Revenue Cycle Management (RCM) Market Size, Share & Trends Analysis By Product (Software, Service), By Type (Integrated & Standalone), By Delivery Mode, By End Use, And Segment Forecasts, 2019 - 2026

Industry Insights

The global revenue cycle management market size was valued at USD 29.5 billion in 2018 and is expected to witness a CAGR of 12.0% over the forecast period. The factors driving demand for Revenue Cycle Management (RCM) are the regulatory mandates for the adoption of Electronic Health Records (EHR) and Electronic Medical Records (EMR) coupled with strong government initiatives, cases of revenue billing errors, demand for cloud based solutions, and the decrease in reimbursements in the healthcare industry.

Increasing demand for cloud based solutions is anticipated to bode well for growth. In February 2018, eClinical Works introduced cloud based platform for the acute cate facilities. The platform designed to form unified EHR, with seamless sharing of data between ambulatory and acute care facilities at USD 599 per month with no upfront charges. Furthermore, in June 2018, Baker Tilly, the U.S based advisory firm introduced Revenue Cycle Innovation Center (RCIC) to streamline operations. RCIC offers actionable data for maximizing revenues with the use of data analytic tools. It features robotic process automation, cloud based telephony tools, reduction in vendor fees, and remote assistance.

Moreover, according to the survey done by Black Book Market Research LLC, the U.S. based research firm, most of the hospitals and mid-size clinics are looking forward to RCM technology vendors to optimize their operational and financial operations. On the basis of the analysis, it is found that 45.0% of the large and community hospitals use RCM software solutions and 35.0% of the small hospitals plan to outsource them.

Furthermore, the growth in healthcare IT and analytics industry are projected to drive the RCM market. Clinicians, physicians, and healthcare managers strive to have automated assessment based on medical history, insurance eligibility, financial coverage, and cost management. RCM software package offers denial management services with the use of analytics. However, high deployment costs for RCM solutions and dearth of trained professionals are expected to limit the market growth.

Product Insights

On the basis of product, the revenue cycle management market is segmented into software and services. In 2018, software held the largest market share of over 45.0% by 2026. The growth is attributed to the increase in usage of Software as a Service (SaaS) for revenue management by the healthcare companies.

The services segment is projected to register the faster CAGR over the study period. The rising trend in outsourcing and increase in investments by key operating in the RCM market for the development of infrastructure required to handle RCM modalities. The services offered include claims settlement, denial management, and insurance recovery. Depending on the requirement of clients, the services are offered in bundled/integrated or individually. This flexibility is expected to boost market growth.

Type Insights

On the basis of type, the market is segmented into standalone and integrated. Standalone software are most commonly used in physician offices whereas mid to large sized hospitals and diagnostic laboratories opt for the integrated solutions. Integrated software segment expected to hold the largest market share by 2026, attributed to the growing number of hospitals in the emerging nations and the launch of less complex integrated solutions. Integrated services coupled with hospitals opted for service vendors associated with RCM market. It possesses advantages such as reduced administrative cost and improved revenue cycle speed and productivity. Thus, integrated service is anticipated to witness increased adoption in near future.

Delivery Mode Insights

On the basis of delivery mode, the market is segmented into on-premise, cloud based, and web based. Cloud based solutions are expected to witness the fastest growth over the forecast period. The segment is gaining popularity in practice management and other healthcare IT solutions. Higher accessibility and rising adoption are the key drivers for the cloud based delivery mode.

Software with on-premise platform is installed on the users’ workstation or server. This software usually has a high up-front cost due to high capital expenditure. However, the cost of ownership is less, as there is very less annual or monthly subscription fees. Web based delivery mode is conducted through the internet without any additional storage, whereas on-premises software installed off site and regulated by the third party organizations.

End Use Insights

On the basis of end use, the market is segmented into physician office, hospitals, diagnostic laboratories, and others. In 2018, physician offices held the leading market share of over 37.0%. According to the data published by Medscape, majority of physicians in U.S. offer healthcare services through either individually owned clinics or small practices, thereby accounting a large target group. Similarly, the hospital segment is anticipated to witness lucrative growth over the forecast period. Countries such as India, Brazil, China, and U.S. are the fastest evolving healthcare providers in the hospital space.

The usage of RCM services in diagnostic labs is guided by the decline in machine downtime, reduction in diagnostic costs, and improvement in patient care. The others segment include pharmacies, ambulatory surgical centers, and rest of healthcare facilities. Multiple enterprises are working towards facilities, who offer round the clock monitoring and dedicated healthcare delivery. The others segment is projected to contribute substantially towards revenue generation over the study period.

Regional Insights

North America is expected to be a significant contributor to the global market. The presence of well-developed healthcare infrastructure, rising adoption among the end-users, and the long term benefits of revenue cycle management solutions are anticipated to favor its growth over the forecast period. In addition, increase in the number of hospitals and physician offices also contributed to its growth.

Asia Pacific is expected to be the dominant and the fastest growing region in the forthcoming years. This growth can be attributed to the increase in target population seeking treatment and usage of automated medical claims in countries such as China, India, Japan, and Singapore.

Revenue Cycle Management Market Share Insights

Some of the key market players include Allscripts Inc.; Cerner Corporation; Change Healthcare; NextGen Healthcare Information Solution LLC; Experian Health; Epic Systems Corporation; McKesson Corporation; and CareCloud Corporation. Companies are focusing on strategic collaborations, agreements, and partnerships. For instance, in January 2019, Change Healthcare and Experian Health partnered to provide identity management solutions to solve issues of patient identification and duplication errors.

Report Scope

Segments Covered in the Report

This report forecasts revenue growth at global, regional, and country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2015 to 2026. For the purpose of this study, Grand View Research has segmented the global Revenue Cycle Management (RCM) market report on the basis of product, type, delivery mode, end use, and region:

• Product Outlook (Revenue, USD Million, 2015 - 2026)

  • Software

  • Services

• Type Outlook (Revenue, USD Million, 2015 - 2026)

  • Integrated

  • Standalone

• Delivery Mode Outlook (Revenue, USD Million, 2015 - 2026)

  • On-premise

  • Web based

  • Cloud based

• End use Outlook (Revenue, USD Million, 2015 - 2026)

  • Physician Offices

  • Hospitals

  • Diagnostic Laboratories

  • Others

• Regional Outlook (Revenue, USD Million, 2015 - 2026)

  • North America

    • U.S.

    • Canada

  • Europe

    • U.K.

    • Germany

    • France

    • Italy

    • Spain

  • Asia Pacific

    • Japan

    • China

    • India

    • Australia

    • South Korea

  • Latin America

    • Brazil

    • Mexico

    • Argentina

    • Colombia

  • Middle East & Africa

    • South Africa

    • Saudi Arabia

    • UAE