Medical Billing Outsourcing Market Size, Share & Trends Report

Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-house, Outsourced), By Service (Front-End, Middle-End, Back-End), By End-use, By Region, And Segment Forecasts, 2023 - 2030

  • Report ID: GVR-1-68038-261-7
  • Number of Pages: 108
  • Format: Electronic (PDF)
  • Historical Range: 2018 - 2021
  • Industry: Healthcare

Research Methodology

A three-pronged approach was followed for deducing the medical billing outsourcing market estimates and forecasts. The process has three steps: information procurement, analysis, and validation. The whole process is cyclical, and steps repeat until the estimates are validated. The three steps are explained in detail below:

Information procurement: Information procurement is one of the most extensive and important stages in our research process, and quality data is critical for accurate analysis. We followed a multi-channel data collection process for medical billing outsourcing market to gather the most reliable and current information possible.

  • We buy access to paid databases such as Hoover’s and Factiva for company financials, industry information, white papers, industry journals, SME journals, and more.
  • We tap into Grand View’s proprietary database of data points and insights from active and archived monitoring and reporting.
  • We conduct primary research with industry experts through questionnaires and one-on-one phone interviews.
  • We pull from reliable secondary sources such as white papers and government statistics, published by organizations like WHO, NGOs, World Bank, etc., Key Opinion Leaders (KoL) publications, company filings, investor documents, and more.
  • We purchase and review investor analyst reports, broker reports, academic commentary, government quotes, and wealth management publications for insightful third-party perspectives.

Analysis: We mine the data collected to establish baselines for forecasting, identify trends and opportunities, gain insight into consumer demographics and drivers, and so much more. We utilized different methods of medical billing outsourcing market data depending on the type of information we’re trying to uncover in our research.

  • Market Research Efforts: Bottom-up Approach for estimating and forecasting demand size and opportunity, top-down Approach for new product forecasting and penetration, and combined approach of both Bottom-up and Top-down for full coverage analysis.

  • Value-Chain-Based Sizing & Forecasting: Supply-side estimates for understanding potential revenue through competitive benchmarking, forecasting, and penetration modeling.

  • Demand-side estimates for identifying parent and ancillary markets, segment modeling, and heuristic forecasting.

  • Qualitative Functional Deployment (QFD) Modelling for market share assessment.

Market formulation and validation: We mine the data collected to establish baselines for forecasting, identify trends and opportunities, gain insight into consumer demographics and drivers, and so much more. We utilize different methods of data analysis depending on the type of information we’re trying to uncover in our research.

  • Market Formulation: This step involves the finalization of market numbers. This step on an internal level is designed to manage outputs from the Data Analysis step.

  • Data Normalization: The final market estimates and forecasts are then aligned and sent to industry experts, in-panel quality control managers for validation.

  • This step also entails the finalization of the report scope and data representation pattern.

  • Validation: The process entails multiple levels of validation. All these steps run in parallel, and the study is forwarded for publishing only if all three levels render validated results.

Medical Billing Outsourcing Market Categorization:

The medical billing outsourcing market was categorized into four segments, namely component (In-house, Outsourced), service (Front-end Services, Middle-end Services, Back-end Services), end-use (Hospital, Physician Office), and region (North America, Europe, Asia Pacific, Latin America, and Middle East & Africa).

Segment Market Methodology:

The medical billing outsourcing market was segmented into component, service, end-use, and regions. The demand at a segment level was deduced using a funnel method. Concepts like the TAM, SAM, SOM, etc., were put into practice to understand the demand. We at GVR deploy three methods to deduce market estimates and determine forecasts. These methods are explained below:

Market research approaches: Bottom-up

  • Demand estimation of each product across countries/regions summed up to from the total market.

  • Variable analysis for demand forecast.

  • Demand estimation via analyzing paid database, and company financials either via annual reports or paid database.

  • Primary interviews for data revalidation and insight collection.

Market research approaches: Top-down

  • Used extensively for new product forecasting or analyzing penetration levels.

  • Tool used invoice product flow and penetration models Use of regression multi-variant analysis for forecasting Involves extensive use of paid and public databases.

  • Primary interviews and vendor-based primary research for variable impact analysis.

Market research approaches: Combined

  • This is the most common method. We apply concepts from both the top-down and bottom-up approaches to arrive at a viable conclusion.

Regional Market Methodology:

The medical billing outsourcing market was analyzed at a regional level. The globe was divided into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa, keeping in focus variables like consumption patterns, export-import regulations, consumer expectations, etc. These regions were further divided into twenty-three countries, namely, the U.S.; Canada; Germany; the UK; Spain; France; Italy; Sweden; Norway; Denmark; Japan; China; India; Australia; Thailand, South Korea; Brazil; Mexico; Argentina; South Africa; Saudi Arabia; Kuwait; UAE.

All three above-mentioned market research methodologies were applied to arrive at regional-level conclusions. The regions were then summed up to form the global market.

Medical billing outsourcing market companies & financials:

The medical billing outsourcing market was analyzed via companies operating in the sector. Analyzing these companies and cross-referencing them to the demand equation helped us validate our assumptions and conclusions. Key market players analyzed include:

  • Experian Information Solutions, Inc. - Experian Information Solutions, Inc. is a prominent player in the healthcare market, offering a range of services through its subsidiary, Experian Health. The company’s primary business segments include credit services, decision analytics, marketing services, and consumer services. Within its credit services, Experian Health provides Revenue Cycle Management (RCM) solutions, which have been a significant contributor to the company’s overall revenue. These RCM services are designed to streamline the financial and clinical aspects of care, ensuring that healthcare providers are properly reimbursed for their services. The company’s RCM solutions are built on proven technology and are aimed at optimizing the revenue cycle, reducing manual tasks, and boosting cash flow. Experian Health’s expertise in RCM spans the entire patient lifecycle, from patient access to collections management, and is supported by integrated products that automate claims workflows and improve healthcare claims management. 

  • GE Healthcare - GE Healthcare is a prominent player in the healthcare market, offering essential healthcare technologies across the globe. The company operates in various segments, including performance improvement solutions, medical imaging, drug discovery, patient monitoring & diagnostics, digital solutions, and biopharmaceutical manufacturing technologies. GE Healthcare is present in more than 140 countries. In June 2018, GE announced its plan to make GE Healthcare a standalone company, which was completed in January 2023.

  • R1 RCM, Inc. - R1 RCM, Inc. is a major player in the healthcare market, specializing in revenue cycle management (RCM) services. The company’s primary service offering is end-to-end RCM, provided through an operating partner relationship or co-managed relationship. R1 RCM operates exclusively through one business segment and serves hospitals and other care providers in the U.S. The company was previously known as Accretive Health, Inc. until 2009, when it was renamed to R1 RCM, Inc.

  • Quest Diagnostics - Quest Diagnostics is a major player in the healthcare market, offering diagnostic products and services. The company provides revenue cycle management (RCM) services through its Care360 RCM billing solutions, which are part of its health IT solutions. Quest Diagnostics’ main customers include clinicians, health plan developers, integrated delivery networks, Accountable Care Organizations (ACOs), and employers. The company’s Quanum Revenue Cycle Management (RCM) provides a comprehensive solution to managing the financial component of a practice, from claims to denials, with a focus on improving collections and revenue

  • Allscripts Healthcare Solutions, Inc. - Allscripts Healthcare Solutions, Inc. is a prominent IT and service company that caters to healthcare organizations. The company is focused on helping healthcare organizations achieve optimized clinical, financial, and operational results. Its main clientele includes hospitals, physicians, governments, health plan developers, retail clinics, life science companies, pharmacy benefit managers, insurance companies, clinics, and post-acute organizations.

  • Kareo, Inc. - Kareo, Inc. is a significant player in the healthcare market, known for its cloud-based medical office software tailored for independent medical practices. The company’s products and services encompass medical practice management software, Electronic Health Record (EHR) solutions, and medical billing services in RCM. Kareo, Inc. serves more than 50,000 providers across the U.S., focusing on smaller independent medical groups, typically with fewer than ten providers. The company’s cloud-based platform is designed to meet the unique needs of independent practices, offering key functions to run a medical practice, including care delivery, medical billing, patient engagement, and marketing.

  • Cerner Corporation - Cerner Corporation is a major player in the healthcare market, offering a range of enterprise-level clinical and financial healthcare IT solutions and services. The company’s primary revenue source is sales of clinical and revenue cycle solutions and services to hospitals and health systems. Cerner Corporation has a global presence, with sales offices in approximately 25 countries. In 2015, the company acquired Siemens AG’s health IT business unit, further expanding its offerings and reach.

  • McKesson Corporation - McKesson Corp. is a Fortune 500 company that operates across two segments: McKesson distribution solutions and technology solutions. The company’s primary revenue source is its McKesson distribution solutions, which account for 98% of its total revenue. Under the McKesson Specialty Health business, it offers revenue cycle and practice management solutions. Additionally, McKesson is a major player in the pharmaceutical and medical supplies distribution market, and it is a significant healthcare IT solutions provider.

  • Genpact - Genpact is a global professional services firm that drives digital-led innovation and digitally-enabled intelligent operations for its clients. The company’s Lean Digital Innovation Centers help clients address their business needs, and its domain-led digital transformation services provide digital-led Transformation Services and design & run Intelligent Operations. Genpact serves various industries, including banking & financial services, insurance, capital markets, life sciences & healthcare, consumer goods & retail, High Tech, and infrastructure manufacturing & services. The company has a presence in more than 25 countries

  • eClinicalWorks -

    eClinicalWorks is a healthcare IT solutions provider. It provides a range of healthcare IT solutions, such as EHR systems, population health, patient engagement, and for RCM. Its primary customers are physicians, hospital outpatient departments, care clinics, ACOs, and health centers.

Value chain-based sizing & forecasting

Supply Side Estimates

  • Company revenue estimation via referring to annual reports, investor presentations, and Hoover’s.

  • Segment revenue determination via variable analysis and penetration modeling.

  • Competitive benchmarking to identify market leaders and their collective revenue shares.

  • Forecasting via analyzing commercialization rates, pipelines, market initiatives, distribution networks, etc.

Demand side estimates

  • Identifying parent markets and ancillary markets

  • Segment penetration analysis to obtain pertinent

  • revenue/volume

  • Heuristic forecasting with the help of subject matter experts

  • Forecasting via variable analysis

Medical Billing Outsourcing Market Report Objectives:

  • Understanding market dynamics (in terms of drivers, restraints, & opportunities) in the countries.

  • Understanding trends & variables in the individual countries & their impact on growth and using analytical tools to provide high-level insights into the market dynamics and the associated growth pattern.

  • Understanding market estimates and forecasts (with the base year as 2022, historic information from 2018 to 2021, and forecast from 2023 to 2030). Regional estimates & forecasts for each category are available and are summed up to form the global market estimates.

Medical Billing Outsourcing Market Report Assumptions:

  • The report provides market value for the base year 2022 and a yearly forecast till 2030 in terms of revenue/volume or both. The market for each of the segment outlooks has been provided on region & country basis for the above-mentioned forecast period.

  • The key industry dynamics, major technological trends, and application markets are evaluated to understand their impact on the demand for the forecast period. The growth rates were estimated using correlation, regression, and time-series analysis.

  • We have used the bottom-up approach for market sizing, analyzing key regional markets, dynamics, & trends for various products and end-users. The total market has been estimated by integrating the country markets.

  • All market estimates and forecasts have been validated through primary interviews with the key industry participants.

  • Inflation has not been accounted for to estimate and forecast the market.

  • Numbers may not add up due to rounding off.

  • Europe consists of EU-8, Central & Eastern Europe, along with the Commonwealth of Independent States (CIS).

  • Asia Pacific includes South Asia, East Asia, Southeast Asia, and Oceania (Australia & New Zealand).

  • Latin America includes Central American countries and the South American continent

  • Middle East includes Western Asia (as assigned by the UN Statistics Division) and the African continent.

Primary Research

GVR strives to procure the latest and unique information for reports directly from industry experts, which gives it a competitive edge. Quality is of utmost importance to us, therefore every year we focus on increasing our experts’ panel. Primary interviews are one of the critical steps in identifying recent market trends and scenarios. This process enables us to justify and validate our market estimates and forecasts to our clients. With more than 8,000 reports in our database, we have connected with some key opinion leaders across various domains, including healthcare, technology, consumer goods, and the chemical sector. Our process starts with identifying the right platform for a particular type of report, i.e., emails, LinkedIn, seminars, or telephonic conversation, as every report is unique and requires a differentiated approach.

We send out questionnaires to different experts from various regions/ countries, which is dependent on the following factors:

  • Report/Market scope: If the market study is global, we send questionnaires to industry experts across various regions, including North America, Europe, Asia Pacific, Latin America, and MEA.

  • Market Penetration: If the market is driven by technological advancements, population density, disease prevalence, or other factors, we identify experts and send out questionnaires based on region or country dominance.

The time to start receiving responses from industry experts varies based on how niche or well-penetrated the market is. Our reports include a detailed chapter on the KoL opinion section, which helps our clients understand the perspective of experts already in the market space.

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