[168 Pages Report] The global revenue cycle management market is projected to reach USD 90.43 Billion in 2022 from USD 45.59 Billion in 2016, at a CAGR of 12.1%. The base year considered for the study is 2016, and the forecast for the market size is provided for the period between 2017 and 2022. In the current market scenario, there is a growing demand for revenue cycle management solutions. The major factors driving the growth of the global market include the decreasing reimbursements in the healthcare industry, regulatory mandates for the adoption of EHR/EMR, government initiatives to boost the adoption of RCM solutions, loss of revenue due to billing errors, and process improvements in healthcare organizations.

By Product, integrated solutions segment is expected to witness growth in the revenue cycle management market during the forecast period.

On the basis of product, the market is broadly segmented into integrated and standalone solutions. The integrated solutions segment is expected to account for the largest share of the global market in 2017 and is projected to register the highest CAGR during the forecast period. Largest share and growth in this segment can be attributed to the rising adoption of value-based payment systems and the growing demand for cost-saving data management solutions.

By Deployment, Cloud-based RCM solutions segment is expected to grow at the highest CAGR during the forecast period.

On the basis of deployment model, the revenue cycle management market has been segmented into cloud-based, web-based, and on-premise solutions. In 2017, the web-based deployment segment is expected to command the largest share of the global market. The large share of this segment is attributed to the increasing demand for mobile support systems for better customer (patient) engagement platforms. Cloud-based RCM solutions on the other hand will register fastest growth rate. Cloud-based RCM solutions store and process a large volume of data generated in the healthcare industry, which can be managed effectively using cloud technologies. Cloud-based solutions are also regarded as affordable solutions for small and medium-sized healthcare facilities that do not want to maintain an in-house infrastructure to fulfill their RCM needs. Moreover, cloud-based solutions increase the accessibility to patient records from disparate information systems in real-time and from remote locations. This functionality helps in significantly improving the workflow efficiency. One of the benefits associated with the cloud computing environment is that it can easily be adjusted and scaled up or down by service providers without incurring any capital expenditure

By Function, claim and denial management segment is expected to grow at the highest CAGR during the forecast period.

Based on function, the market is segmented into claim and denial management, medical billing and coding, patient insurance eligibility check, payment remittance, electronic health record (EHR), Clinical Documentation Improvement (CDI), and others. The claim and denial management segment is expected to account for the largest share of the global market in 2017 and is expected to witness the highest CAGR during the forecast period. The growing demand for claims and denial management due to the dynamic reimbursement structure and the increasing instances of claim denials are the major factors driving the growth of this segment

By End User, physicians segment is expected to grow at the highest CAGR during the forecast period.

On the basis of end user, the market is segmented into physicians, hospitals, laboratories, and other end users (including pharmacies, long-term acute care facilities, and academic medical centers). The physicians segment is estimated to account for the largest share of the global market in 2017 and is projected to register the highest CAGR during the forecast period. The growing adoption of integrated practice management systems among physicians is the key factor driving the growth of this market

In 2017, North America accounted for the largest share of the revenue cycle management market.

The market is segmented into four major regions� North America, Europe, Asia, and the Rest of the World (RoW). The North American regional segment is expected to account for the largest share of this market, followed by Europe. Asia is estimated to be the fastest-growing segment of the market.

North America has been among the leaders in the development of the IT framework for the healthcare industry. The RCM market in the US presents lucrative growth opportunities owing to the presence of several large hospitals and health systems, favorable regulations, rising geriatric population, and the increasing need to curtail healthcare costs in the country. A number of key market players are also based in the US.

Europe is the second-largest RCM market. Government initiatives in this region for eHealth and the need to improve overall efficiency in healthcare organizations are driving market growth for Europe. The RCM markets in Asia and the RoW are in the growth phase. Factors such as increasing government initiatives for eHealth, rising medical tourism, and a growing demand for quality healthcare are driving the growth of the RCM market in these regions.

Market Dynamics

Driver: Regulatory mandates for the adoption of EHR/EMR

Advancements and innovations in healthcare IT have provided several benefits and capabilities for meeting intensified regulatory requirements. In the US, the Patient Protection and Affordable Care Act has led to the restructuring of private insurance, Medicare, and Medicaid systems. In line with these changes, the �Meaningful Use� rules of the American Recovery and Reinvestment Act (ARRA) and Health Information Technology for Economic and Clinical Health Act (HITECH) have mandated the adoption of EMRs/EHRs that will increase data interoperability.

EHRs support RCM systems by maintaining every patient�s health data. This data is used by RCM systems to determine whether the patient is eligible for payment, collect their co-pay after billing and coding claims, track claims, and collect payments. RCM systems help save costs by reducing revenue leakages during claims processing. These advantages of RCM systems have increased their demand in healthcare organizations across the globe

Restraint: IT infrastructural constraints in developing markets

RCM systems are a unified solution to manage the financial and clinical aspects of healthcare organizations. In EHR-integrated RCM systems, the EHR manages the patient�s clinical data while the RCM system processes the claims for payments. However, the success of RCM largely depends on the IT infrastructure and support within the organization.

Effective healthcare information technology uses EHR interoperability to obtain patient information from various departments as well as from various healthcare providers. Collective data from all these departments is used for correct billing and sharp coding, claims denial management, and establishing effective health data security. Most of the developing markets lack the required interoperability infrastructure for RCM management due to budgetary constraints. These infrastructural loopholes prove a major constraint for the RCM market in developing regions.

Opportunity: Growing consolidation among vendors for end-to-end solutions

The healthcare industry in the US is increasingly consolidating, and the large regional and national healthcare systems are expanding in size. The implementation of the Patient Protection and Affordability Act (PPACA) in 2010 has mandated healthcare organizations in the US to use advanced healthcare IT tools. To control costs of healthcare delivery, healthcare organizations in the US are increasing their patient base and optimizing the utilization of available resources.

Hospitals and outsourcing service vendors strengthen their partnerships to provide comprehensive, end-to-end RCM solutions. For instance, in December 2015, Northern Arizona Healthcare (NAH) collaborated with Cerner Corporation (US) to manage the revenue cycle for NAH�s 38 ambulatory care clinics.

Healthcare providers in the European region are also undergoing consolidation. Private hospitals such as Asklepios Kliniken GmbH, Helios Kliniken, and Sana Kliniken AG in Germany are forming larger chains for accessing enhanced infrastructures necessary to provide care successfully in the changing environment. This has increased the demand for healthcare information technology solutions in these markets.

With an increasing number of patients being treated, the number of medical records generated in healthcare organizations has also grown multifold. This has further increased the need for healthcare organizations to effectively manage their medical documents, assets, and workforce while ensuring cost optimization. This provides greater opportunities for RCM vendors to penetrate into the growing healthcare industry across the world.

Challenge: Integration of RCM solutions within healthcare organizations

The healthcare industry is highly information-intensive, wherein patient information is generated in all departments at all points of care within a healthcare organization. However, improper integration of this information reduces the usability of this information to create an exhaustive and accurate patient record. Integrated RCM solutions aid in maintaining end-to-end patient records�right from registration and appointment scheduling to the final payment of balance.

As healthcare organizations are increasingly adopting various RCM solutions and services, there is a greater need of integrating different information technology systems into the IT architecture of organizations in order to ensure maximum utilization. Successful integration of RCM with other systems is the focus of IT infrastructure development projects of healthcare organizations to gain interoperability.

However, integrating a new RCM with a healthcare organization�s legacy information management systems is a daunting task for market players. With differences in data communication standards, a number of information systems are unable to exchange data with different information systems. This is limiting the successful utilization of these systems by healthcare organizations, thereby lowering their adoption.

Scope of the Report

Report Metric Details Market size available for years 2015�2022 Base year considered 2016 Forecast period 2017�2022 Forecast units Million (USD) Segments covered By Product, By Deployment, By Function, By End User, Geography Geographies covered North America (US Canada, Mexico) Europe (Germany, UK, France, Italy, Spain, Rest of Europe (RoE)), Asia, Japan, China, India, Rest of Asia (RoA), Rest of the World (RoW) (Australia, Middle East, Latin America, and Africa) Companies covered Cerner, Mckesson, Quest Diagnostics, Allscripts Healthcare Solutions, Athenahealth, GE Healthcare, Eclinicalworks, Conifer Health Solutions, EPIC Systems, Gebbs Healthcare Solutions, Experian, R1 RCM, Constellation Software, The SSI Group, Nthrive

Key Market players

Cerner, Mckesson, Quest Diagnostics, Allscripts Healthcare Solutions, Athenahealth, GE Healthcare, Eclinicalworks, Conifer Health Solutions, EPIC Systems, Gebbs Healthcare Solutions, Experian, R1 RCM, Constellation Software, The SSI Group, Nthrive

Recent Developments

Critical questions the report answers:

Who are the major market players in the market?

What are the regional growth trends and the largest revenue-generating regions for market?

What are the major drivers and challenges in the market?

What are the major product and services segments in the market?

Who are the major end users of the revenue cycle management solutions?

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