The global revenue cycle management market is projected to reach USD 90.43 Billion in 2022 from USD 51.07 Billion in 2017, at CAGR of 12.1%
Revenue cycle management (RCM) systems enable healthcare organizations to manage their revenue cycles. This is achieved by reducing the number of denied insurance claims, speeding up the explanation of benefits (EOB) reconciliation, improving the quality of information, streamlining denial management, and automating processes. Decreasing reimbursements in the healthcare industry, regulatory mandates for the adoption of EHR/EMR, government initiatives to boost the adoption of RCM solutions, loss of revenue due to billing errors, and process improvements in healthcare organizations are the factors driving the growth of this market.
In this report, the market has been categorized based on product, deployment, function, end user, and region. Based on function, the market is segmented into claim and denial management, medical billing and coding, patient insurance eligibility check, payment remittance, electronic health record (EHR), clinical documentation improvement (CDI), and others. The claim and denial management segment is expected to account for the largest share of the global market in 2017 and is expected to witness the highest CAGR during the forecast period. The growing demand for claims and denial management due to the dynamic reimbursement structure and the increasing instances of claim denials are the major factors driving the growth of this segment.
On the basis of product, the market is broadly segmented into integrated and standalone solutions. The integrated solutions segment is expected to account for the largest share of the global revenue cycle management market in 2017 and is projected to register the highest CAGR during the forecast period. Largest share and growth in this segment can be attributed to the rising adoption of value-based payment systems and the growing demand for cost-saving data management solutions.
In 2017, in terms of value, North America is expected to account for the largest share of the global market. Asia is expected to register the highest growth rate from 2017 to 2022. This can be attributed to increasing patient population, rising demand for centralized and cost-effective financial management solutions, and growing use of electronic insurance medical claims in countries such as Japan, China, India, and Singapore.
The high pricing and costly maintenance of RCM solutions, scarcity of skilled IT professionals, and IT infrastructural constraints in developing markets are the major factors expected to restrain market growth.
The key players in the global revenue cycle management market include McKesson (US), Cerner (US), Quest Diagnostics (US), Allscripts Health Solutions (US), and athenahealth (US).
These players focus on inorganic strategies such as acquisitions, agreements, and collaborations as well as organic strategies such as product launches and expansions to sustain their growth in the global market.
Regulatory Mandates for the Adoption of EHR/EMR
Government Initiatives to Boost the Adoption of RCM Solutions
Loss of Revenue Due to Billing Errors
Process Improvements in Healthcare Organizations
High Pricing and Costly Maintenance of RCM Solutions
Scarcity of Skilled IT Professionals
IT Infrastructural Constraints in Developing Markets
Growing Consolidation Among Vendors for End-To-End Solutions
Rising Demand for Cloud-Based RCM Solutions
Potential RCM Markets for IT Vendors
Integration of RCM Solutions Within Healthcare Organizations