Revenue Cycle Management Market Riding the Wave: Meeting the Growing Market Demand | Mckesson, Quest Diagnostics

Revenue cycle management (RCM) is a financial process used by healthcare systems to track and manage medical bills and revenue generation. It plays a crucial role in registering payment processes and ensuring efficient financial operations in the healthcare industry. RCM can be complex, leading many healthcare providers to outsource this process to professional agents.

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The market for revenue cycle management is driven by factors such as decreased reimbursements, the mandatory adoption of electronic medical records, and the need for efficient financial management. However, the shortage of skilled IT professionals poses a challenge to market growth. The global revenue cycle management market is expected to grow at a CAGR of 12.9% from 2020 to 2026, reaching a value of $147.27 billion.

Market Segmentation:

Function:

Claims & Denial Management
Medical Coding & Billing
Patient Insurance Eligibility Verification
Payment Remittance
Electronic Health Record
Clinical Documentation Improvement
Other Functions
Offering:
Software
Services
Product:
Integrated Solutions
Standalone Solutions
End Users:
Physicians
Hospitals
Laboratories
Other End Users
Geography:
North America
Europe
Asia Pacific
Rest of the World

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Market Insights:

The claim and denial management function is expected to hold the largest market share due to progress in reimbursement structures and the growing prevalence of claim denials or errors in medical claims.

Services are projected to dominate the market offering segment due to the lack of skilled resources in financial processes within the healthcare industry, leading to increased outsourcing of revenue cycle management.

Integrated solutions are expected to have the largest share in the market as the demand for value-based payment systems and cost-effective data management solutions rises.

Among end users, physicians are expected to hold the largest market share, driven by the adoption of consolidated practice management systems.

North America leads the market in terms of geography, supported by a developed IT framework in healthcare, a large number of hospitals, and efficient healthcare systems. Europe follows closely with government initiatives for e-health and improved overall healthcare organization systems.

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Key Players:

Major players in the revenue cycle management market include Cerner, McKesson, Quest Diagnostics, Allscripts Healthcare Solutions, Athenahealth, GE Healthcare, eClinicalWorks, Conifer Health Solutions, Epic Systems, Gebbs Healthcare Solutions, Experian, Agilent Technologies, Constellation Software, The SSI Group, and nThrive.

Conclusion:

The demand for revenue cycle management is increasing globally, driven by regulatory mandates for electronic health record adoption and government initiatives. However, data security and privacy risks pose challenges to market growth. RCM has a significant impact on the healthcare industry, ensuring effective management of healthcare service bills and reducing errors in revenue management. The qualitative and quantitative analysis provided in this report enables users to develop effective strategies and understand the market landscape. The competitive landscape analysis includes strategic initiatives by leading players, such as product innovations, joint ventures, collaborations, and mergers and acquisitions.

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