Ottawa, Oct. 02, 2024 (GLOBE NEWSWIRE) -- The global healthcare revenue cycle management market size is predicted to increase from USD 169.70 billion in 2025 to approximately USD 453.47 billion by 2034, a study published by Towards Healthcare a sister firm of Precedence Statistics. The sector is expected to expand at a double-digit CAGR of 11.54% between 2024 and 2034.
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Key Insights Healthcare Revenue Cycle Management Market:
- North America dominated the market share by 56% in 2023.
- Asia Pacific is expected to grow at the fastest rate of 15.84% CAGR during the forecast period.
- By product type, the integrated segment dominated the healthcare revenue cycle management market share by 72% in 2023.
- By function, the claims & denial management segment held the largest share of the market in 2023.
- By deployment, the cloud-based segment held the largest share of the market in 2023.
- By end-user, the physician office segment dominated the market share by 40% in 2023.
Healthcare Revenue Cycle Management Market (HRCM): Financial Management
The industry evolved in providing revenue cycle management services and solutions to healthcare organization is the healthcare revenue cycle management market. Increasing complexity of healthcare billing and reimbursement regulations, the growing focus on improving patient experience and the need for efficient and cost-effective revenue cycle management processes, are some of the key factors that are driving the healthcare revenue cycle management market.
Health care providers, hospitals and medical practices are increasingly outsourcing revenue cycle management functions to specialized companies to improve their financial performance and streamline operations.
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Recent Developments in Healthcare Revenue Cycle Management:
| Company Name | R1 RCM Inc. |
| Headquarters | Murray, Utah, U.S., North America |
| Development | In January 2024, R1 RCM Inc. acquired Acclara from Providence, a health systems provider. This acquisition aims to strengthen R1 RCM Inc.'s market and enable the company to implement state-of-the-art technology solutions and enhance execution, which enables to improve outcomes for both patients and customers |
| Company Name | Infinx |
| Headquarters | Bengaluru, India, Asia Pacific |
| Development | In July 2024, the establishment of Infinx's brand-new, cutting-edge Research & Development Center in Bengaluru, India, has been announced. Infinx's devotion to promoting innovation and advancing the area of healthcare revenue cycle management (RCM) is demonstrated by this new location. |
Top Companies in the Healthcare Revenue Cycle Management Market:
- Allscripts Healthcare, LLC
- Cognizant
- NextGen Healthcare
- Experian
- FinThrive
- Ensemble Health Partners, Inc.
- AGS Health Inc.
- Dell Technologies
- Adonis
- Cerner Corporation
- Athenahealth
- Experion Information Solutions, Inc.
- Change Healthcare
- Conifer Health Solutions, LLC.
Driver
Growing Inclination Towards Value-Based Care
The shift towards value-based care from traditional fee-for-service models is one of the primary drivers of the healthcare revenue cycle management. Value based care emphasizes improved patient outcomes, lower costs and overall quality of care. To support this transition healthcare organizations, require highly advanced and mature revenue cycle management systems.
Managing patient data, monitoring patient outcomes and analyzing the cost effectiveness at every stage, all these things are required for the transition from fee-for-service to value-based care model,
- In 2023, Cerner Corporation announced partnership with The United States Department of Veterans Affairs for the implementation of its integrated healthcare revenue cycle management solutions. This collaboration aims to shift the veteran affair’s healthcare system to a value-based model which will ensure better patient care and more efficient revenue management. The adoption of such solutions across large scale institutions is a testament to growing popularity and demand for the integrated healthcare revenue cycle management systems to support value-based care.
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Healthcare Revenue Cycle Management, Growth Factors:
| Factors | Impact on HRCM Market |
| Shift to value-based care | Increased demand for integrated solutions |
| Data privacy and security concerns | Investment in cyber security features in HRCM systems |
| Demand for integrated systems | Adoption by large-scale healthcare providers |
Restraint
Data Privacy and Security Concerns Restraining the Market
The risk of data privacy and security breaches this growing significantly as healthcare is becoming increasingly digitalized. More and more scams are being targeted by healthcare data breaches, with sensitive medical data being processed and stored electronically, protecting this information is a priority at certain times. Healthcare organization must comply with regulations such as health insurance portability and accountability act (HIPAA) in the United States and general data protection regulation (GDPR) in Europe to avoid breaches that could lead to major penalties and loss of consumer trust.
- For instance, in May of 2023, CommonSprit Health, one of the largest healthcare systems in the United States, experienced a major cyber-attack which affected patient data and delaying medical services in several hospitals. The bridge highlighted the need for more secure and resilient data management systems and healthcare sector.
Opportunity
Surging Demand for Integrated Systems, Upcoming Opportunity
The increasing complexity in large organizations of healthcare systems has spurred demand for integrated healthcare revenue cycle management solutions. These systems combine multiple functionalities into one cohesive platform which allows more seamless data sharing between different modules such as patient scheduling, medical billing and electronic health records. This integration enhances efficiency, reduces manual errors and supports expansion to multiple locations.
For instance, Athenahealth Launched a new integrated healthcare revenue cycle management platform in September of 2023, which is specially designed for multi-location healthcare providers. This platform allows healthcare providers to manage large databases more effectively which streamlines everything from patient intake to final billing. With integrated solutions like these healthcare organizations can handle complex operations more efficiently which is further driving the growth of integrated healthcare revenue cycle management systems
Integrated Segment Dominated the Healthcare Revenue Cycle Management Market
By product type, the integrated segment dominated the healthcare revenue cycle management market share by 72% in 2023. Integrated systems bring multiple revenue cycle management functions, such as billing quoting and patient scheduling, all this into one unified platform. This reduces errors and makes data management more efficient than healthcare providers especially in larger organizations, with the shift towards value-based care models the demand for integrated revenue cycle management systems continues to grow.
- In 2023 the company called Cerner enhanced integration of its revenue cycle management solutions with Oracle’s cloud infrastructure which is offering faster and more secure data processing for hospitals.
Claims & Denial Management Segment Held Largest Share of Market
In 2023, claims and denial management was the top performing segment in healthcare revenue cycle management market. Claims and denial management segment helps healthcare providers manage claim submissions and resolve denied claims efficiently, which is a crucial part of revenue flow. As insurance claims become more complex the need for robust claims management solutions has grown. The increase in claim denials due to stricter payer policies makes this function essential.
- The company called Waystar and American Medical Association formed a partnership in mid of 2023 to enhance claims management solutions, which is helping healthcare providers reduce denials and improve reimbursement rates.
Cloud-Based Segment Held the Largest Share of the Market
Cloud based healthcare revenue cycle management solutions held the largest market share due to its scalability, cost effectiveness and flexibility, and dominated the healthcare revenue cycle management market in 2023. Cloud based systems allow healthcare organizations to access real time data, streamline workflows and improve collaboration across multiple locations. With growing concerns over data security and the need for compliance with regulations like HIPAA, cloud solutions have evolved to offer better encryption and security features.
- For instance, the expansion of Microsoft Azure’s healthcare cloud solutions in early 2023, improve the efficiency and security of cloud based revenue cycle management systems for major healthcare providers.
Physician Office Segment Dominated the Market in 2023
In 2023, by end use, the physician office segment dominated the healthcare revenue cycle management market by 40% in 2023 holding largest market share. With rising administrative burdens and increasing patient volumes physicians are increasingly adopting revenue cycle management solutions to streamline billing, management of patient records and scheduling. These systems help smaller practices manage their operations more efficiently without adding extra staff.
North America Dominating the Market, by its Advance Technology
The region North America dominated the healthcare revenue cycle management market share by 56% in 2023. The north America's leadership is largely driven by advanced technological developments and sustainable investments in the healthcare infrastructure. Countries like US and Canada please a pivotal role due to their highly developed healthcare systems, which incorporates the latest artificial intelligence, machine learning and automation to streamline the revenue cycle management processes.
For instance, in 2023, Epic Systems, which is the leading healthcare software provider expanded its artificial intelligence based revenue cycle management solutions to help hospitals and clinics enhance their claims processing and denial management. This new trend of the shift towards automation is helping to reduce manual errors, optimization of financial workflows and ensuring faster reimbursements.
Asia Pacific, Fastest Growing Market for Healthcare Revenue Management
The region leadership Pacific is projected to grow at the fastest rate during the forecast time in healthcare revenue cycle management market. Countries like China, Japan, South Korea and India forefront of this growth. The region has rapid population increases, expanding healthcare infrastructure and the digital transformation of healthcare services, these factors are driving the growth of healthcare revenue cycle management market.
- For instance, according to national medical products administration, the Chinese healthcare system provided medical care to 250,000,000 patients in 2023 which highlights the scale of China's operations. This huge patient volume has fueled demand for more robust revenue cycle management solutions to manage patient data.
Also, India is playing a crucial role in growth of do you shop at six market. The Indian hospital industry valued at INR 7940 billion in FY2021 and is expected to reach INR 18,348 billion by FY2027. The increasing adoption of telemedicine and digital healthcare platforms are some of the reasons which is driving this growth.
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Segments Covered in the Report
By Product Type
- Integrated
- Standalone
By Function Type
- Claims & Denial Management
- Medical Coding & Billing
- Eligibility Verification
- Payment Remittance
- Others
By Deployment Type
- Cloud-based
- On-premise
By End-user
- Physician Office
- Hospitals
- Diagnostic Labs and Ambulatory Surgical Centers
- Others
By Region
- North America
- U.S.
- Canada
- Asia Pacific
- China
- Japan
- India
- South Korea
- Thailand
- Europe
- Germany
- UK
- France
- Italy
- Spain
- Sweden
- Denmark
- Norway
- Latin America
- Brazil
- Mexico
- Argentina
- Middle East and Africa (MEA)
- South Africa
- UAE
- Saudi Arabia
- Kuwait
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About Us
Towards Healthcare is a leading global provider of technological solutions, clinical research services, and advanced analytics to the healthcare sector, committed to forming creative connections that result in actionable insights and creative innovations. We are a global strategy consulting firm that assists business leaders in gaining a competitive edge and accelerating growth. We are a provider of technological solutions, clinical research services, and advanced analytics to the healthcare sector, committed to forming creative connections that result in actionable insights and creative innovations.
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