The global medical billing outsourcing market size is expected to reach USD 30.2 billion by 2030, expanding at a CAGR of 12.26% from 2023 to 2030, according to a new report by Grand View Research, Inc. The market is driven primarily by factors such as the increasing importance of regulatory compliance and risk management, the growing need to streamline the medical billing process, and efforts to reduce internal processing costs.
A large amount of clinical code representation for treatment and diagnosis along with the presence of various payers renders medical billing an integral part of any clinical practice. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to the mandatory implementation of complex ICD-11 coding systems, rising healthcare costs, and the federal mandate to deploy EMR to maintain reimbursement levels.
The COVID-19 pandemic had a significant impact on the market, although the healthcare industry was trailing in embracing innovative and digital technologies to improve healthcare. The COVID-19 scenario had put an enormous burden on healthcare providers/organizations to become accustomed to the change. The need for proactive action and the construction of collaborative, comprehensive, adaptable, and scalable digital healthcare infrastructure has been emphasized by the pandemic crisis. Owing to this, many organizations have developed a new strategy that includes digitization and outsourcing non-core functions such as billing and accounting, which has further increased the market growth.
Furthermore, physician offices and clinics are increasingly outsourcing their revenue management to reduce unnecessary costs and avoid the burden of having an administrative team to ensure effective handling of in-house billing functions. In addition, multispecialty healthcare groups are consolidating, requiring EHR integration and resulting in a buildup of large healthcare networks. This integration is expected to create a need for RCM, which will require trained personnel and additional expertise to manage the same. Thus, the consolidation of large healthcare practices is also expected to be one of the factors fueling market growth.
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Based on the components, the outsourced segment accounted for the maximum market share in 2022 owing to the increasing preference among physicians’ offices, hospitals, and startups for outsourced medical billing services for hassle-free claim management at a low cost
The front-end services segment dominated the market in 2022. However, the middle-end services segment is expected to register the highest CAGR during the forecast period due to the growing demand for RCM services offering EHR software
North America dominated the market in 2022. The market is expected to grow due to changing healthcare system and introduction of ICD-11 in the U.S. and pressure from the government to incorporate the EMR
In February 2023, Ventra Health, a global provider of practice management, RCM, and advisory services announced the acquisition of Deras Global Services, a company based in the Philippines. The acquisition is an important aspect of Ventra Health's strategy for service delivery and workforce development on the international level
Grand View Research has segmented the global medical billing outsourcing market based on component, service, end-use, and region:
Medical Billing Outsourcing Component Outlook (Revenue, USD Million, 2018 - 2030)
Medical Billing Outsourcing Service Outlook (Revenue, USD Million, 2018 - 2030)
Medical Billing Outsourcing End-use Outlook (Revenue, USD Million, 2018 - 2030)
Medical Billing OutsourcingRegional Outlook (Revenue, USD Billion, 2018 - 2030)
List of Key Players in the Medical Billing Outsourcing Market
Quest Diagnostics Incorporated
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