U.S. Revenue Cycle Management Market Size By Sourcing (In-House, External Apps/Software), By Delivery Mode (On-Premise, Cloud-Based), By End User (Healthcare Providers, Healthcare Payers) And Forecast

U.S. Revenue Cycle Management Market Size And Forecast

U.S. Revenue Cycle Management Market size was valued at USD 112.5 Billion in 2022 and is projected to reach USD 230.55 Billion by 2030, growing at a CAGR of 10.4% from 2023 to 2030.

The rapidly flourishing healthcare industry along with rising demand for billing transparency as well as fair and timely reimbursement is expected to drive the market demand over the forecast period. Other factors aging population, chronic illness diagnosis, tight labor market, and rising drug and supply costs are expected to fuel the market growth of the country over the period. The U.S. Revenue Cycle Management Market report provides a holistic evaluation of the market. The report offers a comprehensive analysis of key segments, trends, drivers, restraints, competitive landscape, and factors that are playing a substantial role in the market.

U.S. Revenue Cycle Management Market Definition

Revenue Cycle Management (RCM) is generally defined as a method in which healthcare facilities manage the entire billing cycle of the patient ranging from eligibility to final payment. The three main components of RCM include revenue generation, capture, and collection. Gaps and inefficiency reduction along with reimbursement maximization can effectively contribute towards an increase in revenue generation. As the healthcare industry is quality-driven, the revenue cycle entirely depends on the precise and complete documentation of patient information, right from registration to clinical documentation. Even a single gap in data can greatly influence revenue streams.

The U.S. healthcare scene is always buzzing with new tech ideas and solutions! That means revenue cycle managers at hospitals and clinics need to stay sharp and spot ways to improve how happy patients are, how smoothly things run, and, of course, the bottom line. Think about itbetter collections, smarter care practices, happier patients, and getting paid faster all make a big difference. But here's the rubif folks don't have the skills to build and manage the revenue cycle process, we're stuck. Plus, things like higher costs, getting enough resources, managing them well, and wrestling with insurance claims can really slow things down.

U.S. Revenue Cycle Management Market Overview

Healthcare establishments are engaged in implementing digital techniques and processes for claims management, reimbursement, and code which in turn is propelling customers to make room for execution cost limits, risk-sharing, as well as centralized reimbursement structures. Furthermore, healthcare establishments are aiming towards implementing workflow optimization solutions, which, are likely to augment the market growth. Also, favorable government policies and regulations are expected to contribute toward market demand.

Using a well-designed, developed, and implemented RCM system abbreviates the billing and collection cycles by precisely registering, appointing, scheduling, and processing payments. Furthermore, it combines administrative data (including patient’s identity, insurance plan, etc.) with other care facilities received by patients. In addition, it also contributes towards lowering the number of denied claims and enables digital online payments, thus aiding time management. Some of the functions of RCM include storing and managing patient billing information, integrating of EHR and billing systems, and lower administrative expenses.

Market Attractiveness

The image of market attractiveness provided would further help to get information about the region that is majorly leading in the U.S. Revenue Cycle Management Market. We cover the major impacting factors that are responsible for driving the industry growth in the given region.

Porter’s Five Forces

The image provided would further help to get information about Porter’s five forces framework providing a blueprint for understanding the behavior of competitors and a player’s strategic positioning in the respective industry. Porter’s five forces model can be used to assess the competitive landscape in the U.S. Revenue Cycle Management Market, gauge the attractiveness of a certain sector, and assess investment possibilities.

U.S. Revenue Cycle Management MarketSegmentation Analysis

The U.S. Revenue Cycle Management Market is Segmented on the basis of Sourcing, Delivery Mode, and End User.

U.S. Revenue Cycle Management Market, By Sourcing

• In-House
• External Apps/Software
• Outsourcing Services

Based on Sourcing, the market is segmented into In-House, External Apps/Software, and Outsourcing Services. The in-House segment is anticipated to hold the largest market share in 2021. Whereas outsourcing services is expected to witness the highest CAGR over the forecast period. Outsourcing refers to hiring an external third-party company to perform the revenue cycle management process including billing, coding, and other non-provider-related tasks.

U.S. Revenue Cycle Management Market, By Delivery Mode

• On-Premise
• Cloud-Based

Based on Delivery Mode, the market is segmented into On-Premise and Cloud-Based. The cloud-based segment is anticipated to register a higher growth rate owing to widespread benefits such as ease of installation, low maintenance cost, greater security, and higher quality control. Waystar, Kareo, and Athena collector are some of the cloud-based software for RCM.

U.S. Revenue Cycle Management Market, By End User

• Healthcare Providers
• Healthcare Payers

Based on End User, the market is segmented into Healthcare Providers and Healthcare Payers. Healthcare Providers accounted for the largest market share in 2021. The segment includes hospitals, diagnostic centers, nursing homes, and ambulatory surgical centers among others. The adoption of RCM by healthcare providers enables optimized workflow, and improved efficiency, and helps to streamline processes which ultimately contributes towards load reduction.

Key Players

The “U.S. Revenue Cycle Management Market” study report will provide valuable insight with an emphasis on the market including some of the major players are Optum, R1 RCM Inc, Change Healthcare, 3M, The SSI Group, Inc., Allscripts Healthcare, LLC, Cerner Corporation, McKesson Corporation, Epic Systems Corporation, Eclinicalworks, MEDIREVV, NXGN Management, LLC, OSP Labs, and Experian PLC.

These players are investing heavily in research and development activities in order to upscale their technologies and enhance product features that are application specific. Furthermore, the companies are undertaking strategic alliances to gain a strong foothold in the market and enhance its geographic reach. Product differentiations, pricing, and robustness are some of the prominent factors taken into consideration by companies to sustain the market competition.

Key Developments

• In 2021, Vanderbilt announced that it has entered into a collaborative agreement with McKesson to provide a specialty pharmacy consulting suite for the latter’s client.

Ace Matrix Analysis

The Ace Matrix provided in the report would help to understand how the major key players involved in this industry are performing as we provide a ranking for these companies based on various factors such as service features & innovations, scalability, innovation of services, industry coverage, industry reach, and growth roadmap. Based on these factors, we rank the companies into four categories as Active, Cutting Edge, Emerging, and Innovators.

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Reasons to Purchase this Report

We dig deep into the market, using both qual and quant analysis, looking at economic factors and beyond. We'll give you the market value (in USD Billion) for every little slice of the market. Plus, we'll point out which region and segment are set to explode with growth and which ones are already on top. We break down each geographic area, showing you how much of the product/service they're using and what's driving their market. You'll also get a good look at the competitive landscape, including how the big players stack up, their latest product launches, partnerships, expansions, and acquisitions from the last five years. Our company profiles are super detailed – think overview, key insights, product comparisons, and SWOT analysis for all the major players. We'll give you our take on the current and future market outlook, covering recent developments, growth opportunities, drivers, and the challenges in both up-and-coming and established regions. Expect a thorough analysis using Porter's five forces. We'll also give you a peek behind the curtain with a Value Chain analysis. Finally, we present a clear picture of market dynamics, with growth opportunities mapped out for the years ahead, along with 6-month post-sales analyst support.

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