Revenue Cycle Management Market to Reach USD 75.69 Billion by 2026

by | May 28, 2019 | Blog, Medical Billing | 0 comments

It is getting more significant for healthcare providers to follow effective result-oriented strategies to improve their organizations’ financial health. Professional medical billing companies can help hospitals manage their revenue cycle effectively. According to a report from Data Bridge Market Research, the global revenue cycle management market that was about USD 29.5 billion in 2018 is expected to reach USD 75.69 billion by 2026, growing rapidly at a CAGR of 12.5% during 2019 to 2026.

With more and more complicating payer contracts as well as greater regulatory demands, hospitals’ revenue cycle management has been becoming more complex in recent years. A reliable RCM solution manages the patient’s bills from the time of entering the hospital to reimbursement of claims.

Managing revenue cycle involves improving the process of claims management and quality of information, accelerating explanation of benefits (EOB) reconciliation, and streamlining denial management.

Certain key factors that boost the growth of this global market include:

  • decrease in reimbursement in the healthcare industry
  • reduction of total healthcare costs
  • initiatives undertaken by governments for implementation of revenue cycle management solutions, and
  • increasing expenditure by healthcare industry especially made on IT

However, lack of training and skills in the staff as well as the lack of technical infrastructure support are factors that restrain this market growth.

The report classifies RCM market on the basis of product type, stage, function, end-user, deployment, component as well as geography.  While the product types include integrated and standalone RCM, by stage the market is segmented into front office, mid office and back office.

Functions of RCM include claim & denial, medical billing and coding, payment remittance, electronic health record, clinical documentation improvement, insurance verification and other tasks such as scheduling & appointment, referral management, and contract management.

End users of this market are hospitals, general physicians, labs as well as pharmacies, emergency medical centers and others. While the market is divided into web-based, on-premise and cloud-based deployment, by component the market is divided into software and services.

Geographically, the market is segmented into North America, Europe, Asia-Pacific and Middle East & Africa.

All scripts Healthcare Solutions, Inc. (IN), athenahealth, Inc. (US), CareCloud Corporation (US), Cerner Corporation (US), Conifer Health Solutions LLC (US), eClinicalWorks (US), Epic Systems Corporation (US), Experian Information Solutions, Inc.(US), General Electric Company (US), GeBBS Healthcare Solutions (IN), McKesson Corporation (US), NXGN Management, LLC (US), nThrive, Inc. (US), Quest Diagnostics Incorporated (US), SSI Group, LLC (US).

The report also highlights certain key developments in the market -– the newest version of Quanum Enterprise Content Management Solution unveiled by Quest Diagnostics and eClinical Works Revenue Cycle Management (RCM) announced by eClinicalWorks to aid medical practices in optimizing billing.

RCM Tips for Hospitals

In its latest blog, Becker’s Hospital Review has discussed certain expert RCM tips for hospitals such as –

  • Whether considering medical billing outsourcing or performing billing in-house, hospitals should carefully evaluate the pros and cons
  • Revenue cycle departments of hospitals should cooperate with clinical and operational investors to improve transparency of ordered procedures and allow suitable time to secure authorizations
  • Practices should track the right utilization management metrics to improve their clinical decisions, regulations/contracts and billing/finance

Boosting your hospital’s revenue cycle performance can ensure financial viability. Partnering with a reliable provider of AR management services can help practices in submitting error-free claims, better analysis of denied claims, and effective follow-up to settle outstanding claims and dues.

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  • Natalie Tornese
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    CPC: Director of Revenue Cycle Management

    Natalie joined MOS’ Revenue Cycle Management Division in October 2011. She brings twenty five years of hands on management experience to the company.

  • Meghann Drella
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    CPC: Senior Solutions Manager: Practice and RCM

    Meghann joined MOS’ Revenue Cycle Management Division in February of 2013. She is CPC certified with the American Academy of Professional Coders (AAPC).

  • Amber Darst
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    Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS.

  • Loralee Kapp
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    Solutions Manager: Practice and RCM

    Loralee joined MOS’ Revenue Cycle Management Division in October 2021. She has over five years of experience in medical coding and Health Information Management practices.