Revenue Cycle Management Market
Revenue Cycle Management Market Forecasts to 2030 - Global Analysis by Product (Integrated Solutions and Standalone Solutions), Services (Implementation, Support and Maintenance and Other Services), Deployment, Pricing Models, End User and By Geography
According to Stratistics MRC, the Global Revenue Cycle Management Market is accounted for $55.7 billion in 2024 and is expected to reach $112.4 billion by 2030 growing at a CAGR of 12.4% during the forecast period. Revenue Cycle Management (RCM) is the financial process utilized by healthcare facilities to track patient care episodes from registration and appointment scheduling to the final payment of a balance. Revenue Cycle Management involves managing administrative and clinical functions such as insurance verification, billing, and payment collections. Its goal is to improve the financial outcomes and efficiency of healthcare providers by reducing errors and ensuring timely reimbursements.
According to data from the National Center for Health Statistics, healthcare spending in the United States reached $4.1 trillion in 2020, accounting for 19.7% of the country's Gross Domestic Product (GDP).
Market Dynamics:
Driver:
Increasing healthcare costs
Rising healthcare costs are a major driver for the Revenue Cycle Management (RCM) market. As medical expenses continue to climb, healthcare providers are under pressure to optimize their revenue cycles and improve financial performance. RCM solutions help organizations streamline billing processes, reduce claim denials, and accelerate cash flow. By implementing effective RCM systems, providers can capture more revenue, minimize losses, and better manage the financial challenges posed by escalating healthcare costs. This drives demand for sophisticated RCM technologies and services.
Restraint:
Regulatory compliance
Providers must constantly adapt their revenue cycle processes to comply with complex billing rules, coding requirements, and privacy laws like HIPAA. Staying compliant requires ongoing investments in technology upgrades and staff training. The fear of penalties for non-compliance may make some organizations hesitant to adopt new RCM solutions. Navigating the regulatory landscape adds complexity and costs to RCM implementations, potentially slowing market growth.
Opportunity:
Increasing adoption of cloud technology
Cloud platforms offer healthcare providers more flexibility, scalability, and cost-effectiveness compared to on-premise systems. They enable easier integration of RCM processes across multiple facilities and allow real-time access to financial data. Cloud-based RCM solutions also reduce IT infrastructure costs and simplify system maintenance. As more providers recognize these benefits, the demand for cloud RCM technologies is expected to surge, driving market expansion.
Threat:
Cybersecurity risks
Cybersecurity threats pose a significant risk to the RCM market. As healthcare organizations increasingly digitize their revenue cycle processes and store sensitive financial and patient data electronically, they become more vulnerable to cyberattacks. Data breaches can lead to financial losses, regulatory penalties, and damage to reputation. The need for robust security measures adds complexity and cost to RCM implementations. Concerns about data protection may make some providers hesitant to adopt new RCM technologies, potentially limiting market growth.
Covid-19 Impact:
The COVID-19 pandemic significantly impacted the RCM market. It accelerated the adoption of telehealth and digital payment solutions, driving demand for integrated RCM systems. However, reduced patient volumes and elective procedures initially decreased revenues for many providers. The pandemic highlighted the importance of efficient RCM processes to maintain financial stability during crises.
The cloud-Based segment is expected to be the largest during the forecast period
The cloud-based segment is projected to dominate the RCM market due to its numerous advantages. Cloud solutions offer greater flexibility, scalability, and cost-effectiveness compared to on-premise systems. They enable healthcare providers to access RCM tools and data from anywhere, facilitating remote work and multi-facility management. Cloud platforms also simplify system updates and maintenance. As more organizations recognize these benefits and seek to modernize their RCM processes, the adoption of cloud-based solutions is expected to surge, driving this segment's growth.
The managed RCM services segment is expected to have the highest CAGR during the forecast period
The managed RCM services segment is anticipated to experience the highest CAGR in the revenue cycle management market. This growth is driven by the increasing complexity of healthcare billing and reimbursement processes, coupled with a shortage of skilled RCM professionals. Managed RCM services offer healthcare providers a cost-effective way to outsource their revenue cycle operations to specialized experts. These services can help improve financial performance, reduce administrative burden, and allow healthcare organizations to focus on their core mission of patient care while propelling segment growth.
Region with largest share:
During the forecast period, the North American region is expected to dominate the revenue cycle management market. This dominance can be attributed to the presence of advanced healthcare infrastructure, high healthcare spending, and the early adoption of healthcare IT solutions. The region also has a complex reimbursement landscape and stringent regulatory requirements, driving the need for sophisticated RCM solutions. Additionally, the presence of major RCM vendors and ongoing healthcare reforms contribute to North America's leading position in the market.
Region with highest CAGR:
During the forecast period, the Asia Pacific region is expected to witness rapid growth in the revenue cycle management market. This growth is driven by factors such as increasing healthcare expenditure, growing adoption of digital health solutions, and government initiatives to improve healthcare infrastructure. The region's large population and rising prevalence of chronic diseases are also contributing to the demand for efficient RCM solutions. As healthcare providers in Asia Pacific seek to optimize their financial processes and improve patient care, the adoption of RCM technologies is expected to accelerate, leading to high market growth rates.
Key players in the market
Some of the key players in Revenue Cycle Management market include R1 RCM, Oracle, Optum, McKesson Corporation, Change Healthcare, Cerner Corporation, Allscripts Healthcare Solutions, Inc., Athenahealth, Inc., Epic Systems Corporation, GE Healthcare, Experian plc, Conifer Health Solutions, Veradigm, 3M, Cognizant, SSI Group LLC, Huron Consulting Group, and eClinicalWorks.
Key Developments:
In August 2024, The US Oncology Network (The Network), the largest organization of its kind dedicated to advancing local cancer care and better patient outcomes, announced today that Tennessee Cancer Specialists (TCS) has joined The Network, effective August 1, 2024. The practice is the largest community-based oncology provider in eastern Tennessee and the third largest oncology practice in the state. With the addition of TCS, The Network significantly extends its reach into eastern Tennessee while the practice enhances its ability to provide cancer patients in the region convenient access to high-quality, cutting-edge cancer care.
In February 2024, Minneapolis-based Allina Health is partnering with Optum to improve care for patients and providers across Minnesota and Western Wisconsin. Around 2,000 Allina information systems and revenue cycle management employees will transition employment to Optum, part of UnitedHealth Group, beginning May 5, but will continue to support Allina Health's patients and providers under the partnership. The Allina partnership comes after Optum and St. Louis-based SSM Health recently ended their administrative partnership around inpatient care management, digital transformation and revenue cycle management. The deal included the hiring of about 2,100 SSM employees by Optum.
Products Covered:
• Integrated Solutions
• Standalone Solutions
Services Covered:
• Implementation
• Support and Maintenance
• Training and Education
• Consulting
• Managed RCM Services
Deployments Covered:
• On-Premise
• Cloud-Based
• Hybrid
Pricing Models Covered:
• Subscription-based
• Per-transaction
• Value-based
End Users Covered:
• Hospitals
• Physicians
• Diagnostic and Ambulatory Care Centers
• Long-Term Care Centers
• Other End Users
Regions Covered:
• North America
o US
o Canada
o Mexico
• Europe
o Germany
o UK
o Italy
o France
o Spain
o Rest of Europe
• Asia Pacific
o Japan
o China
o India
o Australia
o New Zealand
o South Korea
o Rest of Asia Pacific
• South America
o Argentina
o Brazil
o Chile
o Rest of South America
• Middle East & Africa
o Saudi Arabia
o UAE
o Qatar
o South Africa
o Rest of Middle East & Africa
What our report offers:
- Market share assessments for the regional and country-level segments
- Strategic recommendations for the new entrants
- Covers Market data for the years 2022, 2023, 2024, 2026, and 2030
- Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and recommendations)
- Strategic recommendations in key business segments based on the market estimations
- Competitive landscaping mapping the key common trends
- Company profiling with detailed strategies, financials, and recent developments
- Supply chain trends mapping the latest technological advancements
Free Customization Offerings:
All the customers of this report will be entitled to receive one of the following free customization options:
• Company Profiling
o Comprehensive profiling of additional market players (up to 3)
o SWOT Analysis of key players (up to 3)
• Regional Segmentation
o Market estimations, Forecasts and CAGR of any prominent country as per the client's interest (Note: Depends on feasibility check)
• Competitive Benchmarking
Benchmarking of key players based on product portfolio, geographical presence, and strategic alliances
Table of Contents
1 Executive Summary
2 Preface
2.1 Abstract
2.2 Stake Holders
2.3 Research Scope
2.4 Research Methodology
2.4.1 Data Mining
2.4.2 Data Analysis
2.4.3 Data Validation
2.4.4 Research Approach
2.5 Research Sources
2.5.1 Primary Research Sources
2.5.2 Secondary Research Sources
2.5.3 Assumptions
3 Market Trend Analysis
3.1 Introduction
3.2 Drivers
3.3 Restraints
3.4 Opportunities
3.5 Threats
3.6 Product Analysis
3.7 End User Analysis
3.8 Emerging Markets
3.9 Impact of Covid-19
4 Porters Five Force Analysis
4.1 Bargaining power of suppliers
4.2 Bargaining power of buyers
4.3 Threat of substitutes
4.4 Threat of new entrants
4.5 Competitive rivalry
5 Global Revenue Cycle Management Market, By Product
5.1 Introduction
5.2 Integrated Solutions
5.3 Standalone Solutions
5.3.1 Front-End Solutions
5.3.1.1 Patient Scheduling
5.3.1.2 Insurance Verification
5.3.1.3 Eligibility and Authorization
5.3.1.4 Patient Access
5.3.2 Mid-End Solutions
5.3.2.1 Claims Scrubbing and Editing
5.3.2.2 Chargemaster Management
5.3.2.3 Claims Submission
5.3.2.4 Remittance Processing
5.3.2.5 Denial Management
5.3.3 Back-End Solutions
5.3.3.1 Accounts Receivable Management
5.3.3.2 Collections Management
5.3.3.3 Revenue Integrity
5.3.3.4 Financial Analytics
5.3.3.5 Patient Financial Services
6 Global Revenue Cycle Management Market, By Services
6.1 Introduction
6.2 Implementation
6.3 Support and Maintenance
6.4 Training and Education
6.5 Consulting
6.6 Managed RCM Services
7 Global Revenue Cycle Management Market, By Deployment
7.1 Introduction
7.2 On-Premise
7.3 Cloud-Based
7.4 Hybrid
8 Global Revenue Cycle Management Market, By Pricing Models
8.1 Introduction
8.2 Subscription-based
8.3 Per-transaction
8.4 Value-based
9 Global Revenue Cycle Management Market, By End User
9.1 Introduction
9.2 Hospitals
9.2.1 Small Hospitals
9.2.2 Medium-Sized Hospitals
9.2.3 Large Hospitals
9.2.4 Academic Medical Centers
9.3 Physicians
9.4 Diagnostic and Ambulatory Care Centers
9.5 Long-Term Care Centers
9.6 Other End Users
9.6.1 Dental Clinics
9.6.2 Veterinary Clinics
9.6.3 Retail Clinics
10 Global Revenue Cycle Management Market, By Geography
10.1 Introduction
10.2 North America
10.2.1 US
10.2.2 Canada
10.2.3 Mexico
10.3 Europe
10.3.1 Germany
10.3.2 UK
10.3.3 Italy
10.3.4 France
10.3.5 Spain
10.3.6 Rest of Europe
10.4 Asia Pacific
10.4.1 Japan
10.4.2 China
10.4.3 India
10.4.4 Australia
10.4.5 New Zealand
10.4.6 South Korea
10.4.7 Rest of Asia Pacific
10.5 South America
10.5.1 Argentina
10.5.2 Brazil
10.5.3 Chile
10.5.4 Rest of South America
10.6 Middle East & Africa
10.6.1 Saudi Arabia
10.6.2 UAE
10.6.3 Qatar
10.6.4 South Africa
10.6.5 Rest of Middle East & Africa
11 Key Developments
11.1 Agreements, Partnerships, Collaborations and Joint Ventures
11.2 Acquisitions & Mergers
11.3 New Product Launch
11.4 Expansions
11.5 Other Key Strategies
12 Company Profiling
12.1 R1 RCM
12.2 Oracle
12.3 Optum
12.4 McKesson Corporation
12.5 Change Healthcare
12.6 Cerner Corporation
12.7 Allscripts Healthcare Solutions, Inc.
12.8 Athenahealth, Inc.
12.9 Epic Systems Corporation
12.10 GE Healthcare
12.11 Experian plc
12.12 Conifer Health Solutions
12.13 Veradigm
12.14 3M
12.15 Cognizant
12.16 SSI Group LLC
12.17 Huron Consulting Group
12.18 eClinicalWorks
List of Tables
1 Global Revenue Cycle Management Market Outlook, By Region (2022-2030) ($MN)
2 Global Revenue Cycle Management Market Outlook, By Product (2022-2030) ($MN)
3 Global Revenue Cycle Management Market Outlook, By Integrated Solutions (2022-2030) ($MN)
4 Global Revenue Cycle Management Market Outlook, By Standalone Solutions (2022-2030) ($MN)
5 Global Revenue Cycle Management Market Outlook, By Front-End Solutions (2022-2030) ($MN)
6 Global Revenue Cycle Management Market Outlook, By Mid-End Solutions (2022-2030) ($MN)
7 Global Revenue Cycle Management Market Outlook, By Back-End Solutions (2022-2030) ($MN)
8 Global Revenue Cycle Management Market Outlook, By Services (2022-2030) ($MN)
9 Global Revenue Cycle Management Market Outlook, By Implementation (2022-2030) ($MN)
10 Global Revenue Cycle Management Market Outlook, By Support and Maintenance (2022-2030) ($MN)
11 Global Revenue Cycle Management Market Outlook, By Training and Education (2022-2030) ($MN)
12 Global Revenue Cycle Management Market Outlook, By Consulting (2022-2030) ($MN)
13 Global Revenue Cycle Management Market Outlook, By Managed RCM Services (2022-2030) ($MN)
14 Global Revenue Cycle Management Market Outlook, By Deployment (2022-2030) ($MN)
15 Global Revenue Cycle Management Market Outlook, By On-Premise (2022-2030) ($MN)
16 Global Revenue Cycle Management Market Outlook, By Cloud-Based (2022-2030) ($MN)
17 Global Revenue Cycle Management Market Outlook, By Hybrid (2022-2030) ($MN)
18 Global Revenue Cycle Management Market Outlook, By Pricing Models (2022-2030) ($MN)
19 Global Revenue Cycle Management Market Outlook, By Subscription-based (2022-2030) ($MN)
20 Global Revenue Cycle Management Market Outlook, By Per-transaction (2022-2030) ($MN)
21 Global Revenue Cycle Management Market Outlook, By Value-based (2022-2030) ($MN)
22 Global Revenue Cycle Management Market Outlook, By End User (2022-2030) ($MN)
23 Global Revenue Cycle Management Market Outlook, By Hospitals (2022-2030) ($MN)
24 Global Revenue Cycle Management Market Outlook, By Small Hospitals (2022-2030) ($MN)
25 Global Revenue Cycle Management Market Outlook, By Medium-Sized Hospitals (2022-2030) ($MN)
26 Global Revenue Cycle Management Market Outlook, By Large Hospitals (2022-2030) ($MN)
27 Global Revenue Cycle Management Market Outlook, By Academic Medical Centers (2022-2030) ($MN)
28 Global Revenue Cycle Management Market Outlook, By Physicians (2022-2030) ($MN)
29 Global Revenue Cycle Management Market Outlook, By Diagnostic and Ambulatory Care Centers (2022-2030) ($MN)
30 Global Revenue Cycle Management Market Outlook, By Long-Term Care Centers (2022-2030) ($MN)
31 Global Revenue Cycle Management Market Outlook, By Other End Users (2022-2030) ($MN)
32 Global Revenue Cycle Management Market Outlook, By Dental Clinics (2022-2030) ($MN)
33 Global Revenue Cycle Management Market Outlook, By Veterinary Clinics (2022-2030) ($MN)
34 Global Revenue Cycle Management Market Outlook, By Retail Clinics (2022-2030) ($MN)
Note: Tables for North America, Europe, APAC, South America, and Middle East & Africa Regions are also represented in the same manner as above.
List of Figures
RESEARCH METHODOLOGY
We at ‘Stratistics’ opt for an extensive research approach which involves data mining, data validation, and data analysis. The various research sources include in-house repository, secondary research, competitor’s sources, social media research, client internal data, and primary research.
Our team of analysts prefers the most reliable and authenticated data sources in order to perform the comprehensive literature search. With access to most of the authenticated data bases our team highly considers the best mix of information through various sources to obtain extensive and accurate analysis.
Each report takes an average time of a month and a team of 4 industry analysts. The time may vary depending on the scope and data availability of the desired market report. The various parameters used in the market assessment are standardized in order to enhance the data accuracy.
Data Mining
The data is collected from several authenticated, reliable, paid and unpaid sources and is filtered depending on the scope & objective of the research. Our reports repository acts as an added advantage in this procedure. Data gathering from the raw material suppliers, distributors and the manufacturers is performed on a regular basis, this helps in the comprehensive understanding of the products value chain. Apart from the above mentioned sources the data is also collected from the industry consultants to ensure the objective of the study is in the right direction.
Market trends such as technological advancements, regulatory affairs, market dynamics (Drivers, Restraints, Opportunities and Challenges) are obtained from scientific journals, market related national & international associations and organizations.
Data Analysis
From the data that is collected depending on the scope & objective of the research the data is subjected for the analysis. The critical steps that we follow for the data analysis include:
- Product Lifecycle Analysis
- Competitor analysis
- Risk analysis
- Porters Analysis
- PESTEL Analysis
- SWOT Analysis
The data engineering is performed by the core industry experts considering both the Marketing Mix Modeling and the Demand Forecasting. The marketing mix modeling makes use of multiple-regression techniques to predict the optimal mix of marketing variables. Regression factor is based on a number of variables and how they relate to an outcome such as sales or profits.
Data Validation
The data validation is performed by the exhaustive primary research from the expert interviews. This includes telephonic interviews, focus groups, face to face interviews, and questionnaires to validate our research from all aspects. The industry experts we approach come from the leading firms, involved in the supply chain ranging from the suppliers, distributors to the manufacturers and consumers so as to ensure an unbiased analysis.
We are in touch with more than 15,000 industry experts with the right mix of consultants, CEO's, presidents, vice presidents, managers, experts from both supply side and demand side, executives and so on.
The data validation involves the primary research from the industry experts belonging to:
- Leading Companies
- Suppliers & Distributors
- Manufacturers
- Consumers
- Industry/Strategic Consultants
Apart from the data validation the primary research also helps in performing the fill gap research, i.e. providing solutions for the unmet needs of the research which helps in enhancing the reports quality.
For more details about research methodology, kindly write to us at info@strategymrc.com
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