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U.S. Revenue Cycle Management Market Size, Share & Trends Analysis Report by End User, by Product Type, by Component, by Delivery Mode, by Physician Specialty, by Sourcing, by Function, and Segment Forecasts, 2022-2030

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    Report

  • 102 Pages
  • April 2022
  • Region: United States
  • Grand View Research
  • ID: 5415544
The U.S. revenue cycle management market size is expected to reach USD 308.2 billion by 2030. It is expected to expand at a CAGR of 10.3% from 2022 to 2030. Growing data siloes emerging from multiple healthcare functionalities and departments are driving the need to consolidate and streamline unorganized workflows to boost efficiency and productivity in healthcare organizations. Furthermore, the growing trend of digital health and widespread adoption of healthcare IT solutions are anticipated to accelerate market growth. The market growth in the U.S. can also be attributed to the increasing healthcare IT spending and the growing trend of outsourcing RCM systems and services.



Healthcare systems in the U.S. are undergoing significant transformations and readily adopting electronic processes for claims and reimbursement management. The presence of numerous renowned healthcare facilities, increasing healthcare awareness and spending, and the growing digital literacy are expected to support the growth of the market. Favorable regulatory reforms from government agencies and regular technological advancements by market players are expected to boost market growth over the forthcoming years. The growing need for regular technological advancements is driving market players to revise their product development strategies to improve provider-patient relationship in healthcare facilities. Key participants are focusing on collaborations and strategic partnerships with other market players to combine expertise and grow their business footprint.

For instance, in January 2020, R1 RCM, Inc. entered into a strategic partnership with Rush University System for Health (RUSH) to achieve revenue cycle performance excellence and boost innovation in healthcare. As per the agreement, the platform by R1 RCM would be integrated with RUSH’s Epic EMR workflow, which uses enterprise-wide performance analytics and intelligent automation to improve the company’s current revenue cycle operations. In addition, the collaboration would aid R1 RCM to launch its innovation lab, which focuses on value-based care and incorporates advanced analytics to educate other healthcare institutions in preparing for the future healthcare workforce. This partnership is expected to enable significant improvements in serving patients and financial results in the Chicago metropolitan area.

Market players are introducing innovative product solutions to expand their product portfolio and grow their clientele. For instance, in June 2019, Homecare Homebase (HCHB) introduced a new RCM tool that would reduce the burden related to staffing and time-consuming administrative functions, which often restrict the home health agencies from spending more quality time with patients. Moreover, this new tool offers greater transparency into the murky RCM process that is suitable for agency management, by making use of HCHB dashboards and analytical systems. This new tool makes use of extensive knowledge of the billing process, which aids in achieving and maintaining high collection days and reducing outstanding days in accounts receivable (AR), enabling more time with patients.

U.S. Revenue Cycle Management Market Report Highlights

  • The services component segment dominated the market in 2021 owing to the outsourcing of RCM services from third-party vendors with adequate skill set and workforce.
  • by product type, integrated system spearheaded the market in 2021 owing to the growing demand from healthcare organizations for a synchronized single platform to manage financial activities.
  • The web-based delivery mode segment dominated the market in 2021 owing to the cost-effectiveness and rapid deployment associated with these solutions.
  • The hospitals end-user segment led the market in 2021 owing to the presence of well-established hospitals and growing healthcare IT infrastructure.
  • The others physician specialty segment dominated the market in 2021 owing to the increase in insurance coverage policies for other healthcare services.
  • The in-house sourcing segment held the largest revenue share in 2021 owing to the advantages offered such as patient information confidentiality and entire control of coding operations.
  • Based on function, the claims management segment led the market in 2021 owing to the increasing patient volume and the presence of ineffective claim management systems.


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Table of Contents

Chapter 1 Methodology and Scope
1.1 Market Segmentation and Scope
1.2 Research Methodology
1.2.1 Information procurement
1.3 Information or Data Analysis
1.4 Market Formulation & Validation
1.5 List of Secondary Sources
1.6 List of Primary Sources
Chapter 2 Executive Summary
2.1 Industry Insights
2.2 Segment Insight
2.3 Competitive Insight
2.4 Market Snapshot
Chapter 3 The U.S. Revenue Cycle Management (RCM) Market Variables, Trends & Scope
3.1 Penetration & Growth Prospect Mapping
3.2 Regulatory Framework
3.2.1 Reimbursement framework
3.2.1.1 Regulatory Modifications Influencing Radiology Reimbursement
3.2.1.2 Regulatory Modifications Influencing Cardiology Reimbursement
3.2.1.3 Preparing for Value-Based Reimbursement in Oncology Practices
3.2.2 Standards & Compliances
3.3 Market Dynamics
3.3.1 Market Driver Analysis
3.3.1.1 Technological Advancements
3.3.1.2 Increase in Outsourcing of RCM
3.3.1.3 Increasing Adoption of mHealth
3.3.1.4 Growth of High-deductible Health Plans (HDHPs)
3.3.2 Market Restraint Analysis
3.3.2.1 Increasing Payer Partnerships
3.3.2.2 Lack of Professionals to Handle RCM Processes
3.3.3 Market Opportunities
3.4 The U.S. Revenue Cycle Management Market Analysis Tools
3.4.1 The U.S. Revenue Cycle Management (RCM) Market-PEST Analysis
3.4.1.1 Political Landscape
3.4.1.2 Economic Landscape
3.4.1.3 Social Landscape
3.4.1.4 Technology Landscape
3.4.2 Industry Analysis-Porter’s
3.4.2.1 Bargaining power of suppliers-Moderate
3.4.2.2 Bargaining power of buyers-Moderate
3.4.2.3 Threat of substitution-Low
3.4.2.4 Threat of new entrants-Moderate
3.4.2.5 Competitive rivalry-High
3.5 Pricing Trends, by Physician Specialty
3.6 Product Adoption Patterns Analysis
3.7 Technology Trends in the RCM
3.8 Covid-19 Impact on the U.S. RCM Market
Chapter 4 The U.S. Revenue Cycle Management Market : Competitive Analysis
4.1 Recent Developments & Impact Analysis, by Key Market Participants
4.1.1 Healthcare veteran launched HealthRev Partners
4.1.2 Waystar Health launched Hubble
4.1.3 R1 RCM, Inc. launched R1 Professional
4.1.4 SOC Telemed launched RCM service offering
4.1.5 Mastercard launched a new unit for healthcare billing and data security
4.1.6 Homecare Home-base launched new RCM tool
4.1.7 Apprio, Inc. introduced ApprioHealth
4.1.8 The SSI Group, Inc. launched a new machine learning capability for predicting payor remittance
4.1.9 Healthcare Administrative Partners launched MIPS Measure Assurance Services
4.1.10 Patientco launched PatientWalletSM
4.2 Vendor Landscape
4.2.1 Key company market share analysis, 2021
4.2.2 Company market position analysis
4.2.3 Market Differentiators
4.2.4 Synergy Analysis: Major Deals & Strategic Alliances
4.2.4.1 Investment
4.2.4.2 Partnership
4.2.4.3 Merger & Acquisition
4.2.5 List of key emerging companies/technology disruptors/innovators
Chapter 5 The U.S. Revenue Cycle Management (RCM) Market: End-user Estimates & Trend Analysis
5.1 The U.S. Revenue Cycle Management (RCM) Market: End-user Movement Analysis, USD Billion, 2021 & 2030
5.2 Hospitals
5.2.1 The U.S. RCM market revenue estimates and forecasts for hospitals, 2016-2030 (USD Billion)
5.3 Physician & Clinical Services
5.3.1 The U.S. RCM market revenue estimates and forecasts for Physician and Clinical Services, 2016-2030 (USD Billion)
Chapter 6 The U.S. Revenue Cycle Management (RCM) Market: Product Type Estimates & Trend Analysis
6.1 The U.S. Revenue Cycle Management (RCM) Market: Product Type Movement Analysis, USD Billion, 2021 & 2030
6.2 Integrated System
6.2.1 The U.S. integrated RCM system market revenue estimates and forecasts, 2016-2030 (USD Billion)
6.3 Standalone System
6.3.1 The U.S. standalone RCM system market revenue estimates and forecasts, 2016-2030 (USD Billion)
Chapter 7 The U.S. Revenue Cycle Management (RCM) Market: Component Estimates & Trend Analysis
7.1 The U.S. Revenue Cycle Management (RCM) Market: Component Movement Analysis, USD Billion, 2021 & 2030
7.2 Software Solution
7.2.1 The U.S. RCM Software Solution market revenue estimates and forecasts, 2016-2030 (USD Billion)
7.3 Services
7.3.1 The U.S. RCM Services market revenue estimates and forecasts, 2016-2030 (USD Billion)
Chapter 8 The U.S. Revenue Cycle Management (RCM) Market: Delivery Mode Estimates & Trend Analysis
8.1 The U.S. Revenue Cycle Management (RCM) Market: Delivery Mode Movement Analysis, USD Billion, 2021 & 2030
8.2 On-premise
8.2.1 The U.S. On-premise RCM market revenue estimates and forecasts, 2016-2030 (USD Billion)
8.3 Web-based
8.3.1 The U.S. web-based RCM market revenue estimates and forecasts, 2016-2030 (USD Billion)
8.4 Cloud-based
8.4.1 The U.S. Cloud-based RCM market revenue estimates and forecasts, 2016-2030 (USD Billion)
Chapter 9 The U.S. Revenue Cycle Management (RCM) Market: Physician Specialty Estimates & Trend Analysis
9.1 The U.S. Revenue Cycle Management (RCM) Market: Physician specialty Movement Analysis, USD Billion, 2021 & 2030
9.2 Oncology
9.2.1 The U.S. RCM market revenue estimates and forecasts for oncology, 2016-2030 (USD Billion)
9.3 Cardiology
9.3.1 The U.S. RCM market revenue estimates and forecasts for Cardiology, 2016-2030 (USD Billion)
9.4 Anesthesia
9.4.1 The U.S. RCM market revenue estimates and forecasts for Anesthesia, 2016-2030 (USD Billion)
9.5 Radiology
9.5.1 The U.S. RCM market revenue estimates and forecasts for Radiology, 2016-2030 (USD Billion)
9.6 Pathology
9.6.1 The U.S. RCM market revenue estimates and forecasts for Pathology, 2016-2030 (USD Billion)
9.7 Pain Management
9.7.1 The U.S. RCM market revenue estimates and forecasts for pain Management, 2016-2030 (USD Billion)
9.8 Emergency Services
9.8.1 The U.S. RCM market revenue estimates and forecasts for Emergency Services, 2016-2030 (USD Billion)
9.9 Others
9.9.1 The U.S. RCM market revenue estimates and forecasts for Others, 2016-2030 (USD Billion)
Chapter 10 The U.S. Revenue Cycle Management (RCM) Market: Sourcing Estimates & Trend Analysis
10.1 The U.S. Revenue Cycle Management (RCM) Market: Sourcing Movement Analysis, USD Billion, 2021 & 2030
10.2 In-house
10.2.1 The U.S. In-house RCM market revenue estimates and forecasts, 2016-2030 (USD Billion)
10.3 External RCM Apps/Software
10.3.1 The U.S. External RCM Apps/Software market revenue estimates and forecasts, 2016-2030 (USD Billion)
10.4 Outsourced RCM Services
10.4.1 The U.S. Outsourced RCM Services market revenue estimates and forecasts, 2016-2030 (USD Billion)
Chapter 11 The U.S. Revenue Cycle Management (RCM) Market: Function Estimates & Trend Analysis
11.1 The U.S. Revenue Cycle Management (RCM) Market: Function Movement Analysis, USD Billion, 2021 & 2030
11.2 Product Development
11.2.1 The U.S. RCM market revenue estimates and forecasts for Product development, 2016-2030 (USD Billion)
11.3 Member Engagement
11.3.1 The U.S. RCM market revenue estimates and forecasts for member Engagement, 2016-2030 (USD Billion)
11.4 Network Management
11.4.1 The U.S. RCM market revenue estimates and forecasts for Network Management, 2016-2030 (USD Billion)
11.5 Care Management
11.5.1 The U.S. RCM market revenue estimates and forecasts for Care Management, 2016-2030 (USD Billion)
11.6 Claims Management
11.6.1 The U.S. RCM market revenue estimates and forecasts for Claims Management, 2016-2030 (USD Billion)
11.7 Risk and Compliance
11.7.1 The U.S. RCM market revenue estimates and forecasts for risk and compliance, 2016-2030 (USD Billion)
Chapter 12 Company Profiles
12.1 The SSI Group, Inc.
12.1.1 Company Overview
12.1.2 Financial Performance
12.1.3 Product Benchmarking
12.1.4 Strategic Initiatives
12.2 Allscripts Healthcare, LLC
12.2.1 Company Overview
12.2.2 Financial Performance
12.2.3 Product Benchmarking
12.3 Cerner Corporation
12.3.1 Company Overview
12.3.2 Financial Performance
12.3.2.1 Product Benchmarking
12.4 McKesson Corporation
12.4.1 Company Overview
12.4.2 Financial Performance
12.4.3 Product Benchmarking
12.5 Athenahealth, Inc. (Veritas Capital Fund Management, L.L.C. and Evergreen Coast Capital)
12.5.1 Company Overview
12.5.1.1 Financial Performance
12.5.1.2 Product Benchmarking
12.5.1.3 Strategic Initiatives
12.6 Oncospark, Inc.
12.6.1 Company Overview
12.6.2 Financial Performance
12.6.3 Product Benchmarking
12.7 R1 RCM, Inc.
12.7.1 Company Overview
12.7.2 Financial Performance
12.7.3 Product Benchmarking
12.7.3.1 Strategic Initiatives
12.8 Epic Systems Corporation
12.8.1 Company Overview
12.8.2 Financial Performance
12.8.3 Product Benchmarking
12.9 Eclinicalworks
12.9.1 Company Overview
12.9.2 Financial Performance
12.9.3 Product Benchmarking
12.9.4 Strategic Initiatives
12.10 NXGN Management, LLC
12.10.1 Company Overview
12.10.2 Financial Performance
12.10.3 Product Benchmarking
12.10.4 Strategic Initiatives

Companies Mentioned

  • The SSI Group, Inc.
  • Allscripts Healthcare, LLC
  • Cerner Corporation
  • Mckesson Corporation
  • Athenahealth, Inc. (Veritas Capital Fund Management, L.L.C. and Evergreen Coast Capital)
  • Oncospark, Inc.
  • R1 RCM, Inc.
  • Epic Systems Corporation
  • Eclinicalworks
  • NXGN Management, Llc

Methodology

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Table Information