Revenue Cycle Management Market Size, Share & Trends Report

Revenue Cycle Management Market Size, Share & Trends Analysis Report By Product (Software, Services), By Type (Integrated, Standalone), By Delivery Mode, By End-use, By Region, And Segment Forecasts, 2024 - 2030

  • Report ID: GVR-1-68038-433-8
  • Number of Pages: 130
  • Format: Electronic (PDF)
  • Historical Range: 2018 - 2022
  • Industry: Healthcare

Research Methodology

A three-pronged approach was followed for deducing the revenue cycle management 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 revenue cycle management 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 revenue cycle management 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.

Revenue Cycle Management Market Categorization:

The revenue cycle management market was categorized into eight segments, namely product (Software, Services), type (Integrated, Standalone), delivery mode (Web-based, Cloud-based, On-premise), end-use (Physician Back Offices, Hospitals, Diagnostic Laboratories), specialty (Oncology, Cardiology, Anesthesia, Radiology, Pathology, Pain Management, Emergency Service), sourcing (In-house, External RCM Apps/ Software, Outsourced RCM Services), function (Product Development, Member Engagement, Network Management, Care Management, Claims Management, Risk & Compliances), and region (North America, Europe, Asia Pacific, Latin America, and Middle East & Africa).

Segment Market Methodology:

The revenue cycle management market was segmented into product, type, delivery mode, end-use, specialty, sourcing, function, 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 revenue cycle management 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, the UK, Germany, France, Italy, Spain, Sweden, Denmark, Norway, Japan, China, India, Australia, Thailand, South Korea, Mexico, Brazil, Argentina, South Africa, Saudi Arabia, UAE, Kuwait.

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.

Revenue cycle management market companies & financials:

The revenue cycle management 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:

  • THE SSI GROUP, INC. - The SSI Group, Inc. specializes in providing analytics and solutions for revenue cycle management to healthcare providers, ambulatory surgery centers, and payers. Their product portfolio is diverse, encompassing claims analytics, clearinghouse, claims management, compliance management, and ASC analytics. They have formed partnerships with a variety of organizations, including Jopari Solutions, Inc., Quorum Purchasing Advantage, Fujitsu, United Health Services, the Workgroup for Electronic Data Interchange (WEDI), and Cerner Corporation. In a strategic move in August 2013, they acquired, Inc., a step that was anticipated to boost their capacity to process additional types of claim transactions, such as those in dental practices.

  • ALLSCRIPTS HEALTHCARE, LLC - AllScripts Healthcare, LLC is an IT services and solutions company that aids healthcare organizations in achieving optimal operational, financial, and clinical results. It supports various health organizations such as AMGA, AMIA, Health 2.0, High-Level Seven International, HIMSS, and HSP Consortium. The company has offices in Singapore, Israel, Australia, the UK, and India and offers products such as Sunrise EMR, dbMotion, Population Health Analytics, Precision Medicine, BOSSnet EMR, and FollowMyHealth. It has partnered with technological suppliers such as Microsoft Corporation, iProcedures, Opargo, and Hospital IQ. Furthermore, the company sells its products and services to lab companies, retail pharmacies, physicians, retail clinics, governments, hospitals, consumers, insurance companies, life sciences companies, health systems, and post-acute care organizations.

  • CERNER CORPORATION - Cerner Corporation offers tech-enabled services and healthcare information technology that supports the financial, clinical, & operational needs of organizations of various sizes. It operates in 26 countries and its solutions are contracted at more than 27,500 facilities in 35 countries. The services and solutions of the company can aid clinicians with care decision-making and help organizations in managing their population’s health. In addition, the company offers integrated financial and clinical systems for managing everyday revenue functions. Its tech-enabled service portfolio consists of revenue cycle services, healthcare data analytics, clinical process optimization, operational management services, remote hosting, transactional processing, and employee wellness programs.

  • MCKESSON CORPORATION - McKesson Corporation is a multinational Healthcare Information Technology (HIT). The company has operations in Canada, the UK, Germany, France, Italy, Belgium, Austria, Denmark, Ireland, the Netherlands, Norway, Sweden, Portugal, and Slovenia. It operates in two segments: McKesson Technology Solutions and McKesson Distribution Solutions. Its technology solutions segment includes analytics, software, technology-enabled services, and network solutions services. Mckesson provides healthcare services, medical products, and medicines through partnerships with pharmaceutical manufacturers, governments, pharmacies, & other organizations in the healthcare industry.

  • ATHENAHEALTH, INC. (VERITAS CAPITAL FUND MANAGEMENT, L.L.C. AND EVERGREEN COAST CAPITAL) - athenahealth, Inc. develops healthcare software and offers revenue cycle management services that help in managing & automating billing-related functions useful for practice management platforms in hospitals & ambulatory center settings. In June 2017, the company acquired Praxify Technologies, Inc. for accelerating R&D initiatives of the company through the addition of expertise in user and mobile experience design. In December 2016, athenahealth, Inc. partnered with ADP for bringing cloud-based payroll systems to hospitals.

  • EPIC SYSTEMS CORPORATION - Epic Systems Corporation designs, develops, & produces software and offers various management software to academic facilities, community hospitals, multi-hospital systems, safety net providers, and children’s organizations. The company serves its international customers through offices in the UK, Singapore, Australia, the Netherlands, Denmark, and the UAE (Dubai).Its software applications include broad categories, such as handheld devices, e-health, revenue cycle, enterprise foundation, decision support, clinical access, health plans, and connectivity. The company targets large healthcare organizations that focus on making investments in modernizing technology infrastructures and standardized EHR. Prominent clients of the company include Cleveland Clinic, Mayo Clinic, University of California Health System, Johns Hopkins, and Kaiser Permanente.

  • ECLINICAL WORKS - eClinicalWorks is a privately held healthcare IT company that provides ambulatory clinical software systems and offers record access & electronic record systems for patient flow management, clinical data processing, and electronic communication. The company serves more than 115,000 physicians, 850,000 medical professionals, and 70,000 facilities all over the U.S. It has a global presence in more than 20 countries. Prominent customers of the company include Carson Medical Group, Bluestone Physician Services, Arkansas Heart Hospital, The Children’s Clinic, and Coastal Medical.

  • NXGN MANAGEMENT, LLC - NXGN Management, LLC develops and provides services & software that help automate certain parts of EHR and practice management for medical & dental practices. Prominent partners of the company include Microsoft Corporation, 3M Health Information Systems, Citrix Systems, Fujitsu Computer Products of America, IBM, and Elsevier.The company has three operating divisions: the QSI Dental Division, the RCM Services Division, and the NextGen Division. The RCM Services Division offers revenue cycle management services, such as claims submission, charge entry, hosting, software setup, payment posting, reconciliation, advance analytics, electronic remittance, billing & collections, accounts receivable management, and enrollment credentialing. It caters to single and small practice organizations, like ambulatory care centers, dental schools, medical schools, management service organizations, community health centers, and physician-hospital organizations.

  • CARECLOUD CORPORATION - CareCloud Corporation is a privately held firm catering to the development of healthcare IT solutions, such as EHR, practice management, medical billing, and revenue cycle management. Its products are cloud-based and aim to be at par with the rapidly changing technology. The company initially provided solutions for practice management and evolved over the years to serve the whole practice management spectrum, including RCM and EHR solutions.

  • QUEST DIAGNOSTICS, INC. - Quest Diagnostics, Inc. provides a wide variety of services, which include diagnostic services & insights, and help in the discovery of new disorders & combine the findings to promote a healthy lifestyle. The company also offers a wide variety of diagnostic tests to physicians and has laboratories to support these tests in every major city in the U.S., the UK, Mexico, and India. It is also one of the major providers of solutions in the sectors of revenue management and reimbursement management, with an efficient denial management system.

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

Revenue Cycle Management 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.

Revenue Cycle Management 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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