Healthcare Revenue Cycle Management Market in the US 2016-2020

This industry research report presents a detailed segmentation of the healthcare RCM market in the US by process (integrated RCM and stand-alone RCM), by deployment (on-premises RCM and cloud-based RCM), and by end user (physicians, hospitals, and medical labs). The primary vendors in the market are Allscripts Healthcare Solutions, Cerner, GE Healthcare, McKesson, and SSI Group.

Overview of the healthcare RCM market in the US

Market research analysts at Technavio have predicted that the healthcare RCM market in the US will grow steadily at a CAGR of almost 13% by 2020. This market research analysis identifies the rise in recovery audits due to changing healthcare regulations as one of the primary growth factors for this market. The constantly changing government regulations in the healthcare space leads to a rise in the operational costs. This rise in the operational costs will lead to a decrease in the revenue of the healthcare sector, which already operates at a very low margin. Moreover, there are regular recovery audits to identify illegal payments under the fee-for-service Medicare and this further decreases their revenue. To keep their operational costs low and maintain the audit report, healthcare providers have started investing in RCM solutions and are now outsourcing their medical revenue cycle management operations to third-party vendors.

As a result of the constantly changing government regulations, healthcare billing service providers find it difficult to service clients effectively and this requirement has compelled them to adopt and integrate predictive analytics and business intelligence software technologies. Such technologies assist healthcare service providers to develop more effective models for healthcare services, which will understand the concept of RCM, treatment outcomes, re-admissions, and patient satisfaction much better. Additionally, they can also discover patterns and trends within their operations. The increasing integration of analytics into healthcare services will be one of the major trends that will gain traction in this market in the next four years.

Segmentation by deployment and analysis of the healthcare RCM market in the US

• On-premises RCM
• Cloud-based RCM

During 2015, the cloud-based RCM segment accounted for about 78% of the total market share and dominated this market. Factors such as the rising preference for revenue cycle management outsourcing and the recent hike in the number of application service providers adopting SaaS (software as a service) solutions to meet their infrastructural requirements will fuel the growth of this market segment in the coming years.

Segmentation by end user and analysis of the healthcare RCM market in the US

• Physicians
• Hospitals
• Medical labs

Since RCM helps medical practitioners to improve their overall processes and transfer paper documentation to electronic health records,  more physicians have started using RCM services at their medical facilities. Moreover, RCM solutions also shorten the revenue cycle with systems that electronically capture codes and pass data to physicians' billing systems. Consequently, the number of physicians using RCM solutions is increasing rapidly and according to the report, this market segment accounted for almost 41% of the total market share during 2015.

Competitive landscape and key vendors

Due to the presence of several vendors, this market appears highly fragmented with competitors entering into different market segments. Large vendors service the enterprise market while vendors targeting niche segments provide RCM services to the small- and medium-sized business. There is constant vendor competition in the end-user segment, which is expected to intensify significantly during the forecast period.

Leading vendors in the market are -

• Allscripts Healthcare Solutions
• Cerner
• GE Healthcare
• McKesson
• SSI Group

The other prominent vendors in the market are Adreima, Alleviant, Avadyne Health, Cardon Outreach, Health Systems Management Network, MediRevv, Precyse Solutions, Source Medical Solutions, Sutherland Global Services, Syncordia Technologies and Healthcare Solutions, T-System, and Xerox.

Key questions answered in the report include

• What will the market size and the growth rate be in 2020?
• What are the key factors driving the healthcare RCM market in the US?
• What are the key market trends impacting the growth of the healthcare RCM market in the US?
• What are the challenges to market growth?
• Who are the key vendors in the healthcare RCM market in the US?
• What are the market opportunities and threats faced by the vendors in the healthcare RCM market in the US?
• Trending factors influencing the market shares of the US.
• What are the key outcomes of the five forces analysis of the healthcare RCM market in the US?

Technavio also offers customization on reports based on specific client requirement.

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