Healthcare Revenue Cycle Management Market - By Product (Integrated, Standalone), By Function (Claims & Denial Management, Medical Coding & Billing, Eligibility Verification, Payment Remittance), By Deployment, By End-use & Forecast, 2023-2032

Healthcare Revenue Cycle Management Market - By Product (Integrated, Standalone), By Function (Claims & Denial Management, Medical Coding & Billing, Eligibility Verification, Payment Remittance), By Deployment, By End-use & Forecast, 2023-2032

Healthcare Revenue Cycle Management Market Size

Healthcare Revenue Cycle Management Market size was valued at more than USD 140 billion in 2022. Driven by cumulative healthcare spending, the industry is primed to grow at over 12.5% CAGR from 2023 to 2032.
 

Continuous technical advancements in HRCM solutions are foreseen to promote market growth. New systems enable the automatic filing and evaluation of medical claims. Recent developments, including machine learning (ML) and artificial intelligence (AI), have boosted the usage of these technologies to improve efficiency and expedite the medical billing process. For instance, in January 2022, Waystar, a healthcare billing software company, announced that its platform was used to make payments easier by healthcare providers for around 40% of U.S. patients.

In addition, burgeoning healthcare expenditure in developed and emerging economies is forecast to augment product adoption. Healthcare costs have increased in developed countries, such as the U.S. and Germany, due to the rising frequency of various chronic diseases and cost of treatment.
 

Healthcare Revenue Cycle Management Market Trends

Recurring changes in healthcare regulatory compliance are restraining healthcare revenue cycle management market growth. Revenue cycle experts are dealing with complicated government regulations and payer rules. A strong and reliable revenue cycle management strategy is essential for healthcare businesses to keep up with new payment models and constantly evolving healthcare laws. For instance, the No Surprise Act implemented in 2022 that mandates providers to offer cost estimates supports the smooth functioning of RCM in the healthcare sector. Nonetheless, the introduction of upgraded versions of HRCM solutions is expected to help industry participants overcome this issue.
 

Healthcare Revenue Cycle Management Market Analysis

The healthcare revenue cycle management market is categorized in terms of product into standalone and integrated. The integrated segment was valued at USD 114.5 billion in 2022 and is projected to showcase substantial CAGR through the analysis timeline. The growing demand for integrated systems as they provide effective data management and support the administration of sizable databases is bolstering product adoption. Moreover, surging consumer inclination toward integrated RCM systems with patient scheduling, electronic health records, and medical billing software is slated to provide lucrative opportunities for segment expansion.
 

With respect to function, the medical coding & billing segment held a market share of more than 23% in 2022. The segment is poised to expand at a 11.5% CAGR over 2023-2032, fueled by the increasing availability of upgraded software that reduces errors in data management. Medical coding requires accurate collection of data pertaining to diseases, diagnosis, and symptoms for effectively reimbursing the medical procedure. Many industry players are increasingly developing more sophisticated software and solutions for efficient medical coding and billing. In fact, in October 2022, Nym, a management system manufacturer, launched a radiology coding solution for RCM.
 

On the basis of deployment, the healthcare revenue cycle management market is classified into on-premise and cloud-based. The healthcare revenue cycle management industry valuation from the cloud-based segment is set to reach more than USD 378.5 billion by 2032. Cloud-based solution utilized in HRCM also ensures security and data privacy. Furthermore, the upsurge in the launch of novel cloud-based solutions is primed to spur their adoption in the upcoming period. In March 2022, CareCloud Inc., a healthcare technology firm, introduced CareCloud Remote, a digital health solution for home case management.
 

In terms of end-use, the healthcare revenue cycle management market is segregated into diagnostic labs & ambulatory surgical centers, physician office, hospitals, and others. The global market share from the physician office segment is speculated to progress at over 14% CAGR between 2023 and 2032. This growth is credited to outsourcing and partnerships among healthcare firms and RCM providers. To cite an instance, in October 2022, eClinicalWorks, an ambulatory cloud EHR, announced that Advocare LLC, an independent physician organization, accomplished USD 1 billion in revenue through the use of eClinicalWorks RCM.
 

Regionally, the global healthcare revenue cycle management market is segmented into Asia Pacific, Europe, North America, the Middle East & Africa, and Latin America. European HRCM market valuation is poised to surpass USD 130.5 billion by 2032, owing to an increasing demand for smoother financial management across healthcare facilities. HRCM solutions are increasingly being adopted across countries such as Germany due to the immense growth in their healthcare sector. Moreover, an expanding geriatric population and ongoing pandemic-proofing efforts have also created ideal growth opportunities for the market expansion in the region.
 

Healthcare Revenue Cycle Management Market Share

• R1 RCM, Inc.
• Experian Information Solutions, Inc.
• Allscripts Healthcare, LLC
• AGS Health Inc.
• Athenahealth
• Cerner Corporation
• McKesson Corporation
• CareCloud, Inc.
• Conifer Health Solutions, LLC.
• Change Healthcare
• SSI group Formativ Health
• Dell Technologies
• Cognizant
• Optum (The Advisory Board Company)
• Medical Information Technology, Inc (Meditech)

are some key participants in the healthcare revenue cycle management market.
 

These companies majorly focus on strategic partnerships and product development to boost their market position. In July 2021, R1 RCM, a management services company, acquired VisitPay, a digital payment solution provider. The acquisition united VisitPay's best-in-class consumer payments platform with R1's renowned patient access technology, enabling a seamless financial journey for their patients.
 

Impact of COVID-19 Pandemic

The COVID-19 pandemic impeded market growth due to low hospital outpatient elective care numbers, unpredictable claim volumes, and high healthcare costs per patient. However, the healthcare sector has gradually recovered due to an increase in government efforts to promote RCM solution adoption to prevent revenue losses is anticipated to foster the industry outlook. This can be attributed to the adoption of process improvement projects in healthcare organizations. Hospitals and ambulatory care centers are also consequently generating prominent growth prospects for the healthcare revenue cycle management sector.
 

The healthcare revenue cycle management market research report includes in-depth coverage of the industry with estimates & forecast in terms of revenue in USD from 2018 to 2032 for the following segments

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By Product

• Integrated
• Standalone

By Function

• Claims & denial management
• Medical coding & billing
• Eligibility verification
• Payment remittance
• Others

By Deployment

• On-premise
• Cloud based

By End-use

• Hospitals
• Physician office
• Diagnostic labs and ambulatory surgical centers
• Others

The above information is provided for the following regions and countries

• North America
  • U.S.
  • Canada
• Europe
  • Germany
  • UK
  • France
  • Spain
  • Italy
  • Russia
• Asia Pacific
  • China
  • India
  • Japan
  • Australia
  • South Korea
• Latin America
  • Brazil
  • Mexico
  • Argentina
• Middle East and Africa
  • South Africa
  • Saudi Arabia
  • UAE