REVENUE CYCLE MANAGEMENT MARKET SIZE & SHARE ANALYSIS - GROWTH TRENDS & FORECASTS (2023 - 2028)

 

Revenue Cycle Management Market Analysis:

The market for revenue cycle management was valued at USD 9,196.63 million in the base year and is projected to grow at a compound annual growth rate (CAGR) of 12.26% over the forecast period.

The COVID-19 pandemic had a significant impact on the revenue cycle management market, resulting in declining revenue due to reduced inpatient and outpatient volumes for elective care and higher costs of care for COVID-19 patients. Healthcare providers and payers faced numerous challenges that affected their revenue earnings and inpatient volume. The complexity of medical billing and rising healthcare costs led to a significant increase in demand for outsourcing revenue cycle management solutions worldwide. Additionally, while the Centers for Medicare & Medicaid Services (CMS) announced temporary payment parity for virtual care visits, many commercial payers reimbursed virtual care services at lower rates. Therefore, the pandemic is expected to have a significant impact on the growth of the studied market. However, with the lifting of lockdowns, stabilization of COVID-19 cases in 2021, and the introduction of advanced software to manage revenue, the market growth is expected to return to pre-pandemic levels.

The growth of the revenue cycle management market is attributed to government initiatives to boost the adoption of RCM solutions, increasing revenue loss due to billing errors, and process improvements in healthcare organizations.

The accurate processing of medical claims is crucial for healthcare providers to generate revenue. To improve financial outcomes, healthcare organizations must maintain a quality revenue cycle and insurance billing. The revenue cycle management team comprises accounts receivable (A/R) management and denial management. With mounting pressure on hospitals to reduce costs, most care providers are losing revenue due to claim denials and their failure to submit or delay the denied claim. This has led to the emergence of specialty firms that provide revenue cycle management services.

The most common billing errors include failure to verify insurance, filing an incomplete claim, coding errors, lack of specificity, and missing filing deadlines. Many care providers are now addressing this challenge by working with third-party medical billing professionals who are experts in overall revenue cycle management.

In July 2021, revenue cycle management vendor Waystar announced its plans to acquire Patientco, the latest deal between an RCM vendor and a patient payment company. The RCM vendor intends to enhance the patient’s financial experience by offering consumer-friendly options for paying medical bills. Similarly, in July 2020, athenahealth, Inc. announced that Centricity Business would be renamed athenaIDX. This rebrand aligns the enterprise Revenue Cycle Management (RCM) solution with the company’s product portfolio and leverages the strength of the IDX and athenahealth brands, through the operational integration between Virence Health and athenahealth.

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