Revenue Cycle Management (RCM) Market By Product (Integrated Solutions, Standalone Solutions), By Deployment (Cloud-Based, On-Premises), By End-Use (Hospitals, Pharmacies), And Region for 2024-2031
Report ID: 80626|No. of Pages: 202
Revenue Cycle Management (RCM) Market By Product (Integrated Solutions, Standalone Solutions), By Deployment (Cloud-Based, On-Premises), By End-Use (Hospitals, Pharmacies), And Region for 2024-2031
Revenue Cycle Management (RCM) Market Valuation – 2024-2031
The demand for enhanced revenue cycle management (RCM) systems is being driven by the growing digitalization of healthcare industry. The growing need for workflow optimization with the implementation of synchronized management software systems will propel market expansion in healthcare companies, surpassing USD 132.17 Billion valued in 2023 to reach a valuation of around USD 306.58 Billion by 2031.
In addition to this, the healthcare organizations, private equity firms, and venture capitalists are providing substantial support to the spike in efforts and investments bolstering digital health, mHealth, and healthcare IT, thus enabling the niche market grow at a CAGR of 11.09% from 2024 to 2031.
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Revenue Cycle Management (RCM) Market: Definition/ Overview
Revenue Cycle Management (RCM) is a comprehensive process that encompasses all the administrative tasks involved in capturing, managing, and collecting healthcare revenue. It ensures that healthcare providers receive appropriate reimbursement for the services they deliver while maintaining compliance with complex regulations and payer requirements.
RCM applications extend across various healthcare settings, including hospitals, clinics, physician practices, and home health agencies. It involves tasks such as patient registration, insurance verification, coding and billing, claims submission and follow-up, and revenue analysis. By streamlining these processes, RCM helps healthcare providers improve their financial performance, enhance patient satisfaction, and maintain regulatory compliance.
The future of RCM is marked by significant advancements in technology and increasing regulatory complexity. Automation, artificial intelligence, and machine learning are transforming the way RCM is performed, enabling more efficient and accurate processes. In addition to this, the growing emphasis on value-based care models and the increasing use of electronic health records (EHRs) will continue to shape the RCM landscape.
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How the Growing Demand for Electronic Health Records (EHRs) in Healthcare Industry Fueling the Development of Global Revenue Cycle Management (RCM) Market?
The increasing adoption of digital healthcare solutions and electronic health records (EHRs) is a major driver for the global revenue cycle management market. Healthcare providers are leveraging advanced technologies to streamline billing processes, reduce errors, and improve cash flow. According to the Office of the National Coordinator for Health Information Technology, as of 2021, 96% of U.S. hospitals have adopted certified EHR systems, indicating a strong foundation for revenue cycle management solutions. This digital transformation has been further accelerated by the COVID-19 pandemic, prompting healthcare organizations to seek more efficient ways to manage their financial operations.
Rising healthcare costs and the need for improved financial performance are propelling the demand for revenue cycle management solutions. Healthcare providers are under pressure to optimize their revenue streams while dealing with complex reimbursement models and changing regulations. The Centers for Medicare & Medicaid Services reported that U.S. national health expenditure grew 9.7% to $4.1 trillion in 2020, highlighting the financial challenges faced by the healthcare sector.
The growing emphasis on value-based care models and the shift from fee-for-service to pay-for-performance reimbursement systems are driving the adoption of sophisticated revenue cycle management solutions. These systems help healthcare providers track and report quality metrics, manage risk-based contracts, and optimize reimbursements. The U.S. Department of Health and Human Services aims to have 100% of Medicare fee-for-service payments tied to quality or value by 2025, underscoring the importance of effective revenue cycle management in this new paradigm.
How the Rising Data Security and Privacy Concerns Hindering the Global Revenue Cycle Management (RCM) Market Growth?
The global Revenue Cycle Management (RCM) Market faces significant challenges in data security and privacy. With the increasing digitization of healthcare records, protecting sensitive patient information has become paramount. According to the U.S. Department of Health and Human Services, there were 599 healthcare data breaches affecting 500 or more records in 2022, exposing over 51 million patient records. This highlights the urgent need for robust cybersecurity measures.
Interoperability remains a persistent hurdle in the RCM landscape. The inability of different healthcare systems to seamlessly exchange and interpret shared data leads to inefficiencies and errors in billing and claims processing. The Office of the National Coordinator for Health Information Technology reported in 2023 that only 55% of hospitals had achieved interoperability across all four domains: sending, receiving, finding, and integrating electronic health information. This gap impedes smooth revenue cycle operations.
The ongoing shortage of skilled RCM professionals poses a significant challenge to the industry. As RCM processes become more complex and technology-driven, there is a growing demand for specialists with both healthcare and technical expertise. The U.S. Bureau of Labor Statistics projects a 7% growth in medical records and health information technician jobs from 2021 to 2031, faster than the average for all occupations. However, this growth may not be sufficient to meet the increasing demand.
Category-Wise Acumens
What are the Features Bolstering the Demand of Integrated Solutions Segment?
The integrated solutions segment has emerged as the dominant force in the global Revenue Cycle Management (RCM) Market, driven by the need for streamlined operations and improved financial outcomes. According to the Centers for Medicare & Medicaid Services (CMS), national health spending is projected to grow at an average annual rate of 5.1% from 2021-2030, reaching nearly $6.8 trillion by 2030, highlighting the increasing complexity of healthcare finances and the need for sophisticated RCM solutions.
A centralized database that unifies information from many systems, including as billing software and electronic health records (EHRs), is provided by integrated RCM solutions. In addition to offering a comprehensive perspective of financial operations that facilitates improved decision-making and the detection of income leaks, this system makes use of AI and machine learning to automate processes like eligibility checks and claims processing, which improves accuracy and lowers errors.
How will the Demand for Cloud-Based Deployment Model Projecting the Market Growth?
The cloud-based segment has emerged as a dominant force in the global Revenue Cycle Management (RCM) Market, driven by their scalability, cost-effectiveness, and ability to enhance operational efficiency. According to the Office of the National Coordinator for Health Information Technology (ONC), as of 2023, 96% of non-federal acute care hospitals have adopted certified health IT, indicating a growing trend towards digital solutions in healthcare management.
Cloud-based RCM platforms are particularly attractive for their ability to integrate with existing healthcare IT systems, provide robust data security, and offer automatic updates without disrupting operations. These advantages are driving widespread adoption across healthcare organizations of all sizes. For instance, on February 8, 2024, Optum, a leading health services company, announced the expansion of its cloud-based RCM platform, which now includes advanced AI-driven predictive analytics for improved claims management and revenue forecasting.
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Country/Region-wise Acumens
How will the Advanced Healthcare Infrastructure Propels the Revenue Cycle Management (RCM) Market Growth in North America?
The North American healthcare Revenue Cycle Management (RCM) Market is poised to dominate the market during the forecast period, driven by advanced healthcare infrastructure and increasing adoption of digital solutions. According to the Centers for Medicare & Medicaid Services (CMS), U.S. national health expenditure is projected to reach $6.8 trillion by 2030, growing at an average annual rate of 5.1% from 2021 to 2030. This significant healthcare spending emphasizes the crucial need for efficient RCM solutions to optimize revenue streams and reduce administrative burdens on healthcare providers.
Key players in the North American RCM market continue to innovate and expand their offerings. For instance, on February 8, 2024, Waystar, a leading provider of healthcare payments software, announced its acquisition of ABILITY Network from Inovalon Holdings for $1.7 billion. This strategic move is expected to enhance capabilities of Waystar in claims management, eligibility verification, and payment processing, further solidifying its position in the RCM sector.
How will the Rising Digital Networks and Services Supports the Market Growth in the Europe?
The European Revenue Cycle Management (RCM) Market is anticipated to grow at a rapid CAGR during the forecast period. The European Commission’s Digital Single Market Strategy makes it easier for businesses and consumers to access online goods and services across the continent, fostering the growth potential of the European economy and fostering the development of digital networks and services.
One of the biggest healthcare markets in Europe is the revenue cycle management business in Germany. The large hospital population in Germany is a major contributor to the market expansion in this country. Furthermore, the German healthcare delivery system is well-organized and effective. Approximately 85% of Germans are insured by Social Health Insurance (SHI), and 10% have alternative private health insurance, according to the Commonwealth Fund.
Competitive Landscape
The global Revenue Cycle Management (RCM) Market is a dynamic and competitive landscape, with a mix of established players and emerging challengers vying for market share. These players are actively working to strengthen their presence by implementing strategic plans such as collaborations, mergers, acquisitions, and political support. The organizations are dedicated to continuously improving their product line to meet the needs of a wide range of customers in different regions.
Some of the key players operating in the global Revenue Cycle Management (RCM) Market include:
The SSI Group, Inc., Veradigm LLC (AllScripts Healthcare, LLC), Athenahealth, Inc., Experian Information Solutions, Inc., R1 RCM Inc., Epic Systems Corporation, McKesson Corporation, NXGN Management, LLC, CareCloud Corporation, Quest Diagnostics, Inc., Oracle (Cerner Corporation).
Latest Developments
- On January 2024, R1 RCM Inc. purchased Acclara from Providence, a provider of health systems. The purpose of this acquisition is to expand the market for R1 RCM Inc., provide the firm with cutting-edge technological solutions, and improve execution, all of which will lead to better patient and customer outcomes.
- On July 2023, TELCOR released TELCOR RCM version 21.3. Expanded usage of online application programming interfaces (APIs) and Report Designer, an Executive Module to boost laboratory output and collections, are features of the updated edition.
- On June 2022, R1 RCM Inc. purchased Cloudmed in order to create a top platform for revenue cycle management (RCM) for healthcare providers and to accelerate digital transformation using automation and artificial intelligence.
Report Scope
| Report Attributes | Details |
|---|---|
| Study Period | 2018-2031 |
| Growth Rate | CAGR of ~11.09% from 2024 to 2031 |
| Base Year for Valuation | 2023 |
| Historical Period | 2018-2022 |
| Forecast Period | 2024-2031 |
| Quantitative Units | Value in USD Billion |
| Report Coverage | Historical and Forecast Revenue Forecast, Historical and Forecast Volume, Growth Factors, Trends, Competitive Landscape, Key Players, Segmentation Analysis |
| Segments Covered |
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| Regions Covered |
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| Key Players |
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| Customization | Report customization along with purchase available upon request |
Revenue Cycle Management (RCM) Market, By Category
Product:
- Integrated Solutions
- Standalone Solutions
Deployment:
- Cloud-Based
- On-Premises
End-Use:
- Hospitals
- Ambulatory Surgical Centers
- Long-Term Care Facilities
- Clinics
- Physician Offices
- Diagnostic Laboratories
- Pharmacies
Region:
- North America
- Europe
- Asia Pacific
- Latin America
- Middle East & Africa
Research Methodology of Verified Market Research:
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Reasons to Purchase this Report
• Qualitative and quantitative analysis of the market based on segmentation involving both economic as well as non-economic factors
• Provision of market value (USD Billion) data for each segment and sub-segment
• Indicates the region and segment that is expected to witness the fastest growth as well as to dominate the market
• Analysis by geography highlighting the consumption of the product/service in the region as well as indicating the factors that are affecting the market within each region
• Competitive landscape which incorporates the market ranking of the major players, along with new service/product launches, partnerships, business expansions, and acquisitions in the past five years of companies profiled
• Extensive company profiles comprising of company overview, company insights, product benchmarking, and SWOT analysis for the major market players
• The current as well as the future market outlook of the industry with respect to recent developments which involve growth opportunities and drivers as well as challenges and restraints of both emerging as well as developed regions
• Includes in-depth analysis of the market of various perspectives through Porter’s five forces analysis
• Provides insight into the market through Value Chain
• Market dynamics scenario, along with growth opportunities of the market in the years to come
• 6-month post-sales analyst support
Customization of the Report
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Frequently Asked Questions
1 INTRODUCTION OF GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET
1.1 Overview of the Market
1.2 Scope of Report
1.3 Assumptions
2 EXECUTIVE SUMMARY
3 RESEARCH METHODOLOGY OF VERIFIED MARKET RESEARCH
3.1 Data Mining
3.2 Validation
3.3 Primary Interviews
3.4 List of Data Sources
4 GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET OUTLOOK
4.1 Overview
4.2 Market Dynamics
4.2.1 Drivers
4.2.2 Restraints
4.2.3 Opportunities
4.3 Porters Five Force Model
4.4 Value Chain Analysis
5 GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET, BY PRODUCT
5.1 Overview
5.2 Integrated Solutions
5.3 Standalone Solutions
6 GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET, BY DEPLOYMENT
6.1 Overview
6.2 Cloud-Based
6.3 On-Premises
7 GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET, BY END-USE
7.1 Overview
7.2 Hospitals
7.3 Ambulatory Surgical Centers
7.4 Long-Term Care Facilities
7.5 Clinics
7.6 Physician Offices
7.7 Diagnostic Laboratories
7.8 Pharmacies
8 GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET, BY GEOGRAPHY
8.1 Overview
8.2 North America
8.2.1 U.S.
8.2.2 Canada
8.2.3 Mexico
8.3 Europe
8.3.1 Germany
8.3.2 U.K.
8.3.3 France
8.3.4 Rest of Europe
8.4 Asia Pacific
8.4.1 China
8.4.2 Japan
8.4.3 India
8.4.4 Rest of Asia Pacific
8.5 Rest of the World
8.5.1 Latin America
8.5.2 Middle East and Africa
9 GLOBAL REVENUE CYCLE MANAGEMENT (RCM) MARKET COMPETITIVE LANDSCAPE
9.1 Overview
9.2 Company Market Ranking
9.3 Key Development Strategies
10 COMPANY PROFILES
10.1 The SSI Group, Inc.
10.1.1 Overview
10.1.2 Financial Performance
10.1.3 Product Outlook
10.1.4 Key Developments
10.2 Veradigm LLC (AllScripts Healthcare, LLC)
10.2.1 Overview
10.2.2 Financial Performance
10.2.3 Product Outlook
10.2.4 Key Developments
10.3 Athenahealth, Inc.
10.3.1 Overview
10.3.2 Financial Performance
10.3.3 Product Outlook
10.3.4 Key Developments
10.4 Experian Information Solutions, Inc.
10.4.1 Overview
10.4.2 Financial Performance
10.4.3 Product Outlook
10.4.4 Key Developments
10.5 R1 RCM Inc.
10.5.1 Overview
10.5.2 Financial Performance
10.5.3 Product Outlook
10.5.4 Key Developments
10.6 Epic Systems Corporation
10.6.1 Overview
10.6.2 Financial Performance
10.6.3 Product Outlook
10.6.4 Key Developments
10.7 McKesson Corporation
10.7.1 Overview
10.7.2 Financial Performance
10.7.3 Product Outlook
10.7.4 Key Developments
10.8 NXGN Management, LLC
10.8.1 Overview
10.8.2 Financial Performance
10.8.3 Product Outlook
10.8.4 Key Developments
10.9 CareCloud Corporation
10.9.1 Overview
10.9.2 Financial Performance
10.9.3 Product Outlook
10.9.4 Key Developments
10.10 Quest Diagnostics, Inc.
10.10.1 Overview
10.10.2 Financial Performance
10.10.3 Product Outlook
10.10.4 Key Developments
11 KEY DEVELOPMENTS
11.1 Product Launches/Developments
11.2 Mergers and Acquisitions
11.3 Business Expansions
11.4 Partnerships and Collaborations
12 Appendix
12.1 Related Research
Report Research Methodology
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This additionally supports the market researchers in segmenting different segments of the market for analysing them individually.
We appoint data triangulation strategies to explore different areas of the market. This way, we ensure that all our clients get reliable insights associated with the market. Different elements of research methodology appointed by our experts include:
Exploratory data mining
Market is filled with data. All the data is collected in raw format that undergoes a strict filtering system to ensure that only the required data is left behind. The leftover data is properly validated and its authenticity (of source) is checked before using it further. We also collect and mix the data from our previous market research reports.
All the previous reports are stored in our large in-house data repository. Also, the experts gather reliable information from the paid databases.
For understanding the entire market landscape, we need to get details about the past and ongoing trends also. To achieve this, we collect data from different members of the market (distributors and suppliers) along with government websites.
Last piece of the ‘market research’ puzzle is done by going through the data collected from questionnaires, journals and surveys. VMR analysts also give emphasis to different industry dynamics such as market drivers, restraints and monetary trends. As a result, the final set of collected data is a combination of different forms of raw statistics. All of this data is carved into usable information by putting it through authentication procedures and by using best in-class cross-validation techniques.
Data Collection Matrix
| Perspective | Primary Research | Secondary Research |
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Econometrics and data visualization model
Our analysts offer market evaluations and forecasts using the industry-first simulation models. They utilize the BI-enabled dashboard to deliver real-time market statistics. With the help of embedded analytics, the clients can get details associated with brand analysis. They can also use the online reporting software to understand the different key performance indicators.
All the research models are customized to the prerequisites shared by the global clients.
The collected data includes market dynamics, technology landscape, application development and pricing trends. All of this is fed to the research model which then churns out the relevant data for market study.
Our market research experts offer both short-term (econometric models) and long-term analysis (technology market model) of the market in the same report. This way, the clients can achieve all their goals along with jumping on the emerging opportunities. Technological advancements, new product launches and money flow of the market is compared in different cases to showcase their impacts over the forecasted period.
Analysts use correlation, regression and time series analysis to deliver reliable business insights. Our experienced team of professionals diffuse the technology landscape, regulatory frameworks, economic outlook and business principles to share the details of external factors on the market under investigation.
Different demographics are analyzed individually to give appropriate details about the market. After this, all the region-wise data is joined together to serve the clients with glo-cal perspective. We ensure that all the data is accurate and all the actionable recommendations can be achieved in record time. We work with our clients in every step of the work, from exploring the market to implementing business plans. We largely focus on the following parameters for forecasting about the market under lens:
- Market drivers and restraints, along with their current and expected impact
- Raw material scenario and supply v/s price trends
- Regulatory scenario and expected developments
- Current capacity and expected capacity additions up to 2027
We assign different weights to the above parameters. This way, we are empowered to quantify their impact on the market’s momentum. Further, it helps us in delivering the evidence related to market growth rates.
Primary validation
The last step of the report making revolves around forecasting of the market. Exhaustive interviews of the industry experts and decision makers of the esteemed organizations are taken to validate the findings of our experts.
The assumptions that are made to obtain the statistics and data elements are cross-checked by interviewing managers over F2F discussions as well as over phone calls.
Different members of the market’s value chain such as suppliers, distributors, vendors and end consumers are also approached to deliver an unbiased market picture. All the interviews are conducted across the globe. There is no language barrier due to our experienced and multi-lingual team of professionals. Interviews have the capability to offer critical insights about the market. Current business scenarios and future market expectations escalate the quality of our five-star rated market research reports. Our highly trained team use the primary research with Key Industry Participants (KIPs) for validating the market forecasts:
- Established market players
- Raw data suppliers
- Network participants such as distributors
- End consumers
The aims of doing primary research are:
- Verifying the collected data in terms of accuracy and reliability.
- To understand the ongoing market trends and to foresee the future market growth patterns.
Industry Analysis Matrix
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