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The research report also includes detailed analyses of the competitive landscape of the market and information about 20 market companies, including:
Qualitative and quantitative analysis of companies has been conducted to help clients understand the wider business environment as well as the strengths and weaknesses of key market players. Data is qualitatively analyzed to categorize companies as pure play, category-focused, industry-focused, and diversified; it is quantitatively analyzed to categorize companies as dominant, leading, strong, tentative, and weak.
The market research report provides comprehensive data (region wise segment analysis), with forecasts and estimates in "USD Billion" for the period 2024 to 2028, as well as historical data from 2018 to 2022 for the following segments.
A Comprehensive Overview Healthcare Revenue Cycle Management (RCM) outsourcing refers to the practice where healthcare organizations delegate their revenue cycle processes to third-party service providers. This market encompasses various services such as eligibility verification, payment remittance, and claim processing. Two primary RCM models exist: Integrated and Standalone. Integrated RCM involves outsourcing all administrative and clinical functions, while Standalone focuses on specific areas like claim processing or payment management. RCM solutions can be On-premise or Cloud Based, catering to the needs of various healthcare facilities, including Rural Hospitals, Community Hospitals, and Large Hospitals. Disease prevalence and geriatric population growth are significant factors driving the demand for RCM services. Medical billing companies offer modernization through Integrated HRCM software, facilitating patient scheduling, claims processing, and healthcare service providers' compliance with healthcare laws.
Moreover, big data analytics and AI applications streamline administrative functions, reducing administrative costs and improving patient care. Non-clinical solutions like back-end services (pre-intervention and post-intervention), middle services (claims processing), and front-end services (patient care and medical practice) are essential components of RCM outsourcing. Compliance regulations and financial methodologies are critical considerations for healthcare organizations when selecting an RCM vendor. In conclusion, the Healthcare RCM market is a dynamic and evolving landscape, influenced by factors such as claim volumes, clinical functions, administrative functions, and healthcare laws. The future of RCM outsourcing lies in the integration of advanced technologies and the ability to adapt to the changing needs of healthcare organizations. Healthcare Revenue Cycle Management Outsourcing is transforming how academic medical centers and small hospitals handle their claims and denial management. By leveraging medical coding and billing services, institutions can streamline administrative components and enhance operational efficiency. Medical Billing Outsourcing offers specialized support for hospital outpatient elective care, ensuring accuracy and reducing errors in the billing process. Financial methods and non-clinical solutions play a crucial role in managing the revenue cycle, optimizing processes, and improving overall financial performance. The adoption of these academic medical centers services allows for a more focused approach to patient care while effectively managing claims and denial management. As the industry evolves, integrating these solutions will be vital for maintaining financial health and operational excellence in healthcare settings.
Market Scope |
|
Report Coverage |
Details |
Page number |
136 |
Base year |
2023 |
Historic period |
2018 - 2022 |
Forecast period |
2024-2028 |
Growth momentum & CAGR |
Accelerate at a CAGR of 13.64% |
Market growth 2024-2028 |
USD 4.04 billion |
Market structure |
Fragmented |
YoY growth 2023-2024(%) |
11.73 |
Competitive landscape |
Leading Companies, Market Positioning of Companies, Competitive Strategies, and Industry Risks |
Key companies profiled |
3M Co., CareCloud Inc., Change Healthcare Inc., Clearlake Capital Group L.P., DrChrono Inc., EdgeMED Healthcare LLC, Epic Systems Corp., Firstsource Solutions Ltd., Greenway Health LLC, MedData Inc., NextGen Healthcare Inc., Optum Inc., Parallon Business Solutions, Quest Diagnostics Inc., R1 RCM Inc., Tenet Healthcare Corp., The SSI Group LLC, Vee Technologies Pvt. Ltd., Veradigm LLC, and Vizient Inc. |
Market dynamics |
Parent market analysis, Market forecasting , market forecast , Market growth inducers and obstacles, Fast-growing and slow-growing segment analysis, Market growth and Forecasting, COVID 19 impact and recovery analysis and future consumer dynamics, Market condition analysis for forecast period |
Customization purview |
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The US healthcare RCM outsourcing market size is estimated to increase by USD 4.04 billion with a forecasted CAGR of 13.64% between 2023 and 2028. The growth of the healthcare revenue cycle management (RCM) market depends on several key factors, including a growing mandate toward medical process transparency, rising demand for sophisticated healthcare information system medical solutions requiring periodic upgrades, and improvement in health protection administrative processes. RCM encompasses and integrates all the activities from the pre-registration of a patient to the final invoicing and follow-up activities pertaining to a visit to a hospital or an individual doctor, with the market size calculated based on revenues generated from outsourced RCM services, including maintenance, implementation, and subscriptions, but excluding software licenses, hardware, and revenue from resellers and third-party service providers, with the overall market segmented according to the type of service.
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1 Executive Summary
2 Market Landscape
3 Market Sizing
4 Historic Market Size
5 Five Forces Analysis
6 Market Segmentation by Service
7 Market Segmentation by End-user
8 Customer Landscape
9 Drivers, Challenges, and Opportunity/Restraints
10 Competitive Landscape
11 Competitive Analysis
12 Appendix
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