Report Description of the US Revenue Cycle Management (RCM) Market
Research Scope and Assumption
- The report provides the market value for the base year 2020 and a yearly forecast up to 2028 in terms of revenue (USD billion)
- The key industry dynamics, regulatory scenario, reimbursement scenario, major market trends, and drug markets are evaluated to understand their impacts on the demand for the forecast period. The growth rates were estimated using correlation, regression, and time-series analysis
- We have used the combination of top-down and bottom-up approach for market sizing, analyzing key regional markets, dynamics, and trends for various solutions, services, and end uses
- All market estimates and forecasts have been validated through primary interviews with the Key Industry Players (KIPs) and secondary analysis
- Inflation has not been accounted for in order to estimate and forecast the market
- Numbers may not add up due to rounding off
Research Objective:
- To analyze and forecast the market size of US Revenue Cycle Management Market
- To classify and forecast US Revenue Cycle Management market based on application, drugs, project type, and application.
- To identify drivers and challenges for US Revenue Cycle Management market
- To examine competitive developments such as mergers and acquisitions, agreements, collaborations and partnerships, etc., in US Revenue Cycle Management market
- To conduct pricing analysis for US Revenue Cycle Management market
- To identify and analyze the profile of leading players operating in US Revenue Cycle Management market
Reason to Buy the Report:
- Facilitate decision-making based on strong current and forecast data for Revenue Cycle Management (RCM) market
- Develop strategies based on the latest regulatory framework
- Strategically analyze micro-markets with respect to individual growth trends, future prospects, and their contribution to the market
- Analyze competitive developments such as expansions, investments, mergers & acquisitions, new product developments, and research & developments in the Revenue Cycle Management (RCM) market
- Analyze the opportunities in the market for stakeholders and draw a competitive landscape for market leaders
- To strategically profile key players and comprehensively analyze their market shares and core competencies
- We have technically sound team which do a deep dive research and also provide strategy based consulting analysis
US Revenue Cycle Management (RCM) Executive Summary
Revenue Cycle Management (RCM) refers to the process of identifying, collecting and managing the practice’s revenue from payers based on the services provided. A successful RCM process is essential for a healthcare practice to maintain financial viability and continue to provide quality care for their patients
The US RCM market offers attractive growth opportunities due to the existence of many major hospitals and health systems, favourable legislation, growing geriatric population, and the country’s increasing need to reduce costs in healthcare
Market Size and Key Findings
The US RCM size is at around USD 120.7 billion in 2020 and is projected to reach USD xx billion by 2028, exhibiting a CAGR of xx% during the forecast period
US as world’s third largest community, will be growing at faster pace of 11.42% during the forecasted period till 2028. The benefits etched to the revenue cycle management solutions such as secure, flexible, and cost-effective may bring expansive growth prospects for the revenue cycle management market. US has been identified as game changer and fastest growing economy in RCM. Also, the establishment of teams by federal agencies for regulatory reforms leads to the possibility of reclassification of various healthcare products within the medical industry. The healthcare industry can leverage the efficacy & economic value presented by third-party RCM service providers and focus more on a key purpose, which is patient care. The changing aspects of service outsourcing in healthcare RCM are largely driven by finances.
Market Dynamics
Market Growth Drivers Analysis
- The volume of electronic data produced in the healthcare industry, primarily due to rising patient volumes and the digitization of administrative, clinical, and financial information, has expanded to terabytes and petabytes. Other major factors contributing to this trend are the sheer diversity of data in healthcare
- Rising prominence and usage of HCIT tools
- Given how acquisitive large hospital systems have been in recent years with physician offices and independent practices, the outpatient care setting will continue to be a large market opportunity for RCM vendors
- Large software companies that previously operated outside of healthcare are entering the space via RCM, as it gives access to provider networks, physician practices, data and analytics from insurance providers, such as claims, denial write-offs and underpayment, and provides a steady form of revenue for the acquirer
Market Restraints
The cost associated with maintaining revenue cycle management software is considerably high. Moreover, IT support and maintenance services, which include modifying and upgrading software as per changing user requirements and maintaining an efficient IT infrastructure, represent a recurring expenditure. This accounts for a large share of the total cost of ownership. Also, post-sale custom interface development for device integration requires additional verification and validation to ensure solution accuracy and completeness. This further increases the total cost of ownership for healthcare providers. As a result of the high costs involved, small healthcare facilities are reluctant to replace their legacy systems with RCM solutions
COVID-19 impact on “US Revenue Cycle Management (RCM)”
The Covid-19 pandemic has significantly affected almost all industries across the globe but specifically the healthcare sector. The healthcare providers in the country have reported a significant rise in patient volume, which has also impacted the healthcare costs and medical billing complexities. Due to this, there is a rise in outsourcing of Revenue cycle management (RCM) services in the US as providers need to engage in collaborations for outcome-based, service-level agreement-driven RCM services. This procedure is becoming popular despite the positive impact of the pandemic
Competitive Landscape
Key Players
The “Revenue Cycle Management in US” study report will provide valuable insights with an emphasis on the US market including some of the key market players such as The SSI Group, Inc., McKesson Corp., Allscripts Healthcare, LLC Athenahealth, Inc., Epic Systems Corp., NXGN Management, LLC, Oncospark Inc., eClinicalWorks
Our market analysis also entails a section solely dedicated to such major players wherein our analysts provide an insight to the financial statements of all the major players, along with its product benchmarking and revenue analysis. The competitive landscape section also includes key development strategies, market share, and market ranking analysis of the above-mentioned players
Notable Recent Deals
Some Acquisition and Partnership deals are:
- Nexteligent acquired Professional Revenue Management Services Addition expands Nexteligent’s National Capabilities for Medical Billing, Coding and Electronic Claims Processing for Clinics
- Health Catalyst acquired VitalWare Acquisition helps Health Catalyst’s ability to scale software on top of its cloud-base data, Operating System and further enhance analytics insights. Coronis Health RCM, LLC acquired Revenue Guard Claims Management Revenue Guard will be excellent addition to the management team and will lead EMS (Emergency Medical Services) vertical for Coronis Health
- Revint and Triage merges to become Cloudmed. The merger creates a unique, first-of-its-kind, single source enterprise platform that delivers Revenue Intelligence™ for a smarter, more predictive way for hospitals and health systems
Healthcare Policies and Regulatory Landscape
Policy Changes and Reimbursement Scenario
Competitive and transparent pricing of services, high quality clinical outcomes, and effective billing and collection process are becoming more important than ever. The front-end of the revenue cycle must be diligent with determining Medicaid eligibility and assist uninsured patients understand their coverage options with the insurance exchanges. One of the biggest challenges in revenue cycle management is the ever-changing healthcare regulations and complex reimbursement models introduced every few years. Practices must stay abreast of these changes and ensure that their staff understands them and performs their tasks in compliance with these regulations. Expertise in all aspects of the change may be hard to attain, especially for smaller practices
