Revenue Cycle Management Market in terms of revenue was estimated to be worth $49.6 billion in 2023 and is poised to reach $84.1 billion by 2028, growing at a CAGR of 11.1% from 2023 to 2028 according to a new report by MarketsandMarkets™. The shift from fee-for-service to value-based reimbursement models is transforming the RCM market. Value-based reimbursement models are based on patient outcomes rather than the volume of treatments rendered to patients. Value-based reimbursement models have enhanced patient experience and facilitated financial workflows for providers. This has positively impacted the RCM market growth to a certain extent. Also, growing regulatory requirements & government initiatives are expected to drive demand of the RCM market during the forecast period.
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By product & services segment, the outsourcing services segment is expected to grow at the highest growth rate during the forecast period.
The outsourced services segment is anticipated to expand at a considerable CAGR among the product & service categories throughout the forecast period. This can be attributed to its ability to optimize revenue cycle operations through the utilization of specialized resources and expertise from third-party providers. By doing so, healthcare organizations can focus on their core competencies, achieve cost reductions, and enhance operational efficiency. Furthermore, outsourcing services grant access to advanced technology platforms, enabling seamless integration, streamlined workflows, and robust data analytics capabilities. With scalability and adaptability, outsourcing services drive revenue cycle management advancements, bolster financial stability, and elevate overall performance for healthcare providers.
By delivery mode, the on-premise segment is expected to account for the largest revenue cycle management market share.
In 2022, the on-premise segment held the largest market share for revenue cycle management globally. The significant market share of this segment can be attributed to the security and data safety features possessed by on-premise deployment. Easy data access within the interdependent facilities of a healthcare setting has further elevated the market share.
By end user, the healthcare providers segment is expected to account for the largest share of the revenue cycle management market.
Healthcare payers and providers are the two market segments for revenue cycle management based on end users. RCM offers numerous benefits for healthcare providers, helping them optimize financial performance, improve operational efficiency, and enhance the overall patient experience. These factors have elevated the adoption of RCM solutions amongst healthcare providers, thus, positively impacting the market growth.
North America dominates the revenue cycle management market during the forecast period.
In 2022, North America held the largest market share for revenue cycle management. The large share of this region can be attributed to several factors, including strict regulations, an increase in the number of claims denials, well-established government payers and high numbers of private healthcare payers, and a sizable number of healthcare IT companies.
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Revenue Cycle Management Market Dynamics:
Drivers:
- Growing need to manage unstructured healthcare data
Restraints:
- Deployment costs include licensing and subscription costs
Opportunities:
- Growing demand for AI & cloud-based deployment
Challenges:
- Issues related to data security and confidentiality
Key Market Players:
R1 RCM (US), Oracle (US), Optum (US) are the leading players in the market. Other players include McKesson Corporation (US), Change Healthcare (US), 3M (US), Experian plc (Ireland), Conifer Health Solutions (US), Veradigm (US), GE Healthcare (US), Cognizant (US), athenahealth (US), SSI Group LLC (US), AdvantEdge Healthcare (US), and Huron Consulting Group (US)
Recent Developments:
- In 2023, Optum partnered with Owensboro Health to manage revenue cycle and information technology and improve patient outcomes and safety.
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