Revenue Cycle Management Market by Product (Integrated Solutions, Standalone), Function (Claim & Denial, Medical Coding, Insurance Verification), Deployment (Web based, on premise, Cloud based), End User (Hospitals, Physicians, Lab) - Global Forecast to 2022
[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.
Objectives of the Study
- To define, describe, and forecast the global market on the basis of product, deployment, function, end user, and region
- To provide detailed information regarding the major factors influencing the growth of the market (drivers, restraints, opportunities, and industry-specific challenges)
- To strategically analyze the micromarkets with respect to individual growth trends, prospects, and contributions to the overall market
- To analyze opportunities in the market for stakeholders and provide details of the competitive landscape for market leaders
- To forecast the size of the market segments with respect to four major regional segments, namely, North America, Europe, Asia, and the Rest of the World (RoW)
- To profile the key players in the market and comprehensively analyze their market positions and core competencies
- To track and analyze competitive developments such as partnerships, agreements, and acquisitions; new product developments; and research and development activities in the global market
Research Methodology
Top-down and bottom-up approaches were used to validate the size of the global revenue cycle management market and estimate the size of various other dependent submarkets. Major players in the market were identified through secondary research and their market presence was studied through primary and secondary research. Secondary research included the study of the annual and financial reports of top market players, white papers, medical journals, certified publications, articles from recognized authors, directories, and databases such as Statista, World Health Organization (WHO), Organisation for Economic Co-operation and Development (OECD), Healthcare Information and Management Systems Society (HIMSS), Centers for Medicare and Medicaid Services (CMS), Healthcare IT News, Centers for Disease Control and Prevention (CDC), National Health Service (NHS), whereas primary research included extensive interviews with key opinion leaders such as CEOs, directors, and marketing executives. The percentage splits, shares, and breakdowns of the segments were determined using secondary sources and verified through primary sources. This data is consolidated and added to detailed inputs and analysis from MarketsandMarkets and presented in this report.
The key players in the global market are McKesson (US), Cerner (US), Quest Diagnostics (US), Allscripts Health Solutions (US), and athenahealth (US).
Target Audience:
- Healthcare equipment manufacturers
- Healthcare IT vendors
- Healthcare IT service providers
- Healthcare providers
- Healthcare payers
- Healthcare consultants
- Healthcare associations/institutions
- Business research and consulting service providers
Scope of the Report
The research report categorizes the global market into the following segments and subsegments:- Integrated Solutions
- Standalone solutions
- Web-based
- On-premise
- Cloud-based Services
- Claim and denial management
- Medical billing and coding
- Patient insurance eligibility check
- Payment remittance
- Electronic health record (EHR)
- Clinical documentation improvement (CDI)
- Others (scheduling & appointment, referral management, and contract management)
- Physicians
- Hospitals
- Laboratories
- Other end users (pharmacies, emergency medical centers, and academic medical centers)
- 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
Revenue Cycle Management Market, by Product
Revenue Cycle Management Market, by Deployment
Revenue Cycle Management Market, by Function
Revenue Cycle Management Market, by End User
Revenue Cycle Management Market, by Region
Available Customizations
With the given market data, MarketsandMarkets offers customizations as per the companys specific needs. The following customization options are available for the report:
Product Analysis
Product matrix, which gives a detailed comparison of the product portfolios of each company
Company Information
Detailed analysis and profiling of additional market players (up to 5)
The global revenue cycle management market is projected to reach USD 90.43 Billion in 2022 from USD 51.07 Billion in 2017, at CAGR of 12.1%. Revenue cycle management (RCM) systems enable healthcare organizations to manage their revenue cycles. This is achieved by reducing the number of denied insurance claims, speeding up the explanation of benefits (EOB) reconciliation, improving the quality of information, streamlining denial management, and automating processes. 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 are the factors driving the growth of this market.
In this report, the market has been categorized based on product, deployment, function, end user, and region. 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.
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 revenue cycle management 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.
In 2017, in terms of value, North America is expected to account for the largest share of the global market. Asia is expected to register the highest growth rate from 2017 to 2022. This can be attributed to increasing patient population, rising demand for centralized and cost-effective financial management solutions, and growing use of electronic insurance medical claims in countries such as Japan, China, India, and Singapore.
The high pricing and costly maintenance of RCM solutions, scarcity of skilled IT professionals, and IT infrastructural constraints in developing markets are the major factors expected to restrain market growth.
The key players in the global Revenue Cycle Management Market include McKesson (US), Cerner (US), Quest Diagnostics (US), Allscripts Health Solutions (US), and athenahealth (US). These players focus on inorganic strategies such as acquisitions, agreements, and collaborations as well as organic strategies such as product launches and expansions to sustain their growth in the global market.
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Table of Contents
1 Introduction (Page No. - 16)
1.1 Objectives of the Study
1.2 Market Definition
1.3 Market Scope
1.3.1 Markets Covered
1.3.2 Years Considered for the Study
1.4 Currency
1.5 Limitations
1.6 Stakeholders
2 Research Methodology (Page No. - 19)
2.1 Research Data
2.1.1 Secondary Data
2.1.1.1 Secondary Sources
2.1.2 Primary Data
2.1.2.1 Key Data From Primary Sources
2.1.2.2 Key Industry Insights
2.1.2.3 Breakdown of Primaries
2.2 Market Size Estimation
2.3 Market Breakdown and Data Triangulation
2.4 Research Assumptions
3 Executive Summary (Page No. - 27)
4 Premium Insights (Page No. - 31)
4.1 Attractive Growth Opportunities in Revenue Cycle Management Market
4.2 North America: Market, By Deployment and Country
4.3 Global Market, By End User
4.4 Global Market: Geographic Growth Opportunities
5 Market Overview (Page No. - 35)
5.1 Introduction
5.2 Market Dynamics
5.2.1 Drivers
5.2.1.1 Regulatory Mandates for the Adoption of EHR/EMR
5.2.1.2 Government Initiatives to Boost the Adoption of RCM Solutions
5.2.1.3 Loss of Revenue Due to Billing Errors
5.2.1.4 Process Improvements in Healthcare Organizations
5.2.2 Restraints
5.2.2.1 High Pricing and Costly Maintenance of RCM Solutions
5.2.2.2 Scarcity of Skilled IT Professionals
5.2.2.3 IT Infrastructural Constraints in Developing Markets
5.2.3 Opportunities
5.2.3.1 Growing Consolidation Among Vendors for End-To-End Solutions
5.2.3.2 Rising Demand for Cloud-Based RCM Solutions
5.2.3.3 Potential RCM Markets for IT Vendors
5.2.4 Challenges
5.2.4.1 Integration of RCM Solutions Within Healthcare Organizations
5.2.4.2 Risks Associated With Data Security and Privacy
6 Global Market, By Product (Page No. - 41)
6.1 Introduction
6.2 Integrated Solutions
6.3 Standalone Solutions
7 Global Market, By Deployment (Page No. - 46)
7.1 Introduction
7.2 Web-Based
7.3 On-Premise
7.4 Cloud-Based
8 Global Market, By Function (Page No. - 53)
8.1 Introduction
8.2 Claims & Denial Management
8.3 Medical Coding & Billing
8.4 Patient Insurance Eligibility Verification
8.5 Payment Remittance
8.6 Electronic Health Record (EHR)
8.7 Clinical Documentation Improvement (CDI)
8.8 Other Functions
9 Global Market, By End User (Page No. - 60)
9.1 Introduction
9.2 Physicians
9.3 Hospitals
9.4 Laboratories
9.5 Other End Users
10 Global Market, By Region (Page No. - 69)
10.1 Introduction
10.2 North America
10.2.1 US
10.2.2 Canada
10.2.3 Mexico
10.3 Europe
10.3.1 Germany
10.3.2 UK
10.3.3 France
10.3.4 Italy
10.3.5 Spain
10.3.6 Rest of Europe (RoE)
10.4 Asia
10.4.1 Japan
10.4.2 China
10.4.3 India
10.4.4 Rest of Asia (RoA)
10.5 Rest of the World (RoW)
10.5.1 Australia
10.5.2 Middle East, Latin America, and Africa
11 Competitive Landscape (Page No. - 106)
11.1 Overview
11.2 Ranking of Players, 2016
11.3 Competitive Scenario
11.3.1 Agreements, Collaborations, and Partnerships
11.3.2 Product & Service Launches and Enhancements
11.3.3 Acquisitions
11.3.4 Expansions
12 Company Profiles (Page No. - 111)
(Business Overview, Products Offered, SWOT Anlysis, MnM View.)*
12.1 Cerner
12.2 Mckesson
12.3 Quest Diagnostics
12.4 Allscripts Healthcare Solutions
12.5 Athenahealth
12.6 GE Healthcare
12.7 Eclinicalworks
12.8 Conifer Health Solutions
12.9 EPIC Systems
12.10 Gebbs Healthcare Solutions
12.11 Experian
12.12 R1 RCM
12.13 Constellation Software
12.14 The SSI Group
12.15 Nthrive
*Business Overview, Products Offered, SWOT Anlysis, MnM View Might Not Be Captured in Case of Unlisted Companies.
13 Appendix (Page No. - 159)
13.1 Insights From Industry Experts
13.2 Discussion Guide
13.3 Knowledge Store: Marketsandmarkets Subscription Portal
13.4 Introducing RT: Real-Time Market Intelligence
13.5 Available Customizations
13.6 Related Reports
13.7 Author Details
List of Tables (104 Tables)
Table 1 Global Revenue Cycle Management Market, By Product, 2015-2022 (USD Billion)
Table 2 Integrated Solutions Market, By Region, 2015-2022 (USD Billion)
Table 3 North America: Integrated Solutions Market, By Country, 2015-2022 (USD Billion)
Table 4 Europe: Integrated Solutions Market, By Country/Region, 2015-2022 (USD Billion)
Table 5 Standalone Solutions Market, By Region, 2015-2022 (USD Billion)
Table 6 North America: Standalone Solutions Market, By Country, 2015-2022 (USD Billion)
Table 7 Europe: Standalone Solutions Market, By Country/Region, 2015-2022 (USD Million)
Table 8 Global Market, By Deployment, 20152022 (USD Billion)
Table 9 Web-Based Market, By Region, 20152022 (USD Billion)
Table 10 North America: Market, By Country, 20152022 (USD Billion)
Table 11 Europe: Market, By Country/Region, 20152022 (USD Billion)
Table 12 On-Premise Market, By Region, 20152022 (USD Billion)
Table 13 North America: Market, By Country, 20152022 (USD Billion)
Table 14 Europe: Market, By Country/Region, 20152022 (USD Million)
Table 15 Cloud-Based Market, By Region, 20152022 (USD Million)
Table 16 North America: Market, By Country, 20152022 (USD Million)
Table 17 Europe: Market, By Country/Region, 20152022 (USD Million)
Table 18 Market, By Function, 20152022 (USD Billion)
Table 19 Global Market for Claims & Denial Management, By Region, 20152022 (USD Billion)
Table 20 Global Market for Medical Coding & Billing, By Region, 20152022 (USD Billion)
Table 21 Global Market for Patient Insurance Eligibility Verification, By Region, 20152022 (USD Billion)
Table 22 Global Market for Payment Remittance, By Region, 20152022 (USD Billion)
Table 23 Global Market for EHR, By Region, 20152022 (USD Million)
Table 24 Revenue Cycle Management Market for CDI, By Region, 20152022 (USD Million)
Table 25 Market for Other Functions, By Region, 20152022 (USD Million)
Table 26 Market, By End User, 20152022 (USD Billion)
Table 27 Market for Physicians, By Region, 20152022 (USD Billion)
Table 28 North America: Market for Physicians, By Country, 20152022 (USD Billion)
Table 29 Europe: Market for Physicians, By Country/Region, 20152022 (USD Million)
Table 30 Market for Hospitals, By Region, 20152022 (USD Billion)
Table 31 North America: Market for Hospitals, By Country, 20152022 (USD Billion)
Table 32 Europe: Market for Hospitals, By Country/Region, 20152022 (USD Million)
Table 33 Global Market for Laboratories, By Region, 20152022 (USD Billion)
Table 34 North America: Market for Laboratories, By Country, 20152022 (USD Million)
Table 35 Europe: Market for Laboratories, By Country/Region, 20152022 (USD Million)
Table 36 Global Market for Other End Users, By Region, 20152022 (USD Million)
Table 37 North America: Market for Other End Users, By Country, 20152022 (USD Million)
Table 38 Europe: Market for Other End Users, By Country/Region, 20152022 (USD Million)
Table 39 North America: Market, By Country, 20152022 (USD Billion)
Table 40 Global Market, By Region, 20152022 (USD Billion)
Table 41 North America: Market, By Product, 20152022 (USD Billion)
Table 42 North America: Market, By Deployment, 20152022 (USD Billion)
Table 43 North America: Market, By End User, 20152022 (USD Billion)
Table 44 North America: Market, By Function, 20152022 (USD Billion)
Table 45 US: Market, By Product, 20152022 (USD Billion)
Table 46 US: Market, By Deployment, 20152022 (USD Billion)
Table 47 US: Market, By End User, 20152022 (USD Billion)
Table 48 Canada: Market, By Product, 20152022 (USD Billion)
Table 49 Canada: Market, By Deployment, 20152022 (USD Million)
Table 50 Canada: Market, By End User, 20152022 (USD Million)
Table 51 Mexico: Market, By Product, 20152022 (USD Million)
Table 52 Mexico: Market, By Deployment, 20152022 (USD Million)
Table 53 Mexico: Market, By End User, 20152022 (USD Million)
Table 54 Europe: Market, By Country/Region, 20152022 (USD Billion)
Table 55 Europe: Market, By Product, 20152022 (USD Billion)
Table 56 Europe: Market, By Deployment, 20152022 (USD Billion)
Table 57 Europe: Market, By End User, 20152022 (USD Billion)
Table 58 Europe: Market, By Function, 20152022 (USD Billion)
Table 59 Germany: Revenue Cycle Management Market, By Product, 20152022 (USD Billion)
Table 60 Germany: Market, By Deployment, 20152022 (USD Billion)
Table 61 Germany: Market, By End User, 20152022 (USD Million)
Table 62 UK: Market, By Product, 20152022 (USD Billion)
Table 63 UK: Market, By Deployment, 20152022 (USD Billion)
Table 64 UK: Market, By End User, 20152022 (USD Million)
Table 65 France: Market, By Product, 20152022 (USD Billion)
Table 66 France: Market, By Deployment, 20152022 (USD Billion)
Table 67 France: Market, By End User, 20152022 (USD Million)
Table 68 Italy: Market, By Product, 20152022 (USD Million)
Table 69 Italy: Market, By Deployment, 20152022 (USD Million)
Table 70 Italy: Market, By End User, 20152022 (USD Billion)
Table 71 Spain: Market, By Product, 20152022 (USD Million)
Table 72 Spain: Market, By Deployment, 20152022 (USD Million)
Table 73 Spain: Market, By End User, 20152022 (USD Million)
Table 74 RoE: Market, By Product, 20152022 (USD Million)
Table 75 RoE: Market, By Deployment, 20152022 (USD Million)
Table 76 RoE: Market, By End User, 20152022 (USD Million)
Table 77 Asia: Market, By Country/Region, 20152022 (USD Billion)
Table 78 Asia: Market, By Product, 20152022 (USD Billion)
Table 79 Asia: Market, By Deployment, 20152022 (USD Billion)
Table 80 Asia: Market, By End User, 20152022 (USD Billion)
Table 81 Asia: Market, By Function, 20152022 (USD Billion)
Table 82 Japan: Revenue Cycle Management Market, By Product, 20152022 (USD Billion)
Table 83 Japan: Market, By Deployment, 20152022 (USD Billion)
Table 84 Japan: Market, By End User, 20152022 (USD Billion)
Table 85 China: Market, By Product, 20152022 (USD Billion)
Table 86 China: Market, By Deployment, 20152022 (USD Billion)
Table 87 China: Market, By End User, 20152022 (USD Billion)
Table 88 India: Market, By Product, 20152022 (USD Million)
Table 89 India: Market, By Deployment, 20152022 (USD Million)
Table 90 India: Market, By End User, 20152022 (USD Million)
Table 91 RoA: Market, By Product, 20152022 (USD Million)
Table 92 RoA: Market, By Deployment, 20152022 (USD Million)
Table 93 RoA: Market, By End User, 20152022 (USD Million)
Table 94 RoW: Market, By Product, 20152022 (USD Billion)
Table 95 RoW: Revenue Cycle Management, By Deployment, 20152022 (USD Billion)
Table 96 RoW: Market, By End User, 20152022 (USD Billion)
Table 97 RoW: Market, By Function, 20152022 (USD Billion)
Table 98 Australia: Market, By Product, 20152022 (USD Billion)
Table 99 Australia: Market, By Deployment, 20152022 (USD Billion)
Table 100 Australia: Market, By End User, 20152022 (USD Billion)
Table 101 Middle East, Latin America, and Africa: Market, By Product, 20152022 (USD Billion)
Table 102 Middle East, Latin America, and Africa: Market, By Deployment, 20152022 (USD Billion)
Table 103 Middle East, Latin America, and Africa: Market, By End User, 20152022 (USD Billion)
Table 104 Global Market Ranking, By Key Player, 2016
List of figures (31 Figures)
Figure 1 Research Design
Figure 2 Breakdown of Primary Interviews: By Company Type, Designation, and Region
Figure 3 Global Market: Top-Down Approach
Figure 4 Global Market: Bottom-Up Approach
Figure 5 Market Data Triangulation Methodology
Figure 6 Global Market, By Product, 2017 vs 2022 (USD Billion)
Figure 7 Global Market, By Function, 2017 vs 2022 (USD Billion)
Figure 8 Global Market, By Deployment, 2017 vs 2022 (USD Billion)
Figure 9 Market, By End User, 2017 vs 2022 (USD Billion)
Figure 10 Geographical Snapshot of the Global Market
Figure 11 Global Market to Witness A Double-Digit Growth Rate During the Forecast Period
Figure 12 Web-Based Deployment Segment to Dominate the North American Market in 2017
Figure 13 Physicians Will Continue to Dominate the Revenue Cycle Management Market in 2022
Figure 14 India to Register the Highest Growth Rate During the Forecast Period
Figure 15 Market: Drivers, Restraints, Opportunities, & Challenges
Figure 16 Integrated RCM is Expected to Be the Fastest Growing Segment
Figure 17 Cloud-Based is Expected to Grow at Highest Growth Rate During Forecast Period
Figure 18 Claims & Denial Management Expected to Have Double Digit Growth
Figure 19 Physcians Expected to Account for Largest Share in 2017
Figure 20 North America: Market Snapshot
Figure 21 Asia: Market Snapshot
Figure 22 Key Developments Registered By Leading Players in the RCM Market, 20142017
Figure 23 Cerner: Company Snapshot (2016)
Figure 24 Mckesson: Company Snapshot (2017)
Figure 25 Quest Diagnostics: Company Snapshot (2016)
Figure 26 Allscripts Healthcare Solutions: Company Snapshot (2016)
Figure 27 Athenahealth: Company Snapshot (2016)
Figure 28 GE Healthcare: Company Snapshot (2016)
Figure 29 Experian: Company Snapshot (2017)
Figure 30 R1 RCM: Company Snapshot (2016)
Figure 31 Constellation Software: Company Snapshot (2016)
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Growth opportunities and latent adjacency in Revenue Cycle Management Market