The U.S. revenue cycle management market size was estimated at USD 10.98 billion in 2017. It is anticipated to register a CAGR of 11.2% over the forecast period. Emphasis on increasing the adoption of Electronic Health Records (EHRs) by healthcare delivery networks is projected to drive the rcm market. Moreover, focus on providing value-based care and reducing healthcare expenditure technological advancements, and outsourcing of health information technology services are the prime factors propelling the overall growth.
Stage three of Medicare and Medicaid EHR Incentive Programs focus on improving the use of Certified EHR Technology (CEHRT) to improve health outcomes. This is likely to support growth in demand for revenue cycle management (RCM) systems that can be integrated with EHR systems, to streamline workflow, and to curb the rising healthcare costs.
Besides, government reforms also play a crucial role in boosting the adoption of RCM systems. For instance, the Affordable Care Act (ACA) in the U.S. is focused on expanding health insurance coverage to individuals with low income, improving the quality, and reducing the cost of healthcare. Expanding insurance coverage is expected to increase the number of reimbursements, as well as denials that are required to be managed. Therefore, the demand for efficient systems for the management of reimbursement processes is expected to rise.
Also, the Health Information Technology for Economic and Clinical Health (HITECH) Act promotes the adoption of certified EHR systems. Implementation of Stage 3 of the Medicaid and Medicare EHR Incentive Programs in 2015, which promoted the adoption of Healthcare IT (HIT) systems to improve healthcare quality, is also contributing to the market growth. This is likely to the support growth of RCM systems that can be integrated with EHR systems, streamline workflow, and curb the rising healthcare costs.
Several healthcare providers across the U.S. are undertaking initiatives to facilitate health data exchange and to improve the efficiency of the existing healthcare systems. For instance, the initiative taken by healthcare providers to use paperless healthcare systems and to incorporate HIT systems by 2020 is likely to boost the growth of during the forecast period.
The services segment accounted for the largest share of the U.S. market owing to the increasing trend of outsourcing these services. As healthcare facilities lack resources and skillsets required for the deployment of revenue cycle management solutions, these services are outsourced. Either the complete process is outsourced, or a part of it in the form of long-term contracts.
The number of companies providing outsourcing services to healthcare facilities is anticipated to rise over the forecast period. For instance, Acelerar Tech provides a wide range of solutions for outsourced RCM systems, such as clinical documentation, managing denials, medical coding, patient health information entry, charge capture, patient accounts management, and preadmission and post-registration processes.
The integrated segment led the U.S. RCM market in 2017 contributing around 70% of the market share. It is also anticipated to remain dominant over the forecast period, owing to various changes, such as a preference for volume-based payments instead of value-based payments. Also, integrated solutions offer a streamlined and coordinated format of a variety of financial activities through a single platform, which results in the uniform process of data collection and analysis
The standalone segment is anticipated to grow gradually over the forecast period. These services are sold as a solitary product and have to be installed and used individually in the healthcare system. For instance, stock keeping tools are available as sole products. Hence, it is less preferred as compared to an integrated product.
The web-based segment held a maximum market share in 2017. Unlike on-premises software, web-based software is installed off-site and is supervised by a third party. It is used over the internet and with a web browser and does not require additional hardware or storage. Hence, the data can be accessed by various healthcare providers from different geographic locations.
The cloud-based segment is anticipated to showcase significant growth during the forecast period owing to the flexibility and scalability offered by these solutions. Also, the data can be accessed by various stakeholders at a given particular time.
The physicians’ office led the end-use with a maximum market share of around 42% in 2017. The segment is projected to remain dominant throughout the forecast period. According to a paper published in the Association for Service Management International journal, physician offices and their staff such as consultants, nurses, and office managers deploy practice management systems more to enable smooth functioning of their units.
Other healthcare settings are expected to witness the fastest growth, because hospitals, healthcare centers, and clinical workstations are investing heavily in digitalization and centralization of their workflow. Revenue cycle management systems are a combination of revenue cycle management, patient portals, and clinical intelligence systems that help in supporting this centralization.
The market is highly competitive. Key participants include SSI Group; Allscripts, Cerner Corporation; Mckesson Corporation; athenahealth, Inc.; Epic Systems Corporation; eclinicalworks; NextGen Healthcare Information System; Carecloud Corporation; Quest Diagnostics, Inc.; and Kareo, Inc. In an attempt to retain share, diversify product portfolio, market players are frequently undertaking mergers and acquisitions.
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Attribute |
Details |
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The base year for estimation |
2017 |
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Actual estimates/Historical data |
2014 - 2016 |
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Forecast period |
2018 - 2025 |
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Market representation |
Revenue in USD Million and CAGR from 2018 to 2025 |
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Report coverage |
Revenue forecast, competitive landscape, growth factors and trends |
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Country Scope |
The U.S. |
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15% free customization scope (equivalent to 5 analyst working days) |
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This report forecasts revenue growth at country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2014 to 2025. For this study, Grand View Research has segmented the U.S. revenue cycle management market report based on the product, type, delivery mode, and end use:
Product Outlook (Revenue, USD Million, 2014 - 2025)
Software
Services
Type Outlook (Revenue, USD Million, 2014 - 2025)
Integrated
Standalone
Delivery Mode Outlook (Revenue, USD Million, 2014 - 2025)
On-Premise
Web-based
Cloud-based
End-use Outlook (Revenue, USD Billion, 2014 - 2025)
Physician Back Office
Hospitals
Diagnostic Laboratories
Other Settings
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