Revenue Cycle Management (RCM) Global Market Report 2024

Revenue cycle management (RCM) encompasses the services utilized by healthcare providers to ensure financial viability and maintain the delivery of high-quality treatment to patients. It involves the process of identifying, obtaining, and managing a practice's revenue from payers, based on the services provided. RCM services are crucial for preventing delayed or lost revenue, and they facilitate the tracking of patient care episodes from registration to the final payment of a balance.

The main types of products in revenue cycle management include integrated RCM and standalone RCM. Standalone RCM is self-contained and comprehensive. The components of RCM services include software and various functions such as claims and denial management, medical coding and billing, electronic health records (EHR), clinical documentation improvement (CDI), insurance processing, and other related functions. Deployment types for RCM services include web-based, cloud-based, and on-premises solutions. The end-users involved in RCM services span across hospitals, general physicians, laboratories, and other healthcare entities.

The revenue cycle management market research report is one of a series of new reports that provides revenue cycle management market statistics, including revenue cycle management industry global market size, regional shares, competitors with a revenue cycle management market share, detailed revenue cycle management market segments, market trends and opportunities, and any further data you may need to thrive in the revenue cycle management industry. This revenue cycle management market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenario of the industry.

The revenue cycle management (rcm) market size has grown rapidly in recent years. It will grow from $119.88 billion in 2023 to $136.76 billion in 2024 at a compound annual growth rate (CAGR) of 14.1%. The growth observed in the historic period can be attributed to several factors, including the widespread implementation of electronic health records (EHRs), healthcare reforms and regulatory changes, the increase in healthcare costs, a heightened focus on improving billing and collections processes, and overall growth in healthcare facilities.

The revenue cycle management (rcm) market size is expected to see rapid growth in the next few years. It will grow to $235.76 billion in 2028 at a compound annual growth rate (CAGR) of 14.6%. The anticipated growth in the forecast period can be attributed to various factors, including the transition to value-based care models, the integration of artificial intelligence (AI) and machine learning in revenue cycle management (RCM), the increasing prominence of telehealth and remote patient interactions, a focus on patient-centric financial experiences, the consolidation of RCM services, and efforts to address billing and coding complexities. Additionally, enhanced data analytics for revenue optimization is expected to contribute to the growth of RCM services in the forecast period. Key trends anticipated in the forecast period include the use of predictive analytics for revenue forecasting, the adoption of blockchain for secure and transparent billing processes, the emergence of RCM as a service (RCMaaS) models, the integration of patient engagement platforms in RCM, the implementation of price transparency and cost estimation tools, and the promotion of data interoperability across healthcare systems.

The growth of the revenue cycle management market is expected to be propelled by the increase in healthcare expenditures. Healthcare expenditures encompass all costs associated with providing health services, family planning activities, nutrition endeavors, and emergency aid designated for health. Healthcare facilities are increasingly adopting advanced solutions like revenue cycle management to manage both administrative and clinical functions, responding to the surge in healthcare expenditure. These solutions are integral to claims processing, payment procedures, and revenue generation. For instance, a report by the Centers for Medicare & Medicaid Services projected an average annual increase of 5.1% in national health spending between 2021 and 2030, reaching an estimated $6.8 trillion by 2030. The rising healthcare expenditure is a key driver behind the growth of the revenue cycle management market.

The growing use of telehealth and remote healthcare services is anticipated to drive the expansion of the revenue cycle management market. Telehealth services involve leveraging digital communication technologies for remote healthcare delivery, and revenue cycle management plays a crucial role in ensuring accurate and timely reimbursement for such services. This is essential for healthcare providers to streamline billing processes and address insurance-related matters, contributing to a seamless patient experience. For example, McKinsey & Company reported a significant increase in the utilization of telehealth services, accounting for 13% to 17% of U.S. patient visits across various specialties. The surge in telehealth and remote healthcare services is a key factor fueling the growth of the revenue cycle management market.

A noteworthy trend in the revenue cycle management market is the emphasis on technological advancements. Major companies in this sector are dedicating efforts to developing innovative technological solutions to fortify their market position. In June 2022, Olive, a healthcare automation company based in the U.S., introduced its Autonomous Revenue Cycle (ARC) management suite, leveraging artificial intelligence (AI) to streamline administrative tasks and enhance revenue cycle efficiency. This highlights the trend of incorporating advanced technologies to optimize revenue cycle management processes.

Major companies in the revenue cycle management market are also focusing on the introduction of AI-based platforms to gain a competitive edge. AI platforms in revenue cycle management refer to comprehensive software systems incorporating AI technologies to streamline financial and administrative processes in healthcare. AGS Health LLC, a U.S.-based revenue cycle management company, launched the AGS AI Platform in September 2022. This platform combines automation, AI, and human-in-the-loop services, enhancing visibility into revenue cycle operations and minimizing revenue leakage, denials, and bottlenecks through predictive analytics.

In a strategic move in May 2023, Aspirion, a U.S.-based full-service revenue cycle management (RCM) company, acquired FIRM Revenue Cycle Management Services Inc. for approximately $650 million. This acquisition underscores Aspirion's commitment to investing in businesses equipped to handle the evolving financial challenges within the U.S. healthcare system. FIRM Revenue Cycle Management Services Inc. is a U.S.-based provider of revenue cycle management services. The collaboration aims to create enhanced value for healthcare clients in managing complex financial aspects.

Major companies operating in the revenue cycle management (rcm) market include The SSI Group LLC, Allscripts Healthcare Solutions Inc., Experian Health Inc., R1 RCM Inc., McKesson Corporation, Athenahealth Inc., Epic Systems Corporation, Quest Diagnostics Inc., Cerner Corporation, Constellation Software Inc., GE Healthcare Technologies Inc., eClinicalWorks India Private Limited, NXGN Management LLC, CareCloud Corporation, AdvantEdge Healthcare Solutions, Huron Consulting Group, Optum Inc., 3M Company, Cognizant Technology Solutions Corp., GeBBS Healthcare Solutions, Infosys Limited, Oracle Corporation, Accenture PLC, Conifer Health Solutions LLC, Access Healthcare Services Pvt. Ltd., CareStack, Distributed Control System, Dental Revenue Cycle Management, Dental Revenue Group Inc., Dental Robot, eAssist Dental Solutions, Med Healthcare Revenue Cycle Management, Medusind Solutions, Convergent Technologies Inc., Drchrono Inc.

North America was the largest region in the revenue cycle management market in 2023. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the revenue cycle management (RCM) market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, and Africa.

The countries covered in the revenue cycle management (RCM) market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

The revenue cycle management market includes revenues earned by entities by providing utilization review, medical coding, denial management, referral verification. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD unless otherwise specified).

The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.


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