U.S. Medical Coding Market Size, Share & Trends Analysis Report By Classification System (ICD, HCPCS, CPT), By Component, By Medical Specialty, And Segment Forecasts, 2023 - 2030

Research Methodology

A three-pronged approach was followed for deducing the U.S. medical coding 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 U.S. medical coding 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 U.S. medical coding 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.

U.S. Medical Coding Market Categorization:

The U.S. medical coding market was categorized into three segments, namely classification system (ICD, HCPCS, CPT), component (In-house, Outsourced), medical specialty (Oncology, Cardiology, Anesthesia, Radiology, Pathology, Pain Management, Emergency Services).

Segment Market Methodology:

The U.S. medical coding market was segmented into classification system, component, medical specialty. 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 U.S. medical coding market was analyzed at a regional level.

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.

U.S. medical coding market companies & financials:

The U.S. medical coding 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:

• STARTEK Health, established in 1987, and headquartered in Colorado, U.S., now has 33,000 employees to back its plans. It is a division of Startek, Inc., which offers customer engagement business process outsourcing services across various domains. STARTEK Health specializes in serving healthcare businesses. The company’s healthcare portfolio comprises customized services for payers & healthcare providers and pharmaceuticals & medical devices. Currently, the company has 21 contact centers located onshore, offshore, and nearshore. It has a presence in the Philippines, Jamaica, Honduras, and Canada.

• Oracle Corporation, a technology giant, established in 1977 in Texas, U.S., develops and markets business software & hardware systems. The company’s product & service offerings include business intelligence software, database, middleware server, and storage systems. It also provides communication solutions, such as Customer Relationship Management (CRM), JD Edwards (JDE), and Enterprise Resource Planning (ERP). The company has a presence in over 145 countries. The company helps in the management of coding, billing, and compliance to run healthcare businesses smoothly. It offers services to home healthcare, hospice, medical visits, physicians, nurse practitioners, physicians' assistants, and skilled nursing facilities

• Maxim Healthcare Services, Inc., founded in 1999, in the United States, functions as a subsidiary of Maxim Healthcare Services, established in 1988. It provides coding & auditing solutions and health information services to healthcare operators. The company delivers auditing & review services, Health Information Management (HIM) outsourcing solutions, online medical coding support, and education & training services. This emerging key player in the market is a privately held company.

• Parexel International Corporation, established in 1983, and headquartered in North Carolina, U.S., develops & commercializes biopharmaceuticals and medical devices. It is well-known for quickly fixing issues &requests. The company offers a range of services for the healthcare industry, including medical communications, consulting, contract research, and technological solutions. It has 86 operational units in about 51 countries. This is a privately held company. In March 2018, it launched its medical writing solutions platform, which delivers integrated, streamlined communication services across the drug development and commercialization continuum.

• Aviacode, Inc. (GeBBS Healthcare Solutions, Inc.), founded in 1999, in the Utah, United States, focuses on serving hospitals and other healthcare institutes with coding requirements. The company’s portfolio entails cloud-based coding applications, which help maintain communications in the national network of medical coders. The company serves more than 8,800 physicians from over 61 medical specialties. This is a privately held company. Medical coding, Professional fee coding, Facility coding, Risk adjustment coding, and Other coding services are the key Product Categories offered by the company.

• Verisk Analytics, Inc., founded in 1971 and headquartered in New Jersey, U.S., delivers analytical solutions to customers from numerous application areas including government, energy, financial services, risk management, insurance, and healthcare. The company also provides decision support solutions and predictive analytics to customers in global risk analytics, natural calamities & weather risk, and natural resources intelligence. It operates in over 22 countries. This is a publicly held company.

• Medical Record Associates, LLC, the company established in 1988 and headquartered in Massachusetts, U.S., offers HIM solutions. With experience of working in the domain for more than three decades to back its technology advancements and strategic initiatives, the company provides services to hospitals & physicians. It offers diverse services, including coding, audit & compliance management, cancer registry, HIM consulting, and denial & appeals management. The company also presents special projects for analysis, scanning, filing, and others.

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

U.S. Medical Coding 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.

U.S. Medical Coding 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.