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U.S. Revenue Cycle Management Market Size, Share & Trends Analysis Report by End-use, Product Type, Component, Delivery Mode, Physician Specialty, Sourcing, Function, and Segment Forecasts, 2024-2030

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    Report

  • 100 Pages
  • May 2024
  • Region: United States
  • Grand View Research
  • ID: 5415544
Description Jump to:
The U.S. revenue cycle management market size is expected to reach USD 308.12 billion by 2030, growing at a CAGR of 10.18% over the forecast period. The rapidly transforming healthcare system and adoption of digitalization are paving a path for implementing healthcare IT services such as Revenue Cycle Management (RCM) systems to organize and streamline workflows of healthcare organizations using synchronized management software solutions.

Moreover, healthcare systems in the U.S. are experiencing substantial changes with the adoption of electronic procedures for managing claims and reimbursements. The presence of numerous distinguished healthcare establishments, rising healthcare consciousness & expenditure, and increasing digital literacy are anticipated to boost market growth. Supportive regulatory alterations from government bodies and consistent technological advancements by market stakeholders are projected to further propel growth. The growing need for ongoing technological advancements is compelling the participants to revise their product development approaches to enhance the provider-patient connection within healthcare institutions. Key stakeholders are concentrating on alliances, acquisitions, and strategic collaborations with other industry participants to merge expertise & expand their market presence.

In January 2024, Veradigm LLC announced the acquisition of Koha Health, a full-service RCM provider. The acquisition added further expertise in the Musculoskeletal Medicine (MSK) specialty to the Veradigm Network while also strengthening its capacity to provide revenue cycle services to Ambulatory Surgical Centers (ASCs) and ambulatory healthcare provider practices that use diverse Electronic Health Record (EHR) systems. Veradigm is enhancing its comprehensive revenue cycle services range to offer better value to clients and tap into additional growth opportunities.

U.S. Revenue Cycle Management Market Report Highlights

  • On the basis of product type, the integrated system spearheaded the market in 2023 due to the growing demand from healthcare organizations for a synchronized single platform to manage financial activities.
  • On the basis of delivery mode, the web-based delivery mode segment dominated the market in 2023 due to the cost-effectiveness and rapid deployment of these solutions.
  • On the basis of end-use, the hospitals end-use segment led the market in 2023 due to the presence of well-established hospitals and growing healthcare IT infrastructure.
  • The others physician specialty segment dominated the market in 2023 due to increase in insurance coverage for other healthcare services.
  • The claim management segment led the market in 2023 in the function segment due to the increasing patient volume and the presence of ineffective claim management systems.
  • In September 2022, AGS Health introduced a connected solution that blends automation and Artificial Intelligence (AI) called AGS AI Platform. This solution aims to deliver seamless integration and robust process automation to ease labor shortages and allow flexible, scalable growth.

Table of Contents

Chapter 1. Methodology and Scope
1.1. Market Segmentation & Scope
1.1.1. Segment Definitions
1.2. Estimates and Forecast Timeline
1.3. Research Methodology
1.4. Information Procurement
1.4.1. Purchased Database
1.4.2. Internal Database
1.4.3. Secondary Sources
1.4.4. Primary Research
1.4.5. Details of Primary Research
1.4.6. Research Assumption
1.5. Information or Data Analysis
1.5.1. Data Analysis Models
1.6. Market Formulation & Data Visualization
1.7. Model Details
1.7.1. Commodity Flow Analysis
1.8. Objectives
1.9. List of Secondary Sources
1.10. List of Secondary Sources
Chapter 2. Executive Summary
2.1. U.S. Revenue Cycle Management Market
2.1.1. Market Snapshot
2.1.2. Segment Snapshot
2.1.2.1. End-user & Product Type Segment Outlook
2.1.2.2. Component & Delivery Mode Segment Outlook
2.1.2.3. Physician Specialty & Sourcing Segment Outlook
2.1.2.4. Function Segment Outlook
2.1.3. Competitive Landscape Snapshot
Chapter 3. Market Variables, Trends, & Scope
3.1. Market Lineage Outlook
3.1.1. Parent Market Outlook
3.1.2. Related/Ancillary Market Outlook
3.2. Market Trends and Outlook
3.3. Market Dynamics
3.3.1. Market Driver Analysis
3.3.1.1. Technological Advancements
3.3.1.2. Increase in Outsourcing of RCM
3.3.1.3. Increasing Adoption of MHealth
3.3.1.4. Growth of High-deductible Health Plans (HDHPs)
3.3.2. Market Restraint Analysis
3.3.2.1. Increasing Payer Partnerships
3.3.2.2. Lack of Professionals to Handle RCM Processes
3.4. Regulatory Scenario & Reimbursement Outlook
3.4.1. Regulatory Scenario
3.4.2. Reimbursement Framework
3.5. Business Environment Analysis Tools
3.5.1. Industry Analysis - Porter’s Five Forces Analysis
3.5.1.1. Supplier Power
3.5.1.2. Buyer Power
3.5.1.3. Substitution Threat
3.5.1.4. Threat of New Entrant
3.5.1.5. Competitive Rivalry
3.5.2. PESTEL Analysis
Chapter 4. Product Type Business Analysis
4.1. U.S. Revenue Cycle Management Market: Product Type Movement Analysis
4.2. U.S. Revenue Cycle Management Market: Product Type Segment Dashboard
4.3. Product Type Movement & Market Share Analysis, 2023 & 2030
4.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Product Type
4.5. Integrated System
4.5.1. Integrated System Market, 2018-2030 (USD Billion)
4.6. Standalone System
4.6.1. Standalone System Market, 2018-2030 (USD Billion)
Chapter 5. Component Business Analysis
5.1. U.S. Revenue Cycle Management Market: Component Movement Analysis
5.2. U.S. Revenue Cycle Management Market: Component Segment Dashboard
5.3. Component Movement & Market Share Analysis, 2023 & 2030
5.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Component
5.5. Software Solution
5.5.1. Software Solution Market, 2018-2030 (USD Billion)
5.6. Services
5.6.1. Services Market, 2018-2030 (USD Billion)
Chapter 6. Delivery Mode Business Analysis
6.1. U.S. Revenue Cycle Management Market: Delivery Mode Movement Analysis
6.2. U.S. Revenue Cycle Management Market: Delivery Mode Segment Dashboard
6.3. Delivery Mode Movement & Market Share Analysis, 2023 & 2030
6.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Delivery Mode
6.5. On-premise
6.5.1. On-Premise Market, 2018-2030 (USD Billion)
6.6. Web-based
6.6.1. Web-based Market, 2018-2030 (USD Billion)
6.7. Cloud-based
6.7.1. Cloud-based Market, 2018-2030 (USD Billion)
Chapter 7. Physician Specialty Business Analysis
7.1. U.S. Revenue Cycle Management Market: Physician Specialty Movement Analysis
7.2. U.S. Revenue Cycle Management Market: Physician Specialty Segment Dashboard
7.3. Physician Specialty Movement & Market Share Analysis, 2023 & 2030
7.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Physician Specialty
7.5. Oncology
7.5.1. Oncology Market, 2018-2030 (USD Billion)
7.6. Cardiology
7.6.1. Cardiology Market, 2018-2030 (USD Billion)
7.7. Anesthesia
7.7.1. Anesthesia Market, 2018-2030 (USD Billion)
7.8. Radiology
7.8.1. Radiology Market, 2018-2030 (USD Billion)
7.9. Pathology
7.9.1. Pathology Market, 2018-2030 (USD Billion)
7.10. Pain Management
7.10.1. Pain Management Market, 2018-2030 (USD Billion)
7.11. Emergency Services
7.11.1. Emergency Services Market, 2018-2030 (USD Billion)
7.12. Others
7.12.1. Others Market, 2018-2030 (USD Billion)
Chapter 8. Sourcing Business Analysis
8.1. U.S. Revenue Cycle Management Market: Sourcing Movement Analysis
8.2. U.S. Revenue Cycle Management Market: Sourcing Segment Dashboard
8.3. Sourcing Movement & Market Share Analysis, 2023 & 2030
8.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Sourcing
8.5. In-house
8.5.1. In-house Market, 2018-2030 (USD Billion)
8.6. External RCM Apps/Software
8.6.1. External RCM Apps/Software Market, 2018-2030 (USD Billion)
8.7. Outsourced RCM Services
8.7.1. Outsourced RCM Services Market, 2018-2030 (USD Billion)
Chapter 9. Function Business Analysis
9.1. U.S. Revenue Cycle Management Market: Function Movement Analysis
9.2. U.S. Revenue Cycle Management Market: Function Segment Dashboard
9.3. Function Movement & Market Share Analysis, 2023 & 2030
9.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Function
9.5. Product Development
9.5.1. Product Development Market, 2018-2030 (USD Billion)
9.6. Product Development
9.6.1. Product Development Market, 2018-2030 (USD Billion)
9.7. Member Engagement
9.7.1. Member Engagement Market, 2018-2030 (USD Billion)
9.8. Network Management
9.8.1. Network Management Market, 2018-2030 (USD Billion)
9.9. Care Management
9.9.1. Care Management Market, 2018-2030 (USD Billion)
9.10. Claim Management
9.10.1. Claim Management Market, 2018-2030 (USD Billion)
9.11. Risk and Compliances
9.11.1. Risk and Compliances Market, 2018-2030 (USD Billion)
Chapter 10. End-User Business Analysis
10.1. U.S. Revenue Cycle Management Market: End-User Movement Analysis
10.2. U.S. Revenue Cycle Management Market: End-User Segment Dashboard
10.3. End-User Movement & Market Share Analysis, 2023 & 2030
10.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by End Use
10.5. Hospitals
10.5.1. Hospitals Market, 2018-2030 (USD Billion)
10.6. Physician & Clinical Services
10.6.1. Physician & Clinical Services Market, 2018-2030 (USD Billion)
Chapter 11. Competitive Landscape
11.1. Company Categorization
11.2. Company Market Position Analysis
11.3. Strategy Mapping
11.3.1. Partnership/Collaboration/Alliance
11.3.2. New Product Launch
11.3.3. Mergers & Acquisitions
11.3.4. Others
11.4. Company Profiles/Listing
11.4.1. Athenahealth, Inc.
11.4.1.1. Overview
11.4.1.2. Financial Performance
11.4.1.3. Product Benchmarking
11.4.1.4. Strategic Initiatives
11.4.2. Cerner Corporation
11.4.2.1. Overview
11.4.2.2. Financial Performance
11.4.2.3. Product Benchmarking
11.4.2.4. Strategic Initiatives
11.4.3. EClinicalWorks
11.4.3.1. Overview
11.4.3.2. Financial Performance
11.4.3.3. Product Benchmarking
11.4.3.4. Strategic Initiatives
11.4.4. Epic Systems Corporation
11.4.4.1. Overview
11.4.4.2. Financial Performance
11.4.4.3. Product Benchmarking
11.4.4.4. Strategic Initiatives
11.4.5. McKesson Corporation
11.4.5.1. Overview
11.4.5.2. Financial Performance
11.4.5.3. Product Benchmarking
11.4.5.4. Strategic Initiatives
11.4.6. NXGN Management, LLC
11.4.6.1. Overview
11.4.6.2. Financial Performance
11.4.6.3. Product Benchmarking
11.4.6.4. Strategic Initiatives
11.4.7. Oncospark, Inc.
11.4.7.1. Overview
11.4.7.2. Financial Performance
11.4.7.3. Product Benchmarking
11.4.7.4. Strategic Initiatives
11.4.8. R1 RCM, Inc.
11.4.8.1. Overview
11.4.8.2. Financial Performance
11.4.8.3. Product Benchmarking
11.4.8.4. Strategic Initiatives
11.4.9. The SSI Group, Inc.
11.4.9.1. Overview
11.4.9.2. Financial Performance
11.4.9.3. Product Benchmarking
11.4.9.4. Strategic Initiatives
11.4.10. Veradigm LLC (Allscripts Healthcare LLC)
11.4.10.1. Overview
11.4.10.2. Financial Performance
11.4.10.3. Product Benchmarking
11.4.10.4. Strategic Initiatives
List of Tables
Table 1 List of Secondary Sources
Table 2 List of Abbreviations
Table 3 U.S. Revenue Cycle Management Market, by Product Type, 2018-2030 (USD Million)
Table 4 U.S. Revenue Cycle Management Market, by Component, 2018-2030 (USD Million)
Table 5 U.S. Revenue Cycle Management Market, by Delivery Mode, 2018-2030 (USD Million)
Table 6 U.S. Revenue Cycle Management Market, by Physician Specialty, 2018-2030 (USD Billion)
Table 7 U.S. Revenue Cycle Management Market, by Sourcing, 2018-2030 (USD Billion)
Table 8 U.S. Revenue Cycle Management Market, by Function, 2018-2030 (USD Billion)
Table 9 U.S. Revenue Cycle Management Market, by End Use, 2018-2030 (USD Billion)
List of Figures
Figure 1 U.S. Revenue Cycle Management Market Segmentation
Figure 2 Market Research Process
Figure 3 Information Procurement
Figure 4 Primary Research Pattern
Figure 5 Market Research Approaches
Figure 6 Value-chain-based Sizing & Forecasting
Figure 7 QFD Modeling for Market Share Assessment
Figure 8 Market Formulation & Validation
Figure 9 Market Snapshot
Figure 10 Segment Outlook
Figure 11 Segment Outlook
Figure 12 Competitive Scenario
Figure 13 U.S. Revenue Cycle Management Market Trends & Outlook
Figure 14 Market Driver Relevance Analysis (Current & Future Impact)
Figure 15 Market Restraint Relevance Analysis (Current & Future Impact)
Figure 16 U.S. Revenue Cycle Management Market: Porter’s Five Forces Analysis
Figure 17 U.S. Revenue Cycle Management Market: PESTLE Analysis
Figure 18 U.S. Revenue Cycle Management Market: Product Type Segment Dashboard
Figure 19 U.S. Revenue Cycle Management Market: By Product Type: Market Share Analysis, 2023 & 2030
Figure 20 Integrated Market, 2018-2030 (USD Billion)
Figure 21 Standalone Market, 2018-2030 (USD Billion)
Figure 22 U.S. Revenue Cycle Management Market: Component Segment Dashboard
Figure 23 U.S. Revenue Cycle Management Market: By Component: Market Share Analysis, 2023 & 2030
Figure 24 Software Market, 2018-2030 (USD Billion)
Figure 25 Services Market, 2018-2030 (USD Billion)
Figure 26 U.S. Revenue Cycle Management Market: Delivery Mode Segment Dashboard
Figure 27 U.S. Revenue Cycle Management Market: By Delivery Mode: Market Share Analysis, 2023 & 2030
Figure 28 on Premise Market, 2018-2030 (USD Billion)
Figure 29 Web Based Market, 2018-2030 (USD Billion)
Figure 30 Cloud Based Market, 2018-2030 (USD Billion)
Figure 31 U.S. Revenue Cycle Management Market: Physician Specialty Segment Dashboard
Figure 32 U.S. Revenue Cycle Management Market: By Physician Specialty: Market Share Analysis, 2023 & 2030
Figure 33 Oncology Market, 2018-2030 (USD Billion)
Figure 34 Cardiology Market, 2018-2030 (USD Billion)
Figure 35 Anesthesia Market, 2018-2030 (USD Billion)
Figure 36 Radiology Market, 2018-2030 (USD Billion)
Figure 37 Pathology Market, 2018-2030 (USD Billion)
Figure 38 Pain Management Market, 2018-2030 (USD Billion)
Figure 39 Emergency Services Market, 2018-2030 (USD Billion)
Figure 40 Others Market, 2018-2030 (USD Billion)
Figure 41 U.S. Revenue Cycle Management Market: Sourcing Segment Dashboard
Figure 42 U.S. Revenue Cycle Management Market: By Sourcing: Market Share Analysis, 2023 & 2030
Figure 43 in-house Market, 2018-2030 (USD Billion)
Figure 44 External RCM Apps/Software Market, 2018-2030 (USD Billion)
Figure 45 Outsourced RCM Services Market, 2018-2030 (USD Billion)
Figure 46 U.S. Revenue Cycle Management Market: Function Segment Dashboard
Figure 47 U.S. Revenue Cycle Management Market: By Function: Market Share Analysis, 2023 & 2030
Figure 48 Product Development Market, 2018-2030 (USD Billion)
Figure 49 Member Engagement Market, 2018-2030 (USD Billion)
Figure 50 Network Management Market, 2018-2030 (USD Billion)
Figure 51 Care Management Market, 2018-2030 (USD Billion)
Figure 52 Claims Management Market, 2018-2030 (USD Billion)
Figure 53 Risk and Compliance Market, 2018-2030 (USD Billion)
Figure 54 U.S. Revenue Cycle Management Market: End-user Segment Dashboard
Figure 55 U.S. Revenue Cycle Management Market: By End-user: Market Share Analysis, 2023 & 2030
Figure 56 Hospitals Market, 2018-2030 (USD Billion)
Figure 57 Physician and Clinical Services Market, 2018-2030 (USD Billion)
Figure 58 Competition Categorization
Figure 59 Company Market Position Analysis
Figure 60 Strategy Mapping

Companies Mentioned

  • athenahealth, Inc.
  • Cerner Corporation
  • eClinicalWorks
  • Epic Systems Corporation
  • McKesson Corporation
  • NXGN Management, LLC
  • Oncospark, Inc.
  • R1 RCM, Inc.
  • The SSI Group, Inc.
  • Veradigm LLC (Allscripts Healthcare LLC)

Methodology

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Table Information

Report AttributeDetails
No. of Pages100
PublishedMay 2024
Forecast Period2023 - 2030
Estimated Market Value ( USD ) in 2023 $ 155.59 Billion
Forecasted Market Value ( USD ) by 2030 $ 308.12 Billion
Compound Annual Growth Rate10.1%
Regions CoveredUnited States
No. of Companies Mentioned10

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About the Revenue Cycle Management Market

Revenue Cycle Management (RCM) is a term used to describe the process of managing the financial aspects of a hospital's operations. It includes activities such as patient registration, billing, collections, and payment processing. RCM is an important part of hospital management, as it helps to ensure that the hospital is able to generate revenue and remain financially viable. RCM involves a number of different processes, such as patient registration, coding, billing, collections, and payment processing. It also includes activities such as claims management, accounts receivable management, and financial reporting. RCM is a complex process that requires a high level of accuracy and efficiency. Some of the companies in the RCM market include Cerner Corporation, Allscripts, McKesson Corporation, Epic Systems Corporation, and Athenahealth. These companies provide a range of services, such as software solutions, consulting services, and training. They also offer a variety of products, such as electronic health records, billing systems, and analytics tools. Show Less Read more

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