April20 , 2024

United States Revenue Cycle Management Market Outlook Report 2023: A $220+ Billion Market by 2028 – AI and Cloud Emerge as the Winning Combination

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DUBLIN, Oct. 20, 2023 /PRNewswire/ — The “U.S. Revenue Cycle Management Market – Industry Outlook & Forecast 2023-2028” report has been added to  ResearchAndMarkets.com’s offering.

The U.S. revenue cycle management market is expected to reach a value of $220.45 billion by 2028 from $115.4 billion in 2022, growing at a CAGR of 11.39% from 2022-2028.

The U.S. revenue cycle management (RCM) market is experiencing a dynamic transformation, driven by rapid technological advancements and the integration of AI and cloud-based solutions. This market, highly competitive by nature, is witnessing a surge in innovation that is reshaping the way healthcare organizations manage their financial operations.

The introduction of cloud-based medical billing management, seamless integration of electronic health records, and the increased utilization of digital mediums have revolutionized how claim denials are handled. Vendors in this space are continuously pushing the boundaries of technology, developing new tools and services to cater to an evolving consumer landscape.

AI and Cloud: The Winning Combination

The fusion of Artificial Intelligence (AI) with cloud-based deployment in RCM brings forth a plethora of advantages. These include enhanced efficiency, pinpoint accuracy, scalability, cost-effectiveness, and fortified data security within the U.S. revenue cycle management market. Healthcare organizations are increasingly recognizing the potential of AI and cloud-based solutions in optimizing their revenue cycle operations, thereby elevating their financial performance to new heights.

The AI Revolution

The RCM sector is experiencing a surge in demand for AI-powered solutions, especially those deployed through cloud-based systems. AI-driven RCM solutions are revolutionizing the industry by automating manual and repetitive tasks, reducing the need for human intervention, and boosting efficiency.

Meeting the Growing Demand

As the number of patients seeking healthcare services continues to rise, the volume of medical bills and insurance claims generated is growing exponentially. This surge in volume necessitates more efficient RCM processes to manage billing, coding, and claims. Effective RCM practices are critical to ensuring healthcare providers capture revenue optimally and minimize revenue leakage.

The Benefits of Automation

Automation is the cornerstone of efficient RCM. By leveraging technology and automation, healthcare providers can streamline their revenue cycle operations, allowing them to focus more on delivering high-quality patient care. Automation not only enhances efficiency but also reduces errors, improves revenue capture, and ultimately enhances overall financial performance.

Moreover, automation enables seamless integration of the revenue cycle management process with other critical business functions, including finance, invoicing, and customer service.

In a landscape where technological innovation is driving significant change, AI and cloud-based solutions are empowering healthcare organizations to navigate the complexities of revenue cycle management with precision and agility.

INSIGHTS BY COMPONENT

The post-cycle component segment accounted for the largest U.S. revenue cycle management market share 2022.

The post-cycle component of RCM includes activities after the patient has received care, such as processing claims, collecting payments, and managing accounts receivable. The post-cycle component of RCM is essential to the financial success of healthcare organizations. IT involves various activities, including claims submission, processing, payment posting, accounts receivable management, and reimbursement analysis. These activities are necessary to ensure that the organization is paid for its services.

INSIGHTS BY DELIVERY MODE

In 2022, the cloud-based segment accounted for a larger market share. Cloud-based RCM is a relatively new technology that businesses have been able to leverage for improved efficiency and cost-effectiveness. by leveraging cloud-based solutions, businesses can optimize their revenue cycle, reducing time and related administrative costs by efficiently managing customer information, invoicing, and payments.

Cloud-based RCM solutions provide cost benefits, improved customer experience, and enhanced security, among other benefits. One of the greatest advantages of utilizing cloud-based RCM solutions is its cost savings. by leveraging cloud technology, businesses can save on hardware, software, and maintenance, which can connect multiple remote sites without a traditional costly onsite setup.

INSIGHTS BY SOLUTION TYPE

The integrated segment dominated the market share in 2022. Integrated RCM is an approach to healthcare billing that integrates all processes, from insurance claims filing to payment collection.

In a nutshell, RCM is how healthcare providers efficiently process billing and payments for their care. IT’s all done to maximize cash flow, reduce costs, and increase revenue. Integration is central to a successful RCM system, allowing for data from multiple parts of the healthcare organization to be collected and shared. An enterprise-wide RCM system allows departments to share patient information, process claims quicker, and avoid conflicts between departments.

INSIGHTS BY SERVICE TYPE

The ambulatory care service dominated the U.S. revenue cycle management market, accounting for over 48% in 2022.

Revenue cycle management in ambulatory care is critical to ensuring a successful practice and a steady cash flow. As providers of care, collections for services must be managed in an organized and timely way.  The primary RCM process in ambulatory care includes patient scheduling and registration, coding and abstracting services, claims submission, payment posting, denials management, collections, and customer service.

INSIGHTS BY END-USER

The hospital’s end-user segment accounted for the larger U.S. revenue cycle management market share. RCM is an important part of the healthcare system, especially in hospitals.

RCM is a critical component in hospital operations due to its ability to help hospitals track patient data, maximize efficiency, improve patient satisfaction, and ultimately increase revenue. In today’s healthcare environment of rapidly changing technology and complicated regulations, RCM enables hospitals to remain competitive while adhering to these regulations.

KEY QUESTIONS ANSWERED:

  • How big is the U.S. revenue cycle management market?
  • What is the projected growth rate of the U.S. revenue cycle management market?
  • Who are the key U.S. revenue cycle management market players?
  • What are the rising U.S. revenue cycle management industry trends?
  • Which service type holds the most significant U.S. revenue cycle management market share?

Market Opportunities & Trends

  • Growing Demand For Ai & Cloud-Based Deployment
  • Automation In Rcm
  • Shift Toward Value-Based Reimbursement
  • Increasing Revenue Cycle Integration

Market Growth Enablers

  • Increase In Patient Volume And Rising Demand For Health Insurance
  • Growing Complexity Of Billing And Payment Processes
  • Rising Importance Of Denial Management In Medical Claims
  • Increase In Outsourcing Revenue Cycle Management

Market Restraints

  • High Cost Of Deployment
  • Issues Related To Data Security & Confidentiality
  • Adapting Changes In Medical Billing & Coding

Key Company Profiles

  • Change Healthcare
  • Epic Systems Corporation
  • Experian
  • MCKESSON CORPORATION
  • Oracle
  • R1 RCM
  • Veradigm

Other Prominent Vendors

  • Access Healthcare
  • Acrologic Business Solutions
  • AdvancedMD
  • Advantum Health
  • AllianceMed
  • BellMedEx
  • Bizmatics
  • CareCloud
  • Cognizant
  • Coronis Health
  • CorroHealth
  • The Craneware Group
  • CureMD Healthcare
  • Data Marshall
  • DrChrono
  • EHealthSource
  • Greenway Health
  • InSync Healthcare Solutions
  • IntelliRCM
  • Kareo
  • Medical Billers and Coders
  • MGSI
  • MRO
  • NXGN Management
  • OSP
  • Persistent Systems
  • PMMC
  • Promantra
  • Quadax
  • QWay Healthcare
  • Revele
  • RevenueXL
  • Right Medical Billing
  • Vee Technologies
  • Waystar

For more information about this report visit https://www.researchandmarkets.com/r/9521wf

About ResearchAndMarkets.com
ResearchAndMarkets.com is the world’s leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.


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