healthcare system, enhancing patient engagement along with simplifying the workflow. HRCM software is gaining popularity even in diagnostic laboratories. The prime factors driving the Healthcare revenue cycle management market growth are rising regulatory mandates for the adoption of system like HRCM in healthcare sector and ineffectiveness of the conventional billing systems in administration of on-going billing operations. Parallely, there has been a notable rise in the adoption of cloud-backed revenue cycle management solutions, as they are attributed with flexiblility, security and cost-effectivity. These factors are expected to drive the market growth over the period of time. The government reforms also play an active role in boosting the adoption of the revenue cycle management system. For example, the Affordable Care Act (ACA) introduced in the U.S., focuses on expanding health insurance services to people with low income. This extended insurance can be managed effectively only through revenue cycle management solutions.

But, with ever-changing healthcare guidelines and new economic models, it is difficult for healthcare organizations to maintain stable HRCM and insecurity challenges regarding data management are the factors hampering the growth of this Healthcare revenue cycle management market.

Constant upgrades and big data analytics ensure smooth data management

Advancements and constant upgrades in the HRCM software has positively affected the industry growth throughout the timeframe. Recently upgraded platforms are better than their predecessors, highly efficient and helps in providing enhanced patient care and patient satisfaction. In addition, upgraded HRCM software have reduced the amount receivable from outstanding accounts of several hospitals and healthcare facility providers. Moreover, adoption of centralized software for medical billing and coding has reduced manual errors and enhanced the clinical outcomes and maintained transparency among stakeholders. Henceforth, availability of such technologically advanced systems has spiked the healthcare revenue cycle management market growth.

Advanced HRCM models have revolutionized the workflow in hospitals

Hospitals are major end users of HRCM systems owing to increasing cash flows in hospitals, number of patients are increasing due to rising prevalence of diseases that forces healthcare providers to implement efficient and quick revenue cycle management system for patient data collection and administration. Hospitals try to optimize revenue by integrating advanced HRCM software developed by companies that ensures effective management of patient’s clinical data and financial data. Factors mentioned above are expected to escalate the segmental growth. Furthermore, it also offers greater control on data management that proves beneficial for the segmental growth. In addition, increasing emphasis of major players on providing best-in-class pricing and billing management system will increase its acceptance thereby, ensuring the segmental growth.

In 2018, Allscripts announced Veradigm which is a leading data driven health insights and analytical solution providing company. This partnership will allow Allscripts to enhance existing solutions and widen its customer base in Life Sciences domain. The same year, Carecloud announced that company has expanded its RCM service for more efficient billing and faster payments. In 2019, Zotec Partners launched PAYperless with an aim to help patients make payments online and notify them regularly about their medical spending, appointments and authentication of their information.

Key benefits of the report:

  • This study presents the analytical depiction of the global healthcare 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 Healthcare revenue cycle management market share.
  • The current market is quantitatively analysed to highlight the global healthcare revenue cycle management Healthcare revenue cycle management market growth scenario.
  • Porter’s five forces analysis illustrates the potency of buyers & suppliers in the Healthcare revenue cycle management market.
  • The report provides a detailed global market analysis based on competitive intensity and how the competition will take shape in coming years.

Questions answered in the Healthcare Revenue Cycle Management Market research report:

  • Who are the leading market players active in the healthcare revenue cycle management market?
  • What are the current trends that 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 will help in taking further strategic steps?

Healthcare Revenue Cycle Management Market Report Highlights

Aspects Details
Healthcare Revenue Cycle Management Market By Product
By Product
  • Integrated
  • Standalone
Healthcare Revenue Cycle Management Market By Presence
By Presence
  • On-premises
  • On-cloud
  • Web-based services
Healthcare Revenue Cycle Management Market By Application
By Application
  • Collection and storing of clinical data
  • Medical coding and billing
  • Claims and denial management
  • Others
Healthcare Revenue Cycle Management Market By End user
By End user
  • Diagnostic and research centers
  • Hospitals
  • Physicians
  • Others
Healthcare Revenue Cycle Management Market By Region
By Region
  • North America  (US, Canada, Mexico)
  • Europe  (France, Germany, UK, Italy, Spain, rest of Europe)
  • Asia-Pacific  (Japan, China, India, Australia, South Korea, rest of Asia-Pacific)
  • LAMEA  (Brazil, South Arabia, South Africa, rest of LAMEA)
Key Market Players
Key Market Players

Emdeon, CareCloud, General Electric Healthcare, Accretive Health, Athenahealth, Allscripts Healthcare Solutions, Siemens Healthcare, Cognizant Technology Solutions, Conifer Health Solutions, McKesson Corporation, Cerner, Experian., AGS Health

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Healthcare Revenue Cycle Management Market

Global Opportunity Analysis and Industry Forecast, 2023-2032