Back-end Revenue Cycle Management Market by Product and Services (Claim Processing, Denial Management, Payment Integrity), Delivery Mode (On-Premise, Cloud Based), End-User (Payer, Provider), and Region

The back-end revenue cycle management market is projected to grow at a CAGR of 5.0% during the forecast period.

The global back-end revenue cycle management market is projected to reach USD 10.4 billion by 2023 from USD 8.1 billion in 2018, at a CAGR of 5.0%. Growth in the back-end revenue cycle management market can be attributed to factors such as the growing importance of denials management, increasing patient volume, process improvements in healthcare organizations, and declining reimbursement rates. However, the high cost of deployment, integration of back-end revenue cycle management solutions, data breaches and loss of confidentiality, and lack of skilled IT professionals in healthcare are expected to limit market growth to a certain extent in the coming years.

The services segment is expected to hold the largest market share during the forecast period.

On the basis of product & service, the back-end revenue cycle management market has been segmented into software and services. The services segment is estimated to witness the highest CAGR during 2018–2023. High growth in this segment can be attributed to the recurring nature of services such as training and development, installation, software upgrades, consulting, and maintenance.

The cloud-based delivery mode segment is expected to grow at the highest rate during the forecast period.

On the basis of delivery mode, the back-end revenue cycle management market is segmented into on-premise and cloud-based modes. The cloud-based delivery mode segment is estimated to witness the highest CAGR during the forecast period. Cloud-based solutions help healthcare organizations share and integrate information from different locations, and these solutions are less costly to install and maintain than on-premise solutions, which contribute to the high growth and popularity of the cloud-based delivery model.

Investments to modernize the healthcare infrastructure in the Asian region are expected to offer growth opportunities in the region.

Geographically, the back-end revenue cycle management market is segmented into North America, Europe, Asia, and the Rest of the World. The Asian market is expected to grow at the highest rate during the forecast period. Growth in this region can be attributed to investments to modernize healthcare infrastructures and growing adoption of healthcare IT solutions in China, measures to boost the quality of healthcare delivery in Japan, and rapid growth in the healthcare industry in India.

Breakdown of supply-side primary interviews:

By Company Type: Tier 1: 55%, Tier 2: 20%, and Tier 3: 25%
By Designation: C-level: 35%, Director-level: 25%, and Others: 40%
By Region: North America: 20%, Europe: 25%, APAC: 40%, and RoW: 15%

The major players in the market include athenahealth (US), Cerner Corporation (US), Allscripts Healthcare Solutions, Inc. (US), eClinicalWorks (US), Optum, Inc. (US), McKesson Corporation (US), Conifer Health Solutions (US), GeBBs Healthcare Solutions (US), The SSI Group (US), GE Healthcare (US), and nThrive (US).

Research Coverage
This report studies the back-end revenue cycle management market based on product & service, delivery mode, end user, and region. The report also studies factors (such as drivers, restraints, opportunities, and challenges) affecting market growth. It analyzes the opportunities and challenges in the market and provides details of the competitive landscape for market leaders. Furthermore, the report analyzes micromarkets with respect to their individual growth trends and forecasts the revenue of the market segments with respect to four main regions and respective countries.

Key Benefits of Buying the Report
This report focuses on various levels of analysis—industry trends, market share of top players, and company profiles, which together form basic views and analyze the competitive landscape, emerging segments of the back-end revenue cycle management market, and high-growth regions and their drivers, restraints, challenges, and opportunities. The report will help both established firms as well as new entrants/smaller firms to gauge the pulse of the market and garner greater market shares.

1 Introduction

1.1 Objectives of the Study
1.2 Market Definition
1.3 Market Scope
1.3.1 Markets Covered
1.3.2 Years Considered for the Study
1.4 Currency
1.5 Limitations
1.6 Stakeholders

2 Research Methodology

2.1 Research Data
2.1.1 Secondary Data
2.1.1.1 Secondary Sources
2.1.2 Primary Data
2.1.2.1 Key Data From Primary Sources
2.1.2.2 Breakdown of Primaries
2.1.2.3 Key Industry Insights
2.2 Market Size Estimation
2.3 Market Breakdown and Data Triangulation
2.4 Assumptions for the Study

3 Executive Summary

4 Premium Insights

4.1 Back-end Revenue Cycle Management Market Overview
4.2 Geographic Analysis: North American Back-end Revenue Cycle Management Market, By End User
4.3 US Back-end Revenue Cycle Management Market, 2018
4.4 Geographical Snapshot of the Back-end Revenue Cycle Management Market

5 Market Overview

5.1 Introduction
5.2 Market Dynamics
5.2.1 Market Drivers
5.2.1.1 Growing Importance of Denials Management
5.2.1.2 Increasing Patient Volume
5.2.1.3 Process Improvements in Healthcare Organizations
5.2.1.4 Declining Reimbursement Rates
5.2.2 Market Restraints
5.2.2.1 High Cost of Deployment
5.2.3 Market Opportunities
5.2.3.1 Emerging Countries
5.2.3.2 Cloud-Based Solutions
5.2.3.3 Artificial Intelligence in Health Insurance
5.2.3.4 Rising Adoption of Electronic Health Records
5.2.4 Market Challenges
5.2.4.1 Integration of Back-end Revenue Cycle Management Solutions
5.2.4.2 Data Breaches and Loss of Confidentiality
5.2.4.3 Lack of Skilled It Professionals in Healthcare

6 Back-end Revenue Cycle Management Market, By Product & Service

6.1 Introduction
6.2 Services
6.2.1 Recurring Nature of Services to Drive Market Growth
6.3 Software
6.3.1 Integrated Software
6.3.1.1 Integrated Solutions Help Users to Streamline and Coordinate Multiple Financial Functions Through A Single Platform
6.3.2 Standalone Software
6.3.2.1 Claims Processing Software
6.3.2.1.1 Claims Processing Software to Account for the Largest Share of the Standalone Software Market in 2018
6.3.2.2 Denial Management Software
6.3.2.2.1 Denial Management Software Segment to Witness the Highest Growth Rate During the Forecast Period
6.3.2.3 Coding & Auditing Software
6.3.2.3.1 Mandate to Convert From Icd-9 Classifications to the New Icd-10 Version has Resulted in the Increased Demand for Coding & Auditing Software
6.3.2.4 Billing/Billing Review Software
6.3.2.4.1 Rising Number of Billing Errors to Drive the Adoption of Billing/Billing Review Software
6.3.2.5 Payment Integrity Software
6.3.2.5.1 Payment Integrity Software Provides Advanced Analytics for Assessing Payment Compliance at A Granular Level

7 Back-end Revenue Cycle Management Market, By Delivery Mode

7.1 Introduction
7.2 On-Premise Delivery Mode
7.2.1 Benefits Offered By On-Premise Delivery Models and Limited Penetration of Cloud-Based Technologies to Drive Market Growth
7.3 Cloud-Based Delivery Mode
7.3.1 Open-Access Nature of Cloud-Based Models Poses Security Challenges

8 Back-end Revenue Cycle Management Market, By End User

8.1 Introduction
8.2 Healthcare Payers
8.2.1 Need to Ensure Regulatory Compliance is Aiding the Growth of the Payers Market
8.3 Healthcare Providers
8.3.1 Inpatient Facilities
8.3.1.1 Growing Need to Improve the Profitability of Healthcare Operations to Drive the Adoption of Back-End Rcm Solutions in Inpatient Facilities
8.3.2 Outpatient Facilities & Physician Clinics
8.3.2.1 Need to Improve Operational Workflows and Minimize Medical Errors to Drive Market Growth

9 Back-end Revenue Cycle Management Market, By Region

9.1 Introduction
9.2 North America
9.2.1 US
9.2.1.1 Government Regulations to Support Market Growth in the US
9.2.2 Canada
9.2.2.1 Increasing Digitization and Favorable Funding Initiatives By the Canadian Government are Boosting Market Growth in Canada
9.3 Europe
9.4 Asia
9.5 Rest of the World

10 Competitive Landscape

10.1 Overview
10.2 Competitive Scenario
10.2.1 Product Launches and Enhancements
10.2.2 Agreements, Partnerships, and Collaborations
10.2.3 Acquisitions
10.2.4 Expansions

11 Company Profile

11.1 Athenahealth
11.2 Cerner
11.3 Allscripts Healthcare Solutions
11.4 Eclinicalworks
11.5 Optum, Inc. (A Subsidiary of Unitedhealth Group Inc.)
11.6 Mckesson (Now A Part of Change Healthcare, Inc.)
11.7 Conifer Health Solutions
11.8 Gebbs Healthcare Solutions
11.9 The SSI Group
11.10 GE Healthcare
11.11 Nthrive
11.12 DST Systems
11.13 Cognizant Technology Solutions
11.14 Quest Diagnostics
11.15 Context 4 Healthcare
11.16 Ram Technologies
11.17 Health Solutions Plus (HSP)
11.18 Plexis Healthcare Systems

12 Appendix

12.1 Discussion Guide
12.2 Knowledge Store: Subscription Portal
12.3 Available Customizations
12.4 Related Reports
12.5 Author Details

List of Tables

Table 1 Back-end Revenue Cycle Management Market, By Product & Service, 2016–2023 (USD Million)
Table 2 Back-end Revenue Cycle Management Services Market, By Region, 2016–2023 (USD Million)
Table 3 North America: Back-end Revenue Cycle Management Services Market, By Country, 2016–2023 (USD Million)
Table 4 Back-end Revenue Cycle Management Software Market, By Region, 2016–2023 (USD Million)
Table 5 North America: Back-end Revenue Cycle Management Software Market, By Country, 2016–2023 (USD Million)
Table 6 Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 7 Back-end Revenue Cycle Management Integrated Software Market, By Region, 2016–2023 (USD Million)
Table 8 North America: Back-end Revenue Cycle Management Integrated Software Market, By Country, 2016–2023 (USD Million)
Table 9 Back-end Revenue Cycle Management Standalone Software Market, By Region, 2016–2023 (USD Million)
Table 10 North America: Back-end Revenue Cycle Management Standalone Software Market, By Country, 2016–2023 (USD Million)
Table 11 Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 12 Claims Processing Software Market, By Region, 2016–2023 (USD Million)
Table 13 North America: Claims Processing Software Market, By Country, 2016–2023 (USD Million)
Table 14 Denial Management Software Market, By Region, 2016–2023 (USD Million)
Table 15 North America: Denial Management Software Market, By Country, 2016–2023 (USD Million)
Table 16 Coding & Auditing Software Market, By Region, 2016–2023 (USD Million)
Table 17 North America: Coding & Auditing Software Market, By Country, 2016–2023 (USD Million)
Table 18 Billing/Billing Review Software Market, By Region, 2016–2023 (USD Million)
Table 19 North America: Billing/Billing Review Software Market, By Country, 2016–2023 (USD Million)
Table 20 Payment Integrity Software Market, By Region, 2016–2023 (USD Million)
Table 21 North America: Payment Integrity Software Market, By Country, 2016–2023 (USD Million)
Table 22 Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 23 On-Premise Back-end Revenue Cycle Management Market, By Region, 2016–2023 (USD Million)
Table 24 North America: On-Premise Back-end Revenue Cycle Management Market, By Country, 2016–2023 (USD Million)
Table 25 Cloud-Based Back-end Revenue Cycle Management Market, By Region, 2016–2023 (USD Million)
Table 26 North America: Cloud-Based Back-end Revenue Cycle Management Market, By Country, 2016–2023 (USD Million)
Table 27 Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 28 Back-end Revenue Cycle Management Market for Healthcare Payers, By Region, 2016–2023 (USD Million)
Table 29 North America: Back-end Revenue Cycle Management Market for Healthcare Payers, By Country, 2016–2023 (USD Million)
Table 30 Back-end Revenue Cycle Management Market for Healthcare Providers, By Region, 2016–2023 (USD Million)
Table 31 North America: Back-end Revenue Cycle Management Market for Healthcare Providers, By Country, 2016–2023 (USD Million)
Table 32 Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 33 Back-end Revenue Cycle Management Market for Inpatient Facilities, By Region, 2016–2023 (USD Million)
Table 34 North America: Back-end Revenue Cycle Management Market for Inpatient Facilities, By Country, 2016–2023 (USD Million)
Table 35 Back-end Revenue Cycle Management Market for Outpatient Facilities & Physician Clinics, By Region, 2016–2023 (USD Million)
Table 36 North America: Back-end Revenue Cycle Management Market for Outpatient Facilities & Physician Clinics, By Country, 2016–2023 (USD Million) 64
Table 37 Back-end Revenue Cycle Management Market, By Region, 2016–2023 (USD Million)
Table 38 North America: Back-end Revenue Cycle Management Market, By Country, 2016–2023 (USD Million)
Table 39 North America: Back-end Revenue Cycle Management Market, By Product & Service, 2016–2023 (USD Million)
Table 40 North America: Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 41 North America: Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 42 North America: Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 43 North America: Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 44 North America: Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 45 US: Back-end Revenue Cycle Management Market, By Product & Service, 2016–2023 (USD Million)
Table 46 Us: Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 47 US: Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 48 US: Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 49 US: Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 50 US: Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 51 Canada: Back-end Revenue Cycle Management Market, By Product & Service, 2016–2023 (USD Million)
Table 52 Canada: Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 53 Canada: Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 54 Canada: Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 55 Canada: Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 56 Canada: Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 57 Europe: Back-end Revenue Cycle Management Market, By Product & Service, 2016–2023 (USD Million)
Table 58 Europe: Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 59 Europe: Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 60 Europe: Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 61 Europe: Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 62 Europe: Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 63 Asia: Back-end Revenue Cycle Management Market, By Product & Service, 2016–2023 (USD Million)
Table 64 Asia: Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 65 Asia: Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 66 Asia: Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 67 Asia: Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 68 Asia: Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 69 RoW: Back-end Revenue Cycle Management Market, By Component, 2016–2023 (USD Million)
Table 70 RoW: Back-end Revenue Cycle Management Software Market, By Type, 2016–2023 (USD Million)
Table 71 RoW: Back-end Revenue Cycle Management Standalone Software Market, By Type, 2016–2023 (USD Million)
Table 72 RoW: Back-end Revenue Cycle Management Market, By Delivery Mode, 2016–2023 (USD Million)
Table 73 RoW: Back-end Revenue Cycle Management Market, By End User, 2016–2023 (USD Million)
Table 74 RoW: Back-end Revenue Cycle Management Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 75 Growth Strategy Matrix (2014–2018)
Table 76 Product Launches and Enhancements (2014–2018)
Table 77 Agreements, Partnerships, and Collaborations (2014–2018)
Table 78 Acquisitions, 2014–2018
Table 79 Expansions (2014–2018)

List of Figures

Figure 1 Research Methodology: Back-end Revenue Cycle Management Market
Figure 2 Research Design
Figure 3 Sampling Frame: Primary Research
Figure 4 Market Size Estimation Methodology: Bottom-Up Approach (1/3)
Figure 5 Market Size Estimation Methodology: Bottom-Up Approach (2/3)
Figure 6 Market Size Estimation Methodology: Bottom-Up Approach (3/3)
Figure 7 Market Size Estimation Methodology: Top-Down Approach
Figure 8 Data Triangulation Methodology
Figure 9 Services to Dominate the Back-end Revenue Cycle Management Market, By Product & Service, in 2018
Figure 10 On-Premise Solutions to Account for the Larger Market Share in 2018
Figure 11 North America to Hold the Largest Share in the Back-end Revenue Cycle Management Market During 2018–2023
Figure 12 Growing Importance of Denials Management to Drive Market Growth During the Forecast Period
Figure 13 Healthcare Payers to Account for the Largest Share of the North American Back-end Revenue Cycle Management Market in 2018
Figure 14 Inpatient Settings & On-Premise Delivery Mode to Account for the Largest Market Share in 2018
Figure 15 Asia to Witness the Highest Growth Rate During the Forecast Period
Figure 16 Back-end Revenue Cycle Management Market: Drivers, Restraints, Opportunities, and Challenges
Figure 17 Back-end Revenue Cycle Management Market, By Region, 2018 Vs. 2023 (USD Million)
Figure 18 North America: Back-end Revenue Cycle Management Market Snapshot
Figure 19 Europe: Back-end Revenue Cycle Management Market Snapshot
Figure 20 Asia: Back-end Revenue Cycle Management Market Snapshot
Figure 21 RoW: Back-end Revenue Cycle Management Market Snapshot
Figure 22 Key Developments in the Back-end Revenue Cycle Management Market Between 2014 and 2018
Figure 23 Company Snapshot: Athenahealth (2017)
Figure 24 Company Snapshot: Cerner (2017)
Figure 25 Company Snapshot: Allscripts Healthcare Solutions (2017)
Figure 26 Company Snapshot: Optum, Inc. (2017)
Figure 27 Company Snapshot: Mckesson Corporation (2017)
Figure 28 Company Snapshot: GE Healthcare (2017)
Figure 29 Company Snapshot: DST Systems (2017)
Figure 30 Company Snapshot: Cognizant Technology Solutions (2017)
Figure 31 Company Snapshot: Quest Diagnostics Incorporated (2017)

Samples

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Companies Mentioned

Allscripts Healthcare Solutions
Athenahealth
Cerner
Cognizant Technology Solutions
Conifer Health Solutions
Context 4 Healthcare
DST Systems
Eclinicalworks
GE Healthcare
Gebbs Healthcare Solutions
Health Solutions Plus (HSP)
Mckesson (Now A Part of Change Healthcare, Inc.)
Nthrive
Optum, Inc. (A Subsidiary of Unitedhealth Group Inc.)
Plexis Healthcare Systems
Quest Diagnostics
Ram Technologies
The SSI Group

Table Information

Report Attribute	Details
No. of Pages	137
Published	January 2019
Forecast Period	2018 - 2023
Estimated Market Value ( USD ) in 2018	$ 8.1 billion
Forecasted Market Value ( USD ) by 2023	$ 10.4 billion
Compound Annual Growth Rate	5.1%
Regions Covered	Global
No. of Companies Mentioned	18

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Back-end Revenue Cycle Management Market by Product and Services (Claim Processing, Denial Management, Payment Integrity), Delivery Mode (On-Premise, Cloud Based), End-User (Payer, Provider), and Region - Global Forecast to 2023

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Samples

Companies Mentioned

Table Information

Table of Contents

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Companies Mentioned

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