Revenue Cycle Management Market Size, Share & Trends Analysis Report By Product (Software, Service), By Type (Integrated, Standalone), By Delivery Mode, By Region, And Segment Forecasts, 2020 - 2027

Industry Insights

The global revenue cycle management market size was valued at USD 64.3 billion in 2019 and is anticipated to expand at a CAGR of 12.1% over the forecast period. Key factors driving the market growth are rising regulatory mandates for the adoption of Healthcare Information Technology (HIT) systems in healthcare settings and failure of the traditional billing systems to provide insights about on-going billing operations. Besides, there has been a steep rise in the adoption of cloud-based revenue cycle management solutions, as they are quite flexible, secure, and cost-effective. These factors are expected to drive the market growth over the forecast period.

The key players in the market are launching new solutions in cloud-based space, which has further encouraged the growth of the market. For instance, in February 2019, eClinicalWorks launched its cloud-based acute care EHR and revenue cycle management solution in the market. The company also entered into a partnership with the Hamilton Healthcare System to provide cloud-based solutions to their customers. This solution is intended to provide easy data sharing between ambulatory and acute care settings.

The government reforms also play an active role in boosting the adoption of the revenue cycle management system. For instance, the Affordable Care Act (ACA) or the popular ‘Obamacare’ introduced in the U.S., focuses on expanding health insurance coverage to individuals with low income in the country. The act aims to improve the quality of healthcare services and reduce the cost of care in the country. This extended insurance coverage is expected to increase the number of reimbursements and denials, which can be managed effectively only through revenue cycle management solutions.

Moreover, the increasing adoption and popularity of cloud-based solutions among patients and healthcare settings are further aiding the market growth. Cloud-based solutions store a large amount of data and allow medical administrator access patient information from any location. This leads to faster processing of payments, reimbursements, and claims for both patients and doctors, thus, making the revenue cycle management process more cost-effective for healthcare settings.

The revenue cycle management solution is new in the market, owing to which the healthcare settings are facing a shortage of skilled professionals to manage these systems. This factor is negatively impacting the market growth. However, to minimize the impact, large hospitals and other healthcare facilities in developed economies are outsourcing either a part of the revenue cycle management process or the complete process from developing economies. This is further aiding the market growth and helping to introduce the revenue cycle management (RCM) concept in these economies.

Product Insights

Based on product type, the RCM market is segmented into software and services. In 2019, the software segment accounted for the largest market share and was valued at around USD 39.0 billion. Revenue cycle management software is quite popular as they are centralized and help resolve the complexities associated with patient care and payment in healthcare settings. Moreover, launch of improved versions of existing software in the market as per consumer needs is further anticipated to drive the market growth over the forecast period.

On the other hand, the service segment is anticipated to be the fastest-growing segment over the forecast period. Growing trend of outsourcing revenue cycle management services is the key factor influencing the growth of this segment. Healthcare facilities are facing a lack of resources and skillsets required for the deployment of revenue cycle management. Hence, they are completely or partially outsourcing these services, where the outsourced partner takes care of RCM activities. This helps the medical professionals focus completely on patient care and leave revenue cycle management monitoring on the outsourced partner.

Type Insights

Based on type, the revenue cycle management market can be segmented as integrated and standalone. Integrated solutions accounted for the largest market share of 69.0% in 2019. This large share is majorly attributed to the growing preference for volume-based payments amongst healthcare settings. Another factor contributing to the growth of this segment is that integrated solutions offer a streamlined and coordinated format of a variety of financial activities via single platform, which results in a uniform process of data collection and analysis.

Owing to this factor, the adoption of integrated revenue cycle management solutions is increasing among various healthcare settings. This is also supporting the segment to witness the fastest growth over the forecast period. Moreover, integrated solutions are more cost-effective as compared to standalone solutions, as they are made of various modules that help carry out various transactions through a single software without any additional requirements.

End-use Insights

In 2019, the physician back-office dominated the market with a revenue share of 37.4%. There has been a sheer increase in the number of physicians that have opted for revenue cycle management systems to effectively manage the billing services in their clinics and improve the overall financial performance. The revenue cycle management systems, installed in physicians back-office routinely help the nurses, consultants, and office managers in the smooth functioning of their units.

The other settings segment that mainly consists of pharmacies and ambulatory care centers is anticipated to grow at the fastest rate over the forecast period. Fluctuations in medicine cost, introduction of new drugs in the market, and outdated Charge Description Masters (CDM) in pharmacies cause enormous loss to pharmacies. Hence, to eliminate these issues and increase revenues, many pharmacies have started adopting effective revenue cycle management technology for supporting daily operations, which is likely to aid the market growth over the forecast period.

Regional Insights

North America dominated the global RCM market in 2019 owing to the presence of well-developed healthcare infrastructure, growing adoption of revenue cycle management solutions, and their long-term benefits. Furthermore, an increase in the number of hospitals and physician offices also contributed to its growth. As per the American Hospital Association, the number of registered hospitals in the U.S. were 5,534 in 2018, which has grown to 6,210 in 2019. There is a growth of 12.2% in the number of hospitals, which is anticipated to drive the market growth over the forecast period.

The Asia Pacific region is expected to expand at the fastest CAGR of 13.8% in the global market, owing to the increasing patient population suffering from various chronic diseases, rising government initiatives to combat these diseases, and the growing usage of automated medical claims in the countries such as China, India, Japan, and Singapore. Moreover, Asia Pacific is one of the sought-after regions for outsourcing revenue cycle management services due to the availability of low cost labor in countries such as the Philippines, Indonesia, and India.

Revenue Cycle Management Market Share Insights

Some of the key participants operating in this market are Allscripts Inc.; Experian Health; Cerner Corporation; Change Healthcare; NextGen Healthcare Information Solution LLC; Epic Systems Corporation; CareCloud Corporation; and McKesson Corporation. These companies are focusing on strategic collaborations and introduction of new products to survive the market competition. For instance, in January 2019, Change Healthcare partnered with Experian Health to provide identity management solutions to solve issues of patient identification and duplication in revenue cycle management. In February 2019, Zotec Partners launched - PAYperless - that would help patients make payments online and also notify them regularly about their medical encounters and authentication of their information.

Report Scope

Segments Covered in the Report

This report forecasts revenue growth at global, regional, and country levels and provides an analysis on latest industry trends in each of the sub-segments from 2016 to 2027. For the purpose of this study, Grand View Research has segmented the global revenue cycle management market report based on product, type, delivery mode, end use, and region:

• Product Type Outlook (Revenue, USD Million, 2016 - 2027)

  • Software

  • Services

• Type Outlook (Revenue, USD Million, 2016 - 2027)

  • Integrated

  • Standalone

• Delivery Mode Outlook (Revenue, USD Million, 2016 - 2027)

  • On-premise

  • Web-based

  • Cloud based

• End-use Outlook (Revenue, USD Million, 2016 - 2027)

  • Physician Offices

  • Hospitals

  • Diagnostic Laboratories

  • Others

• Regional Outlook (Revenue, USD Million, 2016 - 2027)

  • North America

    • U.S.

    • Canada

  • Europe

    • U.K.

    • Germany

    • France

    • Italy

    • Spain

    • Russia

  • Asia Pacific

    • China

    • Japan

    • India

    • Singapore

    • South Korea

    • Australia

  • Latin America

    • Mexico

    • Brazil

    • Argentina

  • MEA

    • South Africa

    • Saudi Arabia

    • UAE