Revenue Cycle Management Market – Segmentation, Growth Drivers, Geographical Analysis and Major Key Players

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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.

What the Market Looks Like?

Predicted to grow at a CAGR of 12.1% during the forecast period, the global Revenue Cycle Management Market is estimated to reach USD 90.43 Billion by the end of 2022. North America is expected to dominate the market in 2019

Based on 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.

Based on function, the market is broadly 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 revenue cycle management market in 2019 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

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 What Drives the Market?

The growth of the global market for Revenue Cycle Management is primarily influenced by the following factors:

  • 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

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

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Geographical growth scenario of Revenue Cycle Management Market

Geographically, the Revenue Cycle Management market has been studied for North America. North America is expected to account for the largest share of the global revenue cycle management market. The large share of this regional segment can be attributed to stringent legislative and accreditation requirements regarding healthcare, high adoption rate of HCIT technologies, and regulatory requirements regarding patient safety. Europe is expected to account for the second-largest share of the revenue cycle management market.

Leading market players and strategies adopted

The prominent players in the 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.

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