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Medical Billing Outsourcing Market - Growth, Trends, and Forecast (2020 - 2025)

  • ID: 5176185
  • Report
  • August 2020
  • Region: Global
  • 114 pages
  • Mordor Intelligence
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until Dec 31st 2020
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FEATURED COMPANIES

  • Accretive Health
  • Cerner Corporation
  • EClinicalWorks
  • GE Healthcare
  • Genpact
  • HCL Technologies
  • MORE
The medical billing outsourcing market is majorly driven by factors, such as growing emphasis on compliance and risk management, increasing need to make the medical billing process efficient, and efforts to decrease in-house processing costs.

Unless an office or a medical practitioner is using the services of an experienced billing provider, who has been trained to look for holes in paperwork, there is a good chance that their revenue is not as high as it could be. In fact, statistics estimate that over 20% of a physician's revenue ends up lost, due to loopholes and mistakes in the medical billing process. This has created an increasing need to make the process of billing more efficient, and skilled professionals are required for the process.

Efficient billing can further reduce the cost to the company and can get maximum benefits. Rising patient flow in the hospitals and increasing the burden of medical processes, such as records of patient check-in, and insurance eligibility, are creating chaos in the point of care, and a need to manage such records has been raised. For the sake of improvisation of the medical billing process, the medical billing outsourcing is done to help in assisting the clinicians in the management of patient and billings records. Hence, the rising need for efficient medical billing is influencing the market in a positive manner.

Key Market Trends

Front End Outsourced Medical Billing is Expected to Grow Rapidly over the Forecast Period

The front-end outsourced medical billing services mostly include end-to-end patient access, digital order management, central scheduling, pre-registration, patient registration quality assurance, demographic and insurance verification, pre-certification, and authorization, medical necessity checking, financial counseling with propensity-to-pay, and patient liability estimation.

The previously practiced revenue cycle management practices mostly focused on back-end medical billing services and collection processes. However, in the present era, more focus is on patient-centric healthcare, and healthcare providers are also shifting their focus to the front end of medical billing and revenue cycle management in order to succeed.

The medical billing process has now become more complex than before, with a large number of mergers, partnerships, and new acquisitions in the healthcare space, which has created chaos for health provider’s staff, as patient information is generally inaccurate, information is not easily shared with all stakeholders, and sometimes orders go unfulfilled. The digital order management helps solve this problem by helping health providers automate disparate clinical and financial information entry and aggregating into a single, easily accessible medical claims management system. Hence, the concerned segment of the market is expected to observe steady growth over the forecast period.

North America is Expected to Dominate the Market in the Coming Future

The emergence of novel technologies, along with their adoption, is helping the United States to expand in the healthcare sector. Rising healthcare expenditure is the prime factor responsible for the growth of this sector.

The medical billing outsourcing market in the region is believed to expand, due to the rising need for efficient medical billing and increasing patient flow in the hospitals. Being a developed nation, the healthcare system of the United States is well established and adoption to the paperless work is much higher. To reduce the burden of management of the huge patient flow in the hospitals, medical billing outsourcing is widely done in the country.

As per capita income is high in the country, the cost barrier is never a point of concern in the United States, which is the positive factor for the market studied. The medical billing outsourcing efficiently manages the insurances, including Medicare and Medicaid. Therefore, it is easy for healthcare providers to manage the whole billing processes across the hospitals. Hence, the US medical billing outsourcing market is expected to expand during the forecast period.

Competitive Landscape

The medical billing outsourcing market is highly competitive, and many small to mid-sized companies are competing among each other, along with the global players. Due to the advancements and digitalization of the healthcare industry, the demand for medical billing outsourcing services is increasing, which is providing a great opportunity to the companies to establish their market presence and grab substantial share.

Reasons to Purchase this report:
  • The market estimate (ME) sheet in Excel format
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Note: Product cover images may vary from those shown
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FEATURED COMPANIES

  • Accretive Health
  • Cerner Corporation
  • EClinicalWorks
  • GE Healthcare
  • Genpact
  • HCL Technologies
  • MORE
1 INTRODUCTION
1.1 Study Deliverables
1.2 Study Assumptions
1.3 Scope of the Study

2 RESEARCH METHODOLOGY

3 EXECUTIVE SUMMARY

4 MARKET DYNAMICS
4.1 Market Overview
4.2 Market Drivers
4.2.1 Growing Emphasis on Compliance and Risk Management
4.2.2 Increasing Need to Make Billing Processes Efficient
4.2.3 Efforts to Contain and Decrease In-house Processing Costs
4.3 Market Restraints
4.3.1 Increasing Legislative and Regulatory Pressure
4.3.2 High Costs of Technology
4.4 Porter's Five Forces Analysis
4.4.1 Threat of New Entrants
4.4.2 Bargaining Power of Buyers/Consumers
4.4.3 Bargaining Power of Suppliers
4.4.4 Threat of Substitute Products
4.4.5 Intensity of Competitive Rivalry

5 MARKET SEGMENTATION
5.1 By Service
5.1.1 Front End
5.1.2 Back End
5.2 By End User
5.2.1 Hospitals
5.2.2 Physicians Office
5.2.3 Other End Users
5.3 Geography
5.3.1 North America
5.3.1.1 United States
5.3.1.2 Canada
5.3.1.3 Mexico
5.3.2 Europe
5.3.2.1 Germany
5.3.2.2 United Kingdom
5.3.2.3 France
5.3.2.4 Italy
5.3.2.5 Spain
5.3.2.6 Rest of Europe
5.3.3 Asia-Pacific
5.3.3.1 China
5.3.3.2 Japan
5.3.3.3 India
5.3.3.4 Australia
5.3.3.5 South Korea
5.3.3.6 Rest of Asia-Pacific
5.3.4 Middle East & Africa
5.3.4.1 GCC
5.3.4.2 South Africa
5.3.4.3 Rest of Middle East & Africa
5.3.5 South America
5.3.5.1 Brazil
5.3.5.2 Argentina
5.3.5.3 Rest of South America

6 COMPETITIVE LANDSCAPE
6.1 Company Profiles
6.1.1 Accretive Health
6.1.2 Allscripts Healthcare Solutions, Inc.
6.1.3 Cerner Corporation
6.1.4 EClinicalWorks
6.1.5 Experian Information Solutions Inc.
6.1.6 GE Healthcare
6.1.7 Genpact
6.1.8 HCL Technologies
6.1.9 Kareo
6.1.10 McKesson Corporation
6.1.11 Quest Diagnostics
6.1.12 The SSI Groups

7 MARKET OPPORTUNITIES AND FUTURE TRENDS
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  • Accretive Health
  • Allscripts Healthcare Solutions, Inc.
  • Cerner Corporation
  • EClinicalWorks
  • Experian Information Solutions Inc.
  • GE Healthcare
  • Genpact
  • HCL Technologies
  • Kareo
  • McKesson Corporation
  • Quest Diagnostics
  • The SSI Groups
Note: Product cover images may vary from those shown
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