Healthcare Revenue Cycle Management Market Report 2025

This report covers market characteristics, size and growth, segmentation, regional and country breakdowns, competitive landscape, market shares, trends and strategies for this market. It traces the market’s historic and forecast market growth by geography.

The healthcare revenue cycle management market size has grown rapidly in recent years. It will grow from $69.38 billion in 2024 to $80.53 billion in 2025 at a compound annual growth rate (CAGR) of 16.1%. The growth in the historic period can be attributed to increasing healthcare expenditure, transition to value-based care models, regulatory compliance requirements, growing adoption of electronic health records (EHR) and emphasis on cost reduction and efficiency.

The healthcare revenue cycle management market size is expected to see rapid growth in the next few years. It will grow to $144.54 billion in 2029 at a compound annual growth rate (CAGR) of 15.7%. The growth in the forecast period can be attributed to growing patient financial responsibility, scalable revenue cycle management solutions for mid-sized hospitals, value-based care models driving importance of RCM, partnerships between RCM and EHR providers for comprehensive solutions, payment processing enhancements in RCM systems. Major trends in the forecast period include automation and artificial intelligence (AI), shift towards value-based care reimbursement models, integration of RCM systems with telehealth platforms, data analytics, outsourcing and partnerships.

The increasing adoption of electronic health records (EHR) is expected to drive the growth of the healthcare revenue cycle management market. EHRs are digital versions of patients' medical records that contain comprehensive health information accessible to authorized healthcare providers. The rise in EHR adoption is fueled by several factors, including the need for better access to patient care, improved efficiency in healthcare delivery, and the seamless transfer of information. EHRs enhance healthcare revenue cycle management by enabling accurate documentation, efficient claim processing, and timely reimbursement for medical services. For example, in June 2022, the Department of Health and Social Care, a UK government agency, reported that by December 2023, 90% of NHS trusts were expected to implement EHRs, with full adoption mandated for all trusts by March 2025. As a result, the growing adoption of EHRs is driving the expansion of the healthcare revenue cycle management market.

Key players in the healthcare revenue cycle management sector prioritize innovation, with a focus on developing advanced solutions such as sophisticated revenue management platforms. These platforms are tailored to assist providers in enhancing financial performance, reducing administrative burdens, and elevating patient care quality. An advanced revenue management platform in healthcare denotes sophisticated software solutions aimed at optimizing financial aspects within healthcare organizations, particularly in managing revenue cycles. For instance, FinThrive, a US-based healthcare company, introduced its end-to-end revenue management platform in March 2022. This platform offers seamless revenue management by ensuring flexibility, scalability, and visibility across the revenue cycle, thus enabling accurate billing, regulatory compliance, and efficient financial performance. Such platforms aim to maximize revenue opportunities, minimize administrative costs, boost efficiency, and bolster the financial health of organizations, especially in industries such as healthcare where revenue cycle management is pivotal for sustainability and success.

In January 2024, Veradigm, an integrated data systems and services company based in the US, completed the acquisition of Koha Health for an undisclosed sum. This strategic move aims to augment Veradigm's capabilities in ambulatory services and musculoskeletal care, thereby fortifying its position in the healthcare market and expanding its portfolio of revenue cycle services. Koha Health, a US-based firm specializing in healthcare revenue cycle management, offers a range of services including revenue cycle optimization, strategic advisory services, and patient experience enhancement. This acquisition underscores Veradigm's commitment to enhancing its offerings and market presence, capitalizing on Koha Health's expertise to deliver value-added solutions to its clientele.

Major companies operating in the healthcare revenue cycle management market are McKesson Corporation, 3M Health Information Systems, GE Healthcare, Experian Health, Cerner Corporation, Epic Systems Corporation, Change Healthcare, R1 RCM Inc., Nuance Communications, Conifer Health Solutions, Allscripts Healthcare Solutions, Health Catalyst, Craneware, MEDHOST Inc., NextGen Healthcare, Greenway Health, MedeAnalytics, Source Medical, Patientco, Athenahealth Inc., eClinicalWorks, Optum, nThrive, Waystar, IBM Watson Health, Trizetto Provider Solutions, Quadax, Experity.

North America was the largest region in the healthcare revenue cycle management market in 2024. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the healthcare revenue cycle management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa. The countries covered in the healthcare revenue cycle management market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA, Canada, Italy, Spain.

The healthcare revenue cycle management market includes revenues earned by entities by providing services such as eligibility verification, coding and documentation review, claims submission and management, accounts receivable (AR) management, payment posting and reconciliation, denial management, and appeals. 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).

Healthcare revenue cycle management entails overseeing financial transactions within the healthcare system, from patient registration to reimbursement, to ensure optimal revenue generation. It integrates a variety of services and technological solutions aimed at enhancing financial performance and compliance within healthcare organizations.

At its core, healthcare revenue cycle management comprises two main components: software and services. Software solutions play a pivotal role in automating and optimizing financial processes, encompassing billing, coding, claims processing, and payment collection. These software applications can be deployed either on-premises or via cloud-based platforms, catering to various functions such as claims and denial management, medical coding, billing eligibility verification, and payment remittance. They serve a diverse array of end users, including hospitals, laboratories, physicians, and other healthcare entities.

The healthcare revenue cycle management market research report is one of a series of new reports that provides healthcare revenue cycle management market statistics, including healthcare revenue cycle management industry global market size, regional shares, competitors with a healthcare revenue cycle management market share, detailed healthcare revenue cycle management market segments, market trends and opportunities, and any further data you may need to thrive in the healthcare revenue cycle management industry. This healthcare 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 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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