US Revenue Cycle Management Market Analysis

US Revenue Cycle Management Market Executive Summary

US Revenue Cycle Management Market is valued at around $113.82 Bn in 2022 and is projected to reach $236.98 Bn by 2030, exhibiting a CAGR of 9.6% during the forecast period 2023-2030.

The Revenue Cycle Management Market refers to the market for a set of procedures and various technology to manage the financial aspects of patient care in healthcare organizations. These economic aspects include patient registration, insurance eligibility, and verification, claim procedures, medical coding, A.R. management, payment collection, and revenue generation.

Technological advancements like automation, artificial intelligence, integration with electronic health records, robotic process automation, and blockchain solutions have contributed to the growth of the global market for revenue cycle management in recent years. Digital tools like mobile applications, telehealth services, and self-service portals are integrated with revenue cycle management to improve efficiency and outcome. It has given a boost to the global revenue cycle management market.

There are many global players in the revenue cycle management market but Cerner Corporation, Epic Systems Corporation, Allscripts Healthcare Solutions, Inc., Athenahealth, Inc., McKesson Corporation, GE Healthcare, Quest Diagnostics, NextGen Healthcare, Inc., eClinicalWorks, and R1 RCM Inc. are some of the major players in the market.

The requirement for revenue cycle management is growing due to the supportive growth provided by regulatory compliance. Furthermore, the development of the revenue cycle management market is supported by the rising demand for workflow optimization in healthcare organizations along with cutting-edge synchronized management software systems. The market for revenue cycle management is also expected to develop as a result of the rising demand for cloud-based solutions.

The difficulties that are restricting the growth of the market include the high expenses connected with revenue cycle management adoption and a lack of skilled professionals. On the other hand, it is anticipated that the industry will experience growth opportunities in the coming years due to the growing outsourcing services in developing countries. The market may have a chance to grow as a result of an increase in activities and advancements related to revenue cycle management.

Market Dynamics

Drivers of US Revenue Cycle Management Market:

Increasing Patient Volume and Health Insurance Claims: One of the key factors driving the global market is the rising patient volume and consequent increase in health insurance claims. This is mainly driven by the rising incidence of chronic diseases, the rising demand for high-quality healthcare, and the growing availability of health insurance policies. The number of health insurance claims has increased significantly as a result of increasing demands for healthcare services. As a result, effective revenue cycle management solutions and services are now required to handle the rising number of health insurance claims and increase the revenue for healthcare providers.

Increasing Adoption of Cloud-deployed Revenue Cycle Management: Due to its greater flexibility and improved cost-effectiveness for end users, cloud deployment of RCM is becoming more popular. Cloud-based technologies have made it simple and secure to share medical data. It helps the development and security of telehealth apps while automating backend processes. In order to avoid additional costs for server maintenance, cloud-deployed solutions help healthcare organizations manage electronic medical records, big data analytics, patient portals, and mobile applications. As a result, this component drives growth in the market.

Government Support Initiatives: To protect patient data and guarantee that claims management runs smoothly, the healthcare sector has undergone numerous legislative framework adjustments.  Different laws were put in place to increase access to affordable healthcare and insurance services and to encourage the development of the healthcare IT industry. Together, these elements drive the revenue cycle management market growth.

Restraints of US Revenue Cycle Management Market:

High Cost: Many consulting firms, including revenue cycle management, struggle with offering hidden fees. There may be a number of unexplained expenses, including charges for creating reports, printing statements, setting up services, and canceling services that limit users' access to the system. Therefore, such barriers prevent the industry from growing.

The complexity of the Healthcare System: The healthcare system involves multiple stakeholders, different reimbursement policies, and regulatory models according to different case scenarios. It can be challenging for revenue cycle management as it requires deep domain expertise, excellent knowledge of regulatory frameworks, and the ability to adapt to changes in these policies. It can hinder the growth of the market for revenue cycle management.

Notable Deals in Revenue Cycle Management Market:

In February 2023, Experian introduced AI Advantage, a new revenue cycle management tool that uses artificial intelligence to increase the precision and effectiveness of claims processing. The system was created to assist healthcare providers in reducing denials and improving cash flow.

In November 2022, Epic and Google Cloud teamed up to create a brand-new revenue cycle management system that boosts the efficiency of claims processing with the use of artificial intelligence and machine learning. The system was created to assist healthcare providers in reducing denials and improving cash flow.