Revenue Cycle Management Market: Trends and Developments

[Snehal Shaha]

Revenue Cycle Management (RCM) in healthcare industry has fast become a buzzword over the past few years. It enables the healthcare organizations to manage payments, claims processing, and revenue generation, thereby accelerating the whole revenue cycle in an efficient manner. RCM solution begins when a patient enters or schedules an appointment. It automates the whole procedure with initiation of the process by the patient, quick follow ups, determining the eligibility of the patient, collecting their payment, effective tracking of the claims process, and working on rejected claims among others. The rising need for streamlining the whole process has further boosted the demand for RCM solutions, thereby triggering the growth of the RCM market.

The Revenue Cycle Management Market is expected to reach USD 160.08 billion by 2027 from USD 66.81 billion in 2019, at a CAGR of 12.1%.

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On the basis of function, the market is broadly 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 Revenue Cycle Management Industry 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.

What’s driving the Market?
The growth of the global revenue cycle management market is primarily propelled by the following factors:
 Declining reimbursement scenarios
 Increased initiatives and support from the government
 Reduced healthcare costs
 Consolidation of healthcare providers
Although this market is set to witness a healthy growth ahead, higher costs of RCM solutions and limited number of investments being made in healthcare IT sector are likely to inhibit the growth of this market over the forecast period.

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The key players in the global Revenue Cycle Management Industry are McKesson (US), Cerner (US), Quest Diagnostics (US), Allscripts Health Solutions (US), and athenahealth (US).