The Revenue Cycle Management (RCM) Market size was valued at USD 305.56 billion in 2023 and is expected to grow to USD 735.20 billion by 2031 and grow at a CAGR of 11.6% over the forecast period of 2024-2031.
The demand for advanced revenue cycle management solutions is driven by a rapidly developing era of digitalisation in the healthcare sector. The existence of a practice is dependent upon the acquisition of appropriate assets. The value of obtaining an efficient RCM solution increase as the precise payment of medical services becomes more complex. Market growth is expected to be stimulated by increasing demand for streamlining processes within healthcare organizations and innovative synchronized management software systems. Also, Patient registration, insurance eligibility, and verification, medical coding, claim to process, and payment and AR management are all procedures that fall under revenue cycle management. Growth is driven by increasing support from public authorities and federal agencies in the form of favourable regulatory reform.
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Key Drivers:
Increasing use of cloud deployment for RCM
In view of increased flexibility and greater cost efficiency to end users, the delivery mode in which RCMs are cloud deployed is becoming more efficient. Easy and secure sharing of medical data has been made possible by cloud deployment solutions. In addition, healthcare institutions are helping to manage electronic medical records, big data analysis, patient portals, and mobile devices through cloud deployment solutions.
Increasing adoption of RCM in the healthcare industry
Due to a number of advantages, such as easy availability of trained and skilled staff, compliance with the requirements of the legislation, improved efficiency and cost effectiveness, healthcare facilities are using revenue cycle management software solutions. RCM solutions and services are readily used by the available healthcare facilities due to the numerous benefits.
Restraints:
Deployment costs include licensing and subscription costs
Licensing and implementation costs are significantly high. In addition, there has been a significant increase in the cost of continuing to maintain revenue cycle management software. In addition, recurrent expenditure is the provision of IT support and maintenance services that include software modifications and upgrading according to changing user requirements as well as maintaining an efficient information technology infrastructure. It accounts for a significant proportion of the total costs associated with ownership.
High Unwanted Cost Associated
Opportunities:
Increasing demand for cloud computing and AI deployment
By combining data with artificial intelligence, machine learning algorithms and predictive analytics can be applied to shorten drug discovery times, provide virtual patient assistance or reduce diagnostic time through the processing of medical images, thereby improving outcomes and reducing costs. With its ability to optimize clinical as well as nonclinical processes, the adoption of artificial intelligence in health care is increasing.
Increasing Strategic Initiatives Associated with Revenue Cycle Management (RCM)
Challenges:
data security and confidentiality Issues
The ongoing economic downturn appears to be affecting the RCM market in a multifaceted way, with certain segments benefiting from growth and others facing difficulties. In line with the growing adoption of digitisation solutions and a greater focus on effective revenue management in healthcare organizations, the RCM market is expected to grow. Strategic partnerships aimed at improving the operation of the revenue cycle and patient outcomes are key developments.
The market is still dominated by the demand for integrated RCM solutions, which provide a simplified approach to managing various financial activities within healthcare organisations. For their ability to reduce errors, improve administrative efficiency and increase overall productivity, these solutions are being sought. In particular, because of its cost efficiency, flexibility, and ability to allow secure data sharing and backend simplification, the cloud segment is projected to be quickly growing.
A number of factors, including favourable government regulations, an increase in healthcare expenditure, and an increasing trend towards outsourcing RCM solutions, have a positive impact on the RCM market, despite the economic challenges. Even in the face of economic uncertainty, these factors contribute to a robust growth rate on the RCM market.
Various global markets, including the revenue cycle management sector, have been affected by the Russia Ukraine crisis. The global RCM market showed resilience and growth despite the challenges arising from the crisis, such as sanctions, sharp increases in commodity prices or supply chain interruptions.
The resilience of the RCM market is driven by rising global healthcare costs, which have led to adoption of advanced solutions such as RCM for effective administration and management of medical services. The market's growth and evolution is also due to technological developments in this sector, such as the introduction of artificial intelligence and automated processes related to revenue cycle management. Various products and services, including integrated and standalone RCM solutions, software and services for claims and denial management, medical coding and billing, and electronic health records management, are included in the RCM market. It is intended for a wide range of end users, including hospitals, doctors' offices and laboratories.
By Product
Software
Services
In view of the growing trend for outsourcing these services to health care facilities, the services category was dominant in the RCM market and held a 66.8% share by 2023. Outsourcing of services is increasing as more healthcare organizations increasingly require resources and skills for the implementation of RCM solutions.
By Type
Integrated
Standalone
Due to the growing preference for volume-based payments over value-based payments, the integrated segment accounted for 70.2% of the market in 2023. Integrated solutions, through a single platform resulting in standardised data collection and analysis processes, offer a simplified and synchronized format for different financial activities. A number of benefits, e.g. an increase in collections as well as the planning of alternate payment and reimbursement methods, can be obtained by implementing a revenue cycle management system.
By Delivery Mode
Web-based
Cloud-based
On-premise
In view of growing adoption of Web-based solutions, the online delivery mode segment dominated the market and accounted for a 53.2% share by 2023. Web based solutions do not require additional hardware or storage and can be installed off the premises and managed by a third-party service provider, which is helping to increase adoption of web-based solutions over on-premise solutions delivered. Affordability and rapid deployment are the benefits associated with the delivery of web-based solutions.
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By Specialty
Oncology
Cardiology
Anesthesia
Radiology
Pathology
Pain Management
Emergency Service
Others
By Sourcing
In-house
External RCM Apps/ Software
Outsourced RCM Services
By Function
Product Development
Member Engagement
Network Management
Care Management
Claims Management
Risk & Compliances
By End-Use
Physician Back Offices
Hospitals
Diagnostic Laboratories
Other
In 2023, North America had a market share of 55.8%. In addition, lucrative growth opportunities for the region's market are emerging from the presence of major hospitals and excellent healthcare facilities, as well as an increasing need to reduce medical costs due to a favourable regulatory environment.
In Asia Pacific, the market is expected to grow at a faster pace over the coming years due to increased favourable government initiatives and support, an increase in demand for better health care quality, e.g. Digital literacy, greater adoption of healthcare IT solutions, improved medical infrastructure, higher spending on Health Information Technology as well as increases in patients' unmet needs arising from emerging economies. Moreover, the Asia Pacific market is characterised by a low level of manufacturing. creased focus on reducing health care costs through favourable legislation.
REGIONAL COVERAGE:
North America
US
Canada
Mexico
Europe
Eastern Europe
Poland
Romania
Hungary
Turkey
Rest of Eastern Europe
Western Europe
Germany
France
UK
Italy
Spain
Netherlands
Switzerland
Austria
Rest of Western Europe
Asia Pacific
China
India
Japan
South Korea
Vietnam
Singapore
Australia
Rest of Asia Pacific
Middle East & Africa
Middle East
UAE
Egypt
Saudi Arabia
Qatar
Rest of Middle East
Africa
Nigeria
South Africa
Rest of Africa
Latin America
Brazil
Argentina
Colombia
Rest of Latin America
The major key players are Cerner Corporation, eclinicalworks, Epic Systems Corporation, gebbshealthcare Solutions, GE Healthcare, Experian PLC, Mckesson Corporation, Quest Diagnostics Incorporated, Athenahealth, Inc., Allscripts Healthcare Solutions, Inc.& Other Players
Optum and Owensboro Health entered into an agreement in 2023 to manage the revenue cycle and information technology, improving patient outcomes and safety.
In 2022, the R1 RCM announced 10-year end-to-end RCM partnerships with Scion Health, Sutter Health, and St. Clair Health to streamline workflow standardization and improve patient access platforms.
In 2022, McKesson signed a definitive agreement to acquire Rx Savings Solutions to offer medication therapy more affordable and increase medication adherence to improve outcomes.
| Report Attributes | Details |
| Market Size in 2023 | US$ 305.56 Billion |
| Market Size by 2031 | US$ 735.20 Billion |
| CAGR | CAGR of 11.6% From 2024 to 2031 |
| Base Year | 2023 |
| Forecast Period | 2024-2031 |
| Historical Data | 2020-2022 |
| Report Scope & Coverage | Market Size, Segments Analysis, Competitive Landscape, Regional Analysis, DROC & SWOT Analysis, Forecast Outlook |
| Key Segments | • By Product (Software, Services) • By Type (Integrated, Standalone) • By Delivery Mode (Web-based, Cloud-based, On-premise) • By Specialty (Oncology, Cardiology, Anesthesia, Radiology, Pathology, Pain Management, Emergency Service, Others) • By Sourcing (In-house, External RCM Apps/ Software, Outsourced RCM Services) • By Function (Product Development, Member Engagement, Network Management, Care Management, Claims Management, Risk & Compliances) • By End-use (Physician Back Offices, Hospitals, Diagnostic Laboratories, Other) |
| Regional Analysis/Coverage | North America (US, Canada, Mexico), Europe (Eastern Europe [Poland, Romania, Hungary, Turkey, Rest of Eastern Europe] Western Europe] Germany, France, UK, Italy, Spain, Netherlands, Switzerland, Austria, Rest of Western Europe]), Asia Pacific (China, India, Japan, South Korea, Vietnam, Singapore, Australia, Rest of Asia Pacific), Middle East & Africa (Middle East [UAE, Egypt, Saudi Arabia, Qatar, Rest of Middle East], Africa [Nigeria, South Africa, Rest of Africa], Latin America (Brazil, Argentina, Colombia, Rest of Latin America) |
| Company Profiles | Cerner Corporation, eclinicalworks, Epic Systems Corporation, gebbshealthcare Solutions, GE Healthcare, Experian PLC, Mckesson Corporation, Quest Diagnostics Incorporated, Athenahealth, Inc., Allscripts Healthcare Solutions, Inc |
| Key Drivers | • Government measures are driving up demand. • Cost-effective product development through technological advances |
| Market Opportunities | • Demand for RCM solutions on the cloud. • growing concentration among organizations that provide end-to-end services. |
Ans: The Revenue Cycle Management (RCM) Market was valued at USD 305.56 billion in 2023.
Ans:- Demand for RCM solutions on the cloud and growing concentration among organizations that provide end-to-end services.
Ans:- Revenue cycle management is divided into four categories: type, component, deployment mechanism, and end-user.
Ans:- North America dominated the revenue cycle management market in 2022.
Ans:- The primary growth tactics of Revenue Cycle Management (RCM) market participants include merger and acquisition, business expansion, and product launch.
TABLE OF CONTENTS
1. Introduction
1.1 Market Definition
1.2 Scope
1.3 Research Assumptions
2. Industry Flowchart
3. Research Methodology
4. Market Dynamics
4.1 Drivers
4.2 Restraints
4.3 Opportunities
4.4 Challenges
5. Impact Analysis
5.1 Impact of Russia-Ukraine Crisis
5.2 Impact of Economic Slowdown on Major Countries
5.2.1 Introduction
5.2.2 United States
5.2.3 Canada
5.2.4 Germany
5.2.5 France
5.2.6 UK
5.2.7 China
5.2.8 Japan
5.2.9 South Korea
5.2.10 India
6. Value Chain Analysis
7. Porter’s 5 Forces Model
8. Pest Analysis
9. Revenue Cycle Management (RCM) Market Segmentation, By Product
9.1 Introduction
9.2 Trend Analysis
9.3 Software
9.4 Services
10. Revenue Cycle Management (RCM) Market Segmentation, By Type
10.1 Introduction
10.2 Trend Analysis
10.3 Integrated
10.4 Standalone
11. Revenue Cycle Management (RCM) Market Segmentation, By Delivery Mode
11.1 Introduction
11.2 Trend Analysis
11.3 Web-based
11.4 Cloud-based
11.5 On-premise
12. Revenue Cycle Management (RCM) Market Segmentation, By Specialty
12.1 Introduction
12.2 Trend Analysis
12.3 Oncology
12.4 Cardiology
12.5 Anesthesia
12.6 Radiology
12.7 Pathology
12.8 Pain Management
12.9 Emergency Service
12.10 Others
13. Revenue Cycle Management (RCM) Market Segmentation, By Sourcing
13.1 Introduction
13.2 Trend Analysis
13.3 In-house
13.4 External RCM Apps/ Software
13.5 Outsourced RCM Services
14. Revenue Cycle Management (RCM) Market Segmentation, By Function
14.1 Introduction
14.2 Trend Analysis
14.3 Product Development
14.4 Member Engagement
14.5 Network Management
14.6 Care Management
14.7 Claims Management
14.8 Risk & Compliances
15. Revenue Cycle Management (RCM) Market Segmentation, By End-use
15.1 Introduction
15.2 Trend Analysis
15.3 Physician Back Offices
15.4 Hospitals
15.5 Diagnostic Laboratories
15.6 Other
16. Regional Analysis
16.1 Introduction
16.2 North America
16.2.1 USA
16.2.2 Canada
16.2.3 Mexico
16.3 Europe
16.3.1 Eastern Europe
16.3.1.1 Poland
16.3.1.2 Romania
16.3.1.3 Hungary
16.3.1.4 Turkey
16.3.1.5 Rest of Eastern Europe
16.3.2 Western Europe
16.3.2.1 Germany
16.3.2.2 France
16.3.2.3 UK
16.3.2.4 Italy
16.3.2.5 Spain
16.3.2.6 Netherlands
16.3.2.7 Switzerland
16.3.2.8 Austria
16.3.2.9 Rest of Western Europe
16.4 Asia-Pacific
16.4.1 China
16.4.2 India
16.4.3 Japan
16.4.4 South Korea
16.4.5 Vietnam
16.4.6 Singapore
16.4.7 Australia
16.4.8 Rest of Asia Pacific
16.5 The Middle East & Africa
16.5.1 Middle East
16.5.1.1 UAE
16.5.1.2 Egypt
16.5.1.3 Saudi Arabia
16.5.1.4 Qatar
16.5.1.5 Rest of the Middle East
16.5.2 Africa
16.5.2.1 Nigeria
16.5.2.2 South Africa
16.5.2.3 Rest of Africa
16.6 Latin America
16.6.1 Brazil
16.6.2 Argentina
16.6.3 Colombia
16.6.4 Rest of Latin America
17. Company Profiles
17.1 Cerner Corporation
17.1.1 Company Overview
17.1.2 Financial
17.1.3 Products/ Services Offered
17.1.4 SWOT Analysis
17.1.5 The SNS View
17.2 Eclinicalworks
17.2.1 Company Overview
17.2.2 Financial
17.2.3 Products/ Services Offered
17.2.4 SWOT Analysis
17.2.5 The SNS View
17.3 Epic Systems Corporation
17.3.1 Company Overview
17.3.2 Financial
17.3.3 Products/ Services Offered
17.3.4 SWOT Analysis
17.3.5 The SNS View
17.4 Gebbshealthcare Solutions
17.4.1 Company Overview
17.4.2 Financial
17.4.3 Products/ Services Offered
17.4.4 SWOT Analysis
17.4.5 The SNS View
17.5 GE Healthcare
17.5.1 Company Overview
17.5.2 Financial
17.5.3 Products/ Services Offered
16.5.4 SWOT Analysis
17.5.5 The SNS View
17.6 Experian PLC
17.6.1 Company Overview
17.6.2 Financial
17.6.3 Products/ Services Offered
17.6.4 SWOT Analysis
17.6.5 The SNS View
17.7 Mckesson Corporation
17.7.1 Company Overview
17.7.2 Financial
17.7.3 Products/ Services Offered
17.7.4 SWOT Analysis
17.7.5 The SNS View
17.8 Quest Diagnostics Incorporated
17.8.1 Company Overview
17.8.2 Financial
17.8.3 Products/ Services Offered
17.8.4 SWOT Analysis
17.8.5 The SNS View
17.9 Athenahealth, Inc.
17.9.1 Company Overview
17.9.2 Financial
17.9.3 Products/ Services Offered
17.9.4 SWOT Analysis
17.9.5 The SNS View
17.10 Allscripts Healthcare Solutions, Inc.
17.10.1 Company Overview
17.10.2 Financial
17.10.3 Products/ Services Offered
17.10.4 SWOT Analysis
17.10.5 The SNS View
18. Competitive Landscape
18.1 Competitive Benchmarking
18.2 Market Share Analysis
18.3 Recent Developments
18.3.1 Industry News
18.3.2 Company News
18.3.3 Mergers & Acquisitions
19. Use Case and Best Practices
20. Conclusion
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