The U.S. medical billing outsourcing market size is expected to reach USD 12.3 billion by 2030, registering a CAGR of 11.78% from 2024 to 2030, according to the report. Increasing complexity in health reimbursement and high chances of claim denials are expected to drive market growth. The growing burden of the patient pool, patient data, and claims volumes during and after the pandemic forced the hospital industry to outsource services. This is expected to propel market growth during the forecast period.
The challenges faced by in-house billing services during the pandemic increased the need for an alternative, such as outsourcing services. The challenge mounts when the billing process necessitates adherence to the ICD-11 code and dealing with declining reimbursements and rising healthcare costs. Several healthcare providers such as acute care hospitals and clinics/physician offices prefer outsourcing their billing processes to curb or eliminate these challenges.
The healthcare companies are expanding their product offerings to relieve the burden of claims and reimbursement processes. For instance, in April 2023, Concierge Diagnostics Inc., a mobile diagnostic imaging company in South Florida, added medical billing and consulting services to its portfolio of over 100 referral partners. The aim is to enhance revenue and minimize claim denial while reducing costs for physician practices.
Acceptance of revenue cycle management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing medical billing services include improvement in billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.
The COVID-19 pandemic drastically impacted the market. Reduction in hospital revenue and patient volumes slowed down market growth. New billing and telehealth codes were introduced during the pandemic. Growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. Medical billing providers have spent significant amounts on resources and technology, which can be utilized by healthcare providers after outsourcing the billing process.
The challenges faced by in-house billing services during the pandemic increased the need for an alternative, such as outsourcing services. The challenge mounts when the billing process necessitates adherence to the ICD-11 code and dealing with declining reimbursements and rising healthcare costs. Several healthcare providers such as acute care hospitals and clinics/physician offices prefer outsourcing their billing processes to curb or eliminate these challenges.
The healthcare companies are expanding their product offerings to relieve the burden of claims and reimbursement processes. For instance, in April 2023, Concierge Diagnostics Inc., a mobile diagnostic imaging company in South Florida, added medical billing and consulting services to its portfolio of over 100 referral partners. The aim is to enhance revenue and minimize claim denial while reducing costs for physician practices.
Acceptance of revenue cycle management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing medical billing services include improvement in billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.
The COVID-19 pandemic drastically impacted the market. Reduction in hospital revenue and patient volumes slowed down market growth. New billing and telehealth codes were introduced during the pandemic. Growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. Medical billing providers have spent significant amounts on resources and technology, which can be utilized by healthcare providers after outsourcing the billing process.
U.S. Medical Billing Outsourcing Market Report Highlights
- Based on component, the outsourced segment held the largest revenue share of over 57% in 2023 and is expected to register the fastest growth, owing to a growing focus on minimizing the cost of healthcare delivery and improving the patient and physician relationship
- Based on service, the front-end services segment dominated the market with a revenue share of over 38% in 2023, as these services increase downstream cash flow and decrease rework and cost to collect
- The middle-end services segment is expected to register the fastest CAGR during the forecast period. This is attributed to growing awareness about billing outsourcing among healthcare practitioners and rising adoption of middle-end services among them
- Based on end-use, the hospital segment accounted for the largest revenue share of over 46% in 2023 owing to high claim volumes and rising patient burden. In addition, errorless procedures and minimization of loss due to denial of payments are benefits associated with medical billing outsourcing, which leads to rising adoption in multispecialty hospitals
Table of Contents
Chapter 1. Methodology and Scope
Chapter 2. Executive Summary
Chapter 3. Market Variables, Trends, & Scope
Chapter 4. U.S. Medical Billing Outsourcing Market: Component Estimates & Trend Analysis
Chapter 5. U.S. Medical Billing Outsourcing Market: Services Estimates & Trend Analysis
Chapter 6. U.S. Medical Billing Outsourcing Market: End-use Estimates & Trend Analysis
Chapter 7. Competitive Landscape
List of Tables
List of Figures
Companies Profiled
- R1 RCM, Inc.
- Veradigm LLC (Allscripts Healthcare, LLC)
- Oracle (Cerner Corporation)
- McKesson Corporation
- eClinicalWorks
- Kareo, Inc.
- Promantra Inc.
- AdvancedMD, Inc.
- Quest Diagnostics
Methodology
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Table Information
| Report Attribute | Details |
|---|---|
| No. of Pages | 90 |
| Published | November 2023 |
| Forecast Period | 2023 - 2030 |
| Estimated Market Value ( USD | $ 5.7 Billion |
| Forecasted Market Value ( USD | $ 12.3 Billion |
| Compound Annual Growth Rate | 11.7% |
| Regions Covered | United States |
| No. of Companies Mentioned | 9 |
