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Mid-Revenue Cycle Management/Clinical Documentation Improvement Market by Product & Service (Clinical Documentation, Clinical Coding (NLP, Structure Input), Charge Capture, CDI, DRG, Pre-Bill Review), End User, and Region - Global Forecast to 2023

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    Report

  • 136 Pages
  • January 2019
  • Region: Global
  • Markets and Markets
  • ID: 4727293

The Mid-Revenue Cycle Management/Clinical Documentation Improvement Market is Projected to Grow at a CAGR of 7.9%.

The mid-revenue cycle management/clinical documentation improvement market is expected to reach USD 4.5 billion by 2023 from USD 3.1 billion in 2018, at a CAGR of 7.9%. Market growth is largely driven by the increasing utilization of mid-RCM solutions to reduce healthcare costs, check the loss of revenue due to medical billing and coding errors, resolve issues raised by the decline in reimbursement rates, manage ever-increasing amounts of unstructured data, and maintain regulatory compliance. On the other hand, IT infrastructural constraints in developing countries, a scarcity of skilled IT professionals, and the risks associated with HCIT solutions in terms of data security & privacy may restrain the growth of this market to a certain extent.

The solutions segment accounted for the largest share of the market.

In 2017, solutions accounted for the largest share of the market. The large share of the solutions segment can be attributed to the benefits offered by mid-revenue cycle solutions when they are integrated with EHRs/EMRs, encoder systems, voice/text/speech recognition software, CDI, transcription systems, and other hospital information management systems. Moreover, these solutions also eliminate the duplication of administrative work of entering selected codes into each record. They also decrease the potential for data documentation, charge capture, and coding errors, and improve the overall mid-revenue cycle process.

The healthcare providers segment is projected to witness the highest growth during the forecast period.

The healthcare providers segment is projected to grow at the highest rate over the next five years. Growth in the mid-revenue cycle management solutions market for healthcare providers can be attributed to the significant demand for these solutions from healthcare providers for improving data accuracy in clinical documentation, maximizing hospital revenues by minimizing coding errors, and shortening the claims reimbursement cycle. Revenue losses due to medical billing and coding errors, declining reimbursement rates, and the need to reduce the rising healthcare cost are other key factors supporting the growth in the demand for these solutions.

APAC is projected to witness the highest growth during the forecast period.

The APAC region is projected to grow at the highest rate over the next five years. The improving healthcare infrastructure and the rising healthcare insurance coverage and medical tourism are supporting the growth of the mid-revenue cycle management solutions market in the APAC.
Break of primary participants was as mentioned below:

  • By Company Type – Tier 1–30%, Tier 2–50% and Tier 3–20%
  • By Designation – C-level–45%, Director Level–30%, Others–25%
  • By Region – North America–65%, Europe–15%, Asia Pacific–10%, Rest of the World–10%

Prominent players in this market are 3M Company (US), Optum (US), Nuance (US), M*Modal (US), nThrive (US), Dolbey Systems (US), Streamline Health (US), Vitalware (US), Chartwise (US), Craneware (US), Epic Systems (US), Cerner (US), eZDI Inc. (US), Iodine Software (US), Flash Code (US), and TruCode (US).

Research Coverage:
The report analyzes and aims at estimating the market size and future growth potential of the mid-revenue cycle management/clinical documentation improvement market for different segments such as product & service, end user, and region. The report also includes an in-depth competitive analysis of key players along with their company profiles, product offerings, recent developments, and key market strategies.

Reasons to Buy the Report
The report will enrich established firms as well as new entrants/smaller firms to gauge the pulse of the market. Firms purchasing the report could use one or any combination of the below-mentioned five strategies for strengthening the market, which, in turn, could help them garner a greater market share.

This report provides insights on the following pointers:

  • Market Penetration: Comprehensive information on product portfolios offered by top players in the market. The report analyzes the global mid-revenue cycle management/clinical documentation improvement market by product & service, end user, and region.
  • Product Development/Innovation: Detailed insights on upcoming trends and product launches in the market
  • Market Development: Comprehensive information about lucrative emerging markets. The report analyzes the markets for various mid-revenue cycle management/clinical documentation improvement solutions across regions
  • Market Diversification: Exhaustive information about new products, growing geographies, and recent developments in the market
  • Competitive Assessment: In-depth assessment of growth strategies and products of leading players in the mid-revenue cycle management/clinical documentation improvement market

Table of Contents

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 Limitations
1.5 Currency
1.6 Stakeholders
2 Research Methodology
2.1 Research Approach
2.1.1 Secondary Data
2.1.1.1 Key Data From Secondary Sources
2.1.2 Primary Data
2.1.2.1 Breakdown of Primaries
2.1.2.2 Key Data From Primary Sources
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 Mid-Revenue Cycle Management Solutions Market Overview
4.2 North American Mid-Revenue Cycle Management Solutions Market
4.3 Mid-Revenue Cycle Management Solutions Market: Major Geographic Regions
4.4 Geographic Mix: Mid-Revenue Cycle Management Solutions Market
5 Market Overview
5.1 Introduction
5.2 Market Dynamics
5.2.1 Key Market Drivers
5.2.1.1 Increasing Healthcare Expenditure
5.2.1.2 Loss of Revenue Due to Medical Billing and Coding Errors
5.2.1.3 Declining Reimbursements
5.2.1.4 Growing Need to Manage Increasing Unstructured Healthcare Data
5.2.2 Key Market Restraints
5.2.2.1 It Infrastructural Constraints in Developing Countries
5.2.3 Key Market Opportunities
5.2.3.1 Rising Use of NLP in Documentation
5.2.4 Key Market Challenges
5.2.4.1 Data Security Concerns
5.2.4.2 Reluctance to Switch From Conventional Methods
5.2.4.3 Scarcity of Skilled It Professionals
6 Industry Insights
6.1 Introduction
6.2 Coding Guidelines
6.2.1 US
6.2.2 Europe
6.2.3 Japan
6.2.4 Australia
6.3 Trends in NLP-Enabled Documentation & Coding
7 Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, By Product & Service
7.1 Introduction
7.2 Solutions
7.2.1 Clinical Documentation
7.2.1.1 Advantages of NLP-Enabled Documentation Over Manual Processes is Driving the Adoption of Clinical Documentation Solutions
7.2.2 Clinical Coding
7.2.2.1 NLP Solutions
7.2.2.1.1 NLP Coding Solutions to Dominate the Mid-Revenue Cycle Management Clinical Coding Solutions Market During the Forecast Period
7.2.2.2 Structural Input Solutions
7.2.2.2.1 Structured Input Solutions Help to Improve the Coding Process and Reduce the Coding Procedure Cost
7.2.3 Charge Capture
7.2.3.1 Rising Adoption of Smartphones Among Healthcare Professionals to Drive the Adoption of Charge Capture Solutions
7.2.4 Clinical Documentation Improvement
7.2.4.1 CDI Solutions to Witness the Highest Growth During the Forecast Period Primarily Due to A Decrease in DNFB and Increase in Coding Accuracy
7.2.5 Diagnosis-Related Grouping
7.2.5.1 DRG Solutions Improve Pricing and Reimbursement Accuracy
7.2.6 Pre-Bill Review
7.2.6.1 Declining Reimbursement Rates Have Triggered Awareness of the Pre-Bill Review Process
7.3 Consulting Services
7.3.1 Consulting Services to Witness the Highest Growth Rate in the Mid-Revenue Cycle Management Solutions Market From 2018 to 2023
8 Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, By End User
8.1 Introduction
8.2 Healthcare Providers
8.2.1 Inpatient Settings
8.2.1.1 Mid-Rcm Solutions Play an Integral Role in Inpatient Settings, Improving Quality and Growing Revenues—A Key Growth Driver
8.2.2 Outpatient Settings
8.2.2.1 Growing Preference for Outpatient Facilities to Reduce the Cost of Care to Drive Market Growth
8.3 Healthcare Payers
8.3.1.1 Advantages Such as the Increased Productivity and Profitability of Coding Operations are Driving the Adoption of Mid-Rcm Solutions By Healthcare Payers
9 Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, By Region
9.1 Introduction
9.2 North America
9.2.1 US
9.2.2 Canada
9.3 Europe
9.4 Asia Pacific
9.5 Rest of the World
10 Competitive Landscape
10.1 Overview
10.2 Market Leadership Analysis
10.3 Competitive Scenario
10.3.1 Agreements, Collaborations, & Partnerships
10.3.2 Product Launches and Enhancements
10.3.3 Acquisitions
10.3.4 Expansions
11 Company Profiles
(Business Overview, Products and Services Offered, Recent Developments, SWOT Analysis, MnM View)*
11.1 3M Company
11.2 Optum, Inc. (A Subsidiary of Unitedhealth Group, Inc.)
11.3 Nuance Communications, Inc.
11.4 M*Modal
11.5 Dolbey Systems
11.6 Nthrive, Inc.
11.7 Streamline Health Solutions, LLC
11.8 Vitalware, LLC.
11.9 Chartwise Medical Systems, Inc.
11.10 Iodine Software
*Details on Business Overview, Products and Services Offered, Recent Developments, SWOT Analysis, MnM View Might Not Be Captured in Case of Unlisted Companies.
11.11 Other Leading Players
11.11.1 Craneware
11.11.2 EPIC Systems Corporation
11.11.3 Cerner Corporation
11.11.4 EZDI, Inc.
12 Appendix
12.1 Insights of Industry Experts
12.2 Discussion Guide
12.3 Knowledge Store: Subscription Portal
12.4 Available Customizations
12.5 Related Reports
12.6 Author Details
List of Tables
Table 1 Mid-Revenue Cycle Management Solutions Market Snapshot
Table 2 Mid-Revenue Cycle Management Market: Drivers, Restraints, Opportunities, and Challenges
Table 3 Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 4 Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 5 Mid-Revenue Cycle Management Solutions Market, By Country/Region, 2016–2023 (USD Million)
Table 6 Clinical Documentation Solutions Offered By Key Market Players
Table 7 Mid-Revenue Cycle Management Market for Clinical Documentation Solutions, By Country/Region, 2016–2023 (USD Million)
Table 8 Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 9 Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Country/Region, 2016–2023 (USD Million)
Table 10 NLP Clinical Coding Solutions Offered By Key Market Players
Table 11 Mid-Revenue Cycle Management Market for NLP Solutions, By Country/Region, 2016–2023 (USD Million)
Table 12 Structured Input Clinical Coding Solutions Offered By Key Market Players
Table 13 Mid-Revenue Cycle Management Market for Structural Input Solutions, By Country/Region, 2016–2023 (USD Million)
Table 14 Charge Capture Solutions Offered By Key Market Players
Table 15 Mid-Revenue Cycle Management Market for Charge Capture Solutions, By Country/Region, 2016–2023 (USD Million)
Table 16 CDI Solutions Offered By Key Market Players
Table 17 Mid-Revenue Cycle Management Market for Clinical Documentation Improvement Solutions, By Country/Region, 2016–2023 (USD Million)
Table 18 DRG Solutions Offered By Key Market Players
Table 19 Mid-Revenue Cycle Management Market for Diagnosis-Related Grouping Solutions, By Country/Region, 2016–2023 (USD Million)
Table 20 Pre-Bill Review Solutions Offered By Key Market Players
Table 21 Mid-Revenue Cycle Management Market for Pre-Bill Review Solutions, By Country/Region, 2016–2023 (USD Million)
Table 22 Mid-Revenue Cycle Management Solutions Market for Consulting Services, By Country/Region, 2016–2023 (USD Million)
Table 23 Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 24 Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 25 Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Region, 2016–2023 (USD Million)
Table 26 Mid-Revenue Cycle Management Solutions Market for Inpatient Settings, By Region, 2016–2023 (USD Million)
Table 27 Mid-Revenue Cycle Management Solutions Market for Outpatient Settings, By Region, 2016–2023 (USD Million)
Table 28 Mid-Revenue Cycle Management Solutions Market for Healthcare Payers, By Region, 2016–2023 (USD Million)
Table 29 Mid-Revenue Cycle Management Solutions Market, By Region, 2016–2023 (USD Million)
Table 30 North America: Mid-Revenue Cycle Management Solutions Market, By Country, 2016–2023 (USD Million)
Table 31 North America: Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 32 North America: Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 33 North America: Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 34 North America: Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 35 North America: Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 36 US: Key Macroindicators
Table 37 US: Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 38 US: Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 39 US: Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 40 US: Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 41 US: Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 42 Canada: Key Macroindicators
Table 43 Canada: Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 44 Canada: Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 45 Canada: Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 46 Canada: Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 47 Canada: Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 48 Europe: Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 49 Europe: Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 50 Europe: Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 51 Europe: Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 52 Europe: Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 53 APAC: Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 54 APAC: Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 55 APAC: Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 56 APAC: Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 57 APAC: Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 58 RoW: Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2016–2023 (USD Million)
Table 59 RoW: Mid-Revenue Cycle Management Solutions Market, By Type, 2016–2023 (USD Million)
Table 60 RoW: Mid-Revenue Cycle Management Market for Clinical Coding Solutions, By Type, 2016–2023 (USD Million)
Table 61 RoW: Mid-Revenue Cycle Management Solutions Market, By End User, 2016–2023 (USD Million)
Table 62 RoW: Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2016–2023 (USD Million)
Table 63 Key Developments in the Mid-Revenue Cycle Management Solutions Market Between January 2014 and November 2018
Table 64 Growth Strategy Matrix (2014–2018)
Table 65 Market Position of Leading Players in Mid-Revenue Cycle Management Solutions Market
Table 66 Agreements, Collaborations, & Partnerships, 2014–2018
Table 67 Product Launches and Enhancements, 2014–2018
Table 68 Acquisitions, 2014–2018
Table 69 Expansions, 2014–2018
List of Figures
Figure 1 Research Design
Figure 2 Breakdown of Primary Interviews: By Company Type, Designation, and Region
Figure 3 Bottom-Up Approach
Figure 4 Top-Down Approach
Figure 5 Data Triangulation Methodology
Figure 6 Mid-Revenue Cycle Management Solutions Market, By Product & Service, 2018 vs 2023 (USD Million)
Figure 7 Mid-Revenue Cycle Management Solutions Market, By Type, 2018 vs 2023 (USD Million)
Figure 8 Mid-Revenue Cycle Management Solutions Market for Clinical Coding, By Type, 2018 vs 2023 (USD Million)
Figure 9 Mid-Revenue Cycle Management Solutions Market, By End User, 2018 vs 2023 (USD Million)
Figure 10 Mid-Revenue Cycle Management Solutions Market for Healthcare Providers, By Type, 2018 vs 2023 (USD Million)
Figure 11 North America Dominated the Mid-Revenue Cycle Management Solutions Market in 2017
Figure 12 Increasing Utilization of Mid-RCM Solutions to Reduce Healthcare Costs—A Key Factor Driving Market Growth
Figure 13 The US Will Continue to Dominate the Market Through 2023
Figure 14 APAC to Grow at the Highest CAGR During the Forecast Period
Figure 15 North America Will Continue to Dominate the Market Through 2023
Figure 16 Consulting Services Segment to Witness the Highest Growth During the Forecast Period
Figure 17 Healthcare Providers to Register the Highest Growth Rate of the Mid-Revenue Cycle Management Solutions Market During the Forecast Period
Figure 18 Mid-Revenue Cycle Management Solutions Market: Geographic Growth Opportunities
Figure 19 North America: Mid-Revenue Cycle Management Solutions Market Snapshot
Figure 20 Europe: Mid-Revenue Cycle Management Solutions Market Snapshot
Figure 21 APAC: Mid-Revenue Cycle Management Solutions Market Snapshot
Figure 22 RoW: Mid-Revenue Cycle Management Solutions Market Snapshot
Figure 23 3M: Company Snapshot (2017)
Figure 24 Optum: Company Snapshot (2017)
Figure 25 Nuance: Company Snapshot (2017)
Figure 26 Streamline Health: Company Snapshot (2017)

Samples

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Companies Mentioned

  • 3M Company
  • Cerner Corporation
  • Chartwise Medical Systems, Inc.
  • Craneware
  • Dolbey Systems
  • EPIC Systems Corporation
  • EZDI, Inc.
  • Iodine Software
  • M*Modal
  • Nthrive, Inc.
  • Nuance Communications, Inc.
  • Optum, Inc. (A Subsidiary of Unitedhealth Group, Inc.)
  • Streamline Health Solutions, LLC
  • Vitalware, LLC.

Table Information