The global medical billing outsourcing market size is projected to reach USD 25.9 billion by 2028, based on a new report by Grand View Research, Inc. The market is expected to expand at a CAGR of 12.66% from 2021 to 2028. A large amount of clinical code representation for diagnosis and treatment coupled with the presence of multiple payers renders medical billing an intricate part of any clinical practice, posing significant challenges. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to obligatory implementation of complex ICD-11 coding systems, increasing healthcare costs, and a federal mandate to implement Electronic Medical Records (EMR) to maintain reimbursement levels.
The COVID-19 pandemic has negatively affected the market. Though, the healthcare industry was trailing in embracing innovative and digital technologies to improve healthcare. The COVID-19 scenario has put an enormous burden on healthcare providers/organizations to become accustomed to the change. The recovery from the financial impact of the coronavirus pandemic could take a long time. Thus, players operating in the market need to create new policies/strategies powered by telemedicine solutions and patient-centric collections to rise above the challenges of COVID-19.
Furthermore, clinics/physician offices are gradually outsourcing their revenue management to cut unnecessary costs and prevent the burden of managing an administrative team to ensure effective handling of in-house billing functions. In addition, multispecialty healthcare groups are implementing consolidation requiring EHR integration and building large healthcare networks. This integration creates a need for revenue cycle management (RCM), which, in turn, demands additional expertise and trained personnel to manage the same. Thus, the consolidation of large healthcare practices is also expected to be one of the factors fueling the market growth.
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The outsourced segment accounted for the largest revenue share in 2020 and is expected to witness a high CAGR attributed to the rising preference of hospitals, physician office, and startups opting for outsourced medical billing services for hassle-free claim management at low cost
The front-end services segment led the market in 2020. However, the middle-end services segment is expected to register the highest CAGR over the forecast period due to the growing demand for Revenue Cycle Management (RCM) services offering Electronic Health Records (EHR) software
Hospitals, possessing higher claim volumes, accounted for the largest revenue share in the market in 2020 and is estimated to maintain the dominance even during the forecast years
North America held the largest revenue share in 2020. It is projected to expand further as U.S. has witnessed a change in the healthcare system with the introduction of ICD-11 coding in 2019 and pressure from the government to incorporate the Electronic Medical Record (EMR) management system
Medical billing and Revenue Cycle Management (RCM) companies such as Athenahealth, are offering successful implementation of EMR at the practice level and are expected to transform the market
Grand View Research has segmented the global medical billing outsourcing market on the basis of component, service, end-use, and region:
Medical Billing Outsourcing Component Outlook (Revenue, USD Million, 2016 - 2028)
Medical Billing Outsourcing Service Outlook (Revenue, USD Million, 2016 - 2028)
Medical Billing Outsourcing End-use Outlook (Revenue, USD Million, 2016 - 2028)
Medical Billing Outsourcing Regional Outlook (Revenue, USD Million, 2016 - 2028)
Middle East & Africa (MEA)
List of Key Players of Medical Billing Outsourcing Market
R1 RCM, Inc.
Allscripts Healthcare Solutions, Inc.
Experian Information Solutions, Inc.
HCL Technologies Limited
The SSI Group, LLC.
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