Healthcare RCM Outsourcing in the US Industry 2019
Healthcare Revenue Cycle Management (RCM) outsourcing market in the US will grow at a Common Annual Growth Rate (CAGR) of 11% to reach 21.9 Billion USD by 2024. The market is split within many small vendors to occupy the market share. The maximum growth (45%) will come from back end services market. Some of the key drivers for market growth are improvement in healthcare administrative processes, claims management processes, and smooth billing operations. In 2018, the market value of Healthcare RCM outsourcing market in the US reached USD 11.7 Billion.
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• Change Healthcare
• Conifer Health Solutions
• MEDNAX Services
RCM is a financial procedure that takes care of claims processing, payment and revenue generation. Healthcare institutions, medical billing companies mostly use this to follow up on claims management. Key benefits of this process are to have a better understanding and control of revenue cycles by doctors, reduction in office software, equipment and infrastructure costs, and ease in maintaining medical billing. Due to stringent rules put forward by governments on healthcare, administrative overhead cost has been increased.
Hence, to manage the healthcare administrative expenses, bring operational efficiency and optimization, and control financial challenges (to speed up billing), US Healthcare organizations have outsourced this job to other RCM companies. Other factors – rapid urbanization, industrialization, and increase in types of diseases have helped this market to flourish. Also, these outsourced companies have helped US healthcare organizations to do away with the expenses required for staff hiring for billing, claims management, denial management, value-based reimbursements, etc.
The healthcare RCM Outsourcing Market in the US is segmented based on type, services and application. Based on type, the market is split into preintervention, intervention and post-intervention. Based on services, the market is segmented into front end services, back-end services, and middle services. Among these, back-end services contribute to the largest market share. Basis application, hospital is the leading segment contributing to highest market share. Front-end services include preintervention services like patient registration, eligibility verification, insurance cover etc. The medical billing companies in the US are growing because of high accuracy of patient health record leading to quick final settlements and claims management.
The healthcare RCM Outsourcing Market in the US is divided into North America (United States, Canada, Mexico), Europe (Germany, France, UK, Italy, Russia, Spain, Nordic countries, Benelux, Poland ), Asia Pacific (China, Japan, India, ASEAN, Australia, and New Zealand), South America (Brazil, Peru, Chile, Others), the Middle-East and Africa (GCC, Saudi Arabia, Turkey, South Africa and North Africa). North America will lead the market due to the prolific growth of Hospital Information Systems, Electronic Health record management and other technological advancements of recording availability of medicines. Increase in Cloud computing is also another factor for healthcare RCM outsourcing companies to grow.
Continuous consolidation in healthcare RCM outsourcing market in US is recognized as one of the critical trends to spur growth. Mergers and Acquisitions are considered basis other important criteria, for example, productivity, improved margin, organic growth, scale and increase in various product offering. The key challenge as recognized by the market is fierce competition among players, availability of skilled resources or IT professionals, pricy maintenance of RCM solutions.
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Table of Contents – Major Key Points
PART 01: EXECUTIVE SUMMARY
PART 02: SCOPE OF THE REPORT
PART 03: RESEARCH METHODOLOGY
PART 04: MARKET LANDSCAPE
PART 05: MARKET SIZING
PART 06: FIVE FORCES ANALYSIS
PART 07: MARKET SEGMENTATION BY TYPE OF SERVICE
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