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Medical Billing Outsourcing Market Size, Share & Trends Analysis Report by Component (In-house, Outsourced), by Service (Front End, Middle End, Back End), by End-use, by Region, and Segment Forecasts, 2021-2028

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    Report

  • 108 Pages
  • April 2021
  • Region: Global
  • Grand View Research
  • ID: 4761220
Description Jump to:
The global medical billing outsourcing market size is projected to reach USD 25.3 billion by 2028. The market is expected to expand at a CAGR of 12.3% from 2021 to 2028. A large amount of clinical code representation for diagnosis and treatment coupled with the presence of multiple payers renders medical billing an intricate part of any clinical practice, posing significant challenges. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to obligatory implementation of complex ICD-11 coding systems, increasing healthcare costs, and a federal mandate to implement Electronic Medical Records (EMR) to maintain reimbursement levels.

The COVID-19 pandemic has negatively affected the market. Though, the healthcare industry was trailing in embracing innovative and digital technologies to improve healthcare. The COVID-19 scenario has put an enormous burden on healthcare providers/organizations to become accustomed to the change. The recovery from the financial impact of the coronavirus pandemic could take a long time. Thus, players operating in the market need to create new policies/strategies powered by telemedicine solutions and patient-centric collections to rise above the challenges of COVID-19.

Furthermore, clinics/physician offices are gradually outsourcing their revenue management to cut unnecessary costs and prevent the burden of managing an administrative team to ensure effective handling of in-house billing functions. In addition, multispecialty healthcare groups are implementing consolidation requiring EHR integration and building large healthcare networks. This integration creates a need for revenue cycle management (RCM), which, in turn, demands additional expertise and trained personnel to manage the same. Thus, the consolidation of large healthcare practices is also expected to be one of the factors fueling the market growth.

Medical Billing Outsourcing Market Report Highlights

  • The outsourced segment accounted for the largest revenue share in 2020 and is expected to witness a high CAGR attributed to the rising preference of hospitals, physician office, and startups opting for outsourced medical billing services for hassle-free claim management at low cost
  • The front-end services segment led the market in 2020. However, the middle-end services segment is expected to register the highest CAGR over the forecast period due to the growing demand for Revenue Cycle Management (RCM) services offering Electronic Health Records (EHR) software
  • Hospitals, possessing higher claim volumes, accounted for the largest revenue share in the market in 2020 and is estimated to maintain the dominance even during the forecast years
  • North America held the largest revenue share in 2020. It is projected to expand further as U.S. has witnessed a change in the healthcare system with the introduction of ICD-11 coding in 2019 and pressure from the government to incorporate the Electronic Medical Record (EMR) management system
  • Medical billing and Revenue Cycle Management (RCM) companies such as Athenahealth, are offering successful implementation of EMR at the practice level and are expected to transform the market

Table of Contents

Chapter 1 Methodology and Scope
1.1 Market Segmentation & Scope
1.1.1 Estimates and Forecast Timeline
1.2 Research Methodology
1.3 Information procurement
1.3.1 Purchased Database
1.3.2 Internal Database
1.3.3 Secondary Sources
1.3.4 Primary research
1.4 Information or Data Analysis
1.4.1 Data Analysis Models
1.5 Market Formulation & Validation
1.6 Model Details
1.6.1 Commodity flow analysis (Model 1)
1.6.2 Volume price analysis (model 2)
1.7 List of Secondary Sources
1.8 Objectives
1.8.1 Objective - 1
1.8.2 Objective - 2
Chapter 2 Executive Summary
2.1 Market Outlook
2.2 Segment Outlook
2.2.1 Component
2.2.2 Service
2.2.3 End-use
2.3 Competitive Insights
Chapter 3 Market Variables, Trends & Scope
3.1 Market Segmentation
3.2 Parent Market Outlook
3.3 Market Dynamics
3.3.1 Market driver analysis
3.3.1.1 Growing focus on increasing profitability and revenue generated by the business
3.3.1.2 Federal mandate to implement digital record-keeping by healthcare providers
3.3.1.3 Rapidly changing healthcare regulations
3.3.2 Market restraint analysis
3.3.2.1 High threat of data breaching
3.4 Penetration & Growth Prospect Mapping
3.4.1 Penetration Analysis
3.5 Medical Billing Outsourcing Market: Business Environment Analysis Tools
3.5.1 Medical Billing Outsourcing Market - PESTLE Analysis, by Factor (Political & Legal, Economic & Technological)
3.5.2 Industry Analysis - Porter’s
3.6 Major Deals & Strategic Alliances Analysis
3.7 Market Entry Strategies
Chapter 4 Medical Billing Outsourcing Market: Competitive Analysis
4.1 Recent Developments & Impact Analysis, by Key Market Participants
4.2 Strategic Framework/ Competition Categorization (Key innovators, Market leaders, emerging players)
4.3 Company Market Position Analysis (Geographic presence, product portfolio, strategic initiatives, employee strength)
Chapter 5 Medical Billing Outsourcing Market: Component Analysis
5.1 Medical Billing Outsourcing Component Market Share Analysis, 2020 & 2028
5.2 Medical Billing Outsourcing Component Market: Segment Dashboard
5.3 Market Size & Forecasts and Trend Analyses, 2016 to 2028 for the Component Segment
5.3.1 In-house
5.3.1.1 In-house billing market, 2016 - 2028 (USD Million)
5.3.2 Outsourced
5.3.2.1 Outsourced billing market, 2016 - 2028 (USD Million)
Chapter 6 Medical Billing Outsourcing Market: Service Analysis
6.1 Medical Billing Outsourcing Service Market Share Analysis, 2020 & 2028
6.2 Medical Billing Outsourcing Service Market: Segment Dashboard
6.3 Market Size & Forecasts and Trend Analyses, 2016 to 2028 for the Service Segment
6.3.1 Front-end Services
6.3.1.1 Front-end services market, 2016 - 2028 (USD Million)
6.3.2 Middle-end Services
6.3.2.1 Middle-end services market, 2016 - 2028 (USD Million)
6.3.3 Back-end Services
6.3.3.1 Back-end services market, 2016 - 2028 (USD Million)
Chapter 7 Medical Billing Outsourcing Market: End Use Analysis
7.1 Medical Billing Outsourcing End-use Market Share Analysis, 2018 & 2028
7.2 Medical Billing Outsourcing End-use Market: Segment Dashboard
7.3 Market Size & Forecasts and Trend Analyses, 2016 to 2028 for the Service Segment
7.3.1 Hospital
7.3.1.1 Hospital market, 2016 - 2028 (USD Million)
7.3.2 Physician offices
7.3.2.1 Physician offices market, 2016 - 2028 (USD Million)
7.3.3 Others
7.3.3.1 Others market, 2016 - 2028 (USD Million)
Chapter 8 Regional Outlook
8.1 Regional Market Share Analysis, 2020 & 2028
8.2 Regional Market Dashboard
8.3 Regional Market Snapshot (Market Size, CAGR, Top Verticals, Key Players, Top Trends)
8.4 List of Regional Players
8.4.1 North America
8.4.2 Europe
8.4.3 Asia Pacific
8.4.4 Middle East and Africa
8.4.5 Latin America
8.5 SWOT Analysis, by Factor (Political & Legal, Economic, and Technological)
8.5.1 North America
8.5.2 Europe
8.5.3 Asia Pacific
8.5.4 Latin America
8.5.5 MEA
8.6 Market Size & Forecasts and Trend Analysis, 2020 to 2028
8.7 North America
8.7.1 North America medical billing outsourcing market, 2016 - 2028 (USD Million)
8.7.2 U.S.
8.7.2.1 U.S. medical billing outsourcing market, 2016 - 2028 (USD Million)
8.7.3 Canada
8.7.3.1 Canada medical billing outsourcing market, 2016 - 2028 (USD Million)
8.8 Europe
8.8.1 Europe medical billing outsourcing market, 2016 - 2028 (USD Million)
8.8.2 Germany
8.8.2.1 Germany medical billing outsourcing market, 2016 - 2028 (USD Million)
8.8.3 U.K.
8.8.3.1 U.K. medical billing outsourcing market, 2016 - 2028 (USD Million)
8.8.4 Spain
8.8.4.1 Spain medical billing outsourcing market, 2016 - 2028 (USD Million)
8.8.5 France
8.8.5.1 France medical billing outsourcing market, 2016 - 2028 (USD Million)
8.8.6 Italy
8.8.6.1 Italy medical billing outsourcing market, 2016 - 2028 (USD Million)
8.9 Asia Pacific
8.9.1 Asia Pacific medical billing outsourcing market, 2016 - 2028 (USD Million)
8.9.2 Japan
8.9.2.1 Japan medical billing outsourcing market, 2016 - 2028 (USD Million)
8.9.3 China
8.9.3.1 China medical billing outsourcing market, 2016 - 2028 (USD Million)
8.9.4 India
8.9.4.1 India medical billing outsourcing market, 2016 - 2028 (USD Million)
8.10 Latin America
8.10.1 Latin America medical billing outsourcing market, 2016 - 2028 (USD Million)
8.10.2 Brazil
8.10.2.1 Brazil medical billing outsourcing market, 2016 - 2028 (USD Million)
8.10.3 Mexico
8.10.3.1 Mexico medical billing outsourcing market, 2016 - 2028 (USD Million)
8.11 Middle East & Africa
8.11.1 MEA medical billing outsourcing market, 2016 - 2028 (USD Million)
8.11.2 South Africa
8.11.2.1 South Africa medical billing outsourcing market, 2016 - 2028 (USD Million)
8.11.3 Saudi Arabia
8.11.3.1 Saudi Arabia medical billing outsourcing market, 2016 - 2028 (USD Million)
Chapter 9 Competitive Landscape
9.1 Company Profiles
9.1.1 Experian Information Solutions, Inc.
9.1.1.1 Company overview
9.1.1.2 Financial performance
9.1.1.3 Product benchmarking
9.1.1.4 Strategic initiatives
9.1.1.5 SWOT analysis
9.1.2 GE Healthcare
9.1.2.1 Company overview
9.1.2.2 Financial performance
9.1.2.3 Product benchmarking
9.1.2.4 Strategic initiatives
9.1.2.5 SWOT analysis
9.1.3 R1 RCM, Inc. (Accretive Health)
9.1.3.1 Company overview
9.1.3.2 Financial performance
9.1.3.3 Product benchmarking
9.1.3.4 Strategic initiatives
9.1.3.5 SWOT analysis
9.1.4 Quest Diagnostics
9.1.4.1 Company overview
9.1.4.2 Financial performance
9.1.4.3 Product benchmarking
9.1.4.4 SWOT analysis
9.1.5 Allscripts Healthcare Solutions, Inc.
9.1.5.1 Company overview
9.1.5.2 Financial performance
9.1.5.3 Product benchmarking
9.1.5.4 Strategic initiatives
9.1.5.5 SWOT analysis
9.1.6 Kareo, Inc.
9.1.6.1 Company overview
9.1.6.2 Product benchmarking
9.1.6.3 Strategic initiatives
9.1.7 Cerner Corporation
9.1.7.1 Company overview
9.1.7.2 Financial performance
9.1.7.3 Product benchmarking
9.1.7.4 Strategic initiatives
9.1.7.5 SWOT analysis
9.1.8 Mckesson Corporation
9.1.8.1 Company overview
9.1.8.2 Financial performance
9.1.8.3 Product benchmarking
9.1.8.4 Strategic initiatives
9.1.8.5 SWOT analysis
9.1.9 Genpact
9.1.9.1 Company overview
9.1.9.2 Financial performance
9.1.9.3 Product benchmarking
9.1.9.4 SWOT analysis
9.1.10 eClinicalWorks, LLC
9.1.10.1 Company overview
9.1.10.2 Product benchmarking
List of Tables
Table 1 List of secondary sources
Table 2 List of abbreviation
Table 3 North America medical billing outsourcing market, by country, 2016 - 2028 (USD Million)
Table 4 North America medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 5 North America medical billing outsourcing market, by service 2016 - 2028 (USD Million)
Table 6 North America medical billing outsourcing market, by end use 2016 - 2028 (USD Million)
Table 7 U.S. medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 8 U.S. medical billing outsourcing market, by service 2016 - 2028 (USD Million)
Table 9 U.S. medical billing outsourcing market, by end use 2016 - 2028 (USD Million)
Table 10 Canada medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 11 Canada medical billing outsourcing market, by service 2016 - 2028 (USD Million)
Table 12 Canada medical billing outsourcing market, by end use 2016 - 2028 (USD Million)
Table 13 Europe medical billing outsourcing market, by country, 2016 - 2028 (USD Million)
Table 14 Europe medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 15 Europe medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 16 Europe medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 17 Germany medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 18 Germany medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 19 Germany medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 20 U.K. medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 21 U.K. medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 22 U.K. medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 23 Spain medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 24 Spain medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 25 Spain medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 26 France medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 27 France medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 28 France medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 29 Italy medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 30 Italy medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 31 Italy medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 32 Asia Pacific medical billing outsourcing market, by country, 2016 - 2028 (USD Million)
Table 33 Asia Pacific medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 34 Asia Pacific medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 35 Asia Pacific medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 36 Japan medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 37 Japan medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 38 Japan medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 39 China medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 40 China medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 41 China medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 42 India medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 43 India medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 44 India medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 45 Latin America medical billing outsourcing market, by country, 2016 - 2028 (USD Million)
Table 46 Latin America medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 47 Latin America medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 48 Latin America medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 49 Brazil medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 50 Brazil medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 51 Brazil medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 52 Mexico medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 53 Mexico medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 54 Mexico medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 55 MEA medical billing outsourcing market, by country, 2016 - 2028 (USD Million)
Table 56 MEA medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 57 MEA medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 58 MEA medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 59 South Africa medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 60 South Africa medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 61 South Africa medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
Table 62 Saudi Arabia medical billing outsourcing market, by component, 2016 - 2028 (USD Million)
Table 63 Saudi Arabia medical billing outsourcing market, by service, 2016 - 2028 (USD Million)
Table 64 Saudi Arabia medical billing outsourcing market, by end use, 2016 - 2028 (USD Million)
List of Figures
Fig. 1 Market research process
FIG. 2 Information procurement
FIG. 3 Primary research pattern
FIG. 4 Market research approaches
FIG. 5 Value chain based sizing & forecasting
FIG. 6 QFD modelling for market share assessment
FIG. 7 Market formulation & validation
FIG. 8 Medical billing outsourcing market outlook, 2018
FIG. 9 Medical billing outsourcing market segmentation
FIG. 10 Market Dynamics
FIG. 11 Market driver relevance analysis (Current & future impact)
FIG. 12 Market restraint relevance analysis (Current & future impact)
FIG. 13 Penetration & growth prospect mapping
FIG. 14 Medical billing outsourcing market - PESTLE analysis
FIG. 15 Medical billing outsourcing market: Porter’s five forces model
FIG. 16 Market entry strategies
FIG. 17 Company/competition categorization (Key innovators, market leaders, emerging players)
FIG. 18 Strategy framework
FIG. 19 Medical billing outsourcing competitive landscape: Market position analysis (based on products, regional presence, and recent updates (2018))
FIG. 20 Medical billing outsourcing component market share analysis, 2018 & 2028
FIG. 21 Medical billing outsourcing component market: Segment dashboard
FIG. 22 In-house medical billing market, 2016 - 2028 (USD Million)
FIG. 23 Outsourced medical billing market, 2014 - 2028 (USD Million)
FIG. 24 Medical billing outsourcing service market share analysis, 2018 & 2028
FIG. 25 Medical billing outsourcing service market: Segment dashboard
FIG. 26 Front-end services market, 2016 - 2028 (USD Million)
FIG. 27 Middle-end services market, 2016 - 2028 (USD Million)
FIG. 28 Back-end services market, 2016 - 2028 (USD Million)
FIG. 29 Medical billing outsourcing end-use market share analysis, 2018 & 2028
FIG. 30 Medical billing outsourcing end-use market: Segment dashboard
FIG. 31 Hospitals market, 2016 - 2028 (USD Million)
FIG. 32 Physician offices market, 2016 - 2028 (USD Million)
FIG. 33 Others market, 2016 - 2028 (USD Million)
FIG. 34 Regional outlook, 2018 & 2028
FIG. 35 Regional marketplace: Key takeaways
FIG. 36 North America medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 37 U.S. medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 38 Canada medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 39 Europe medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 40 Germany medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 41 U.K. medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 42 Spain medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 43 France medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 44 Italy medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 45 Asia Pacific medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 46 Japan medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 47 China medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 48 India medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 49 Latin America medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 50 Brazil medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 51 Mexico medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 52 MEA medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 53 South Africa medical billing outsourcing market, 2016 - 2028 (USD Million)
FIG. 54 Saudi Arabia medical billing outsourcing market, 2016 - 2028 (USD Million)

Companies Mentioned

  • Experian Information Solutions, Inc.
  • GE Healthcare
  • R1 RCM, Inc. (Accretive Health)
  • Quest Diagnostics
  • Allscripts Healthcare Solutions, Inc.
  • Kareo, Inc.
  • Cerner Corporation
  • Mckesson Corporation
  • Genpact
  • eClinicalWorks, LLC

Methodology

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Table Information

Report AttributeDetails
No. of Pages108
PublishedApril 2021
Forecast Period2021 - 2028
Estimated Market Value ( USD ) in 2021 $ 11.3 billion
Forecasted Market Value ( USD ) by 2028 $ 25.9 billion
Compound Annual Growth Rate12.6%
Regions CoveredGlobal
No. of Companies Mentioned10

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