Revenue Cycle Management Market Trends

Growth Drivers

• Expanding Opportunities for Medical Billing Software & Medical Billing Companies - The rising need for healthcare service providers to improve workflow efficiency, along with the adoption of practices that save time and money for healthcare facilities with a lower number of denied claims and make it possible for patients to make payments online, is expected to promote the adoption of these advanced RCM systems. Currently, there are little less than 300 medical billing companies operating in the United States alone.

• Rising Trend of Outsourcing Financial Process – With healthcare providers thriving towards improving the patient experience with the delivery of high-quality care and lower costs, most other processes are being outsourced nowadays. Also, as per findings, the average error rate in self-compiled claims is nearly 30% but this number is anticipated to drop to less than 1% with the outsourcing of medical billing to any reputable firm. This, as a result, is expected to boost market growth in the upcoming years.

• Growing Coverage of Health Insurance Program – For instance, as per data, approximately 60 million individuals, or 18.2% of the U.S. population were enrolled in Medicare in 2021 while many individuals were covered by private health insurance. The increasing number of insured patients, medical records, and growing usage of codes assist the insurance company in determining coverage and the medical necessity of the services is expected to boost the adoption of systems such as revenue cycle, patient engagement, and care coordination service.
• Rapidly Changing Healthcare Sector – The growing digital transformation of the healthcare sector and the use of information technology together with the rapidly increasing incorporation of artificial intelligence (AI) and machine learning in the delivery of high-quality care, enhancing the patient experience is estimated to propel the market growth. As per investigations, the total spending on digital transformation globally reached over USD 1.3 trillion in 2022 and is growing at a rate of over 10% year on year.

Challenges

• Reluctancy to switch over to the latest management model – Many healthcare divisions still rely on conventional methods of revenue management and are reluctant to adopt such technologies as they involve a lengthy and time-consuming process, which is attributed to hamper the market growth in the near future. Moreover, the lack of proper IT infrastructure in many underdeveloped and developing countries as well as the lack of proper technical guidance for the smooth switch is further anticipated to restrict the industry growth over the forecast period.

• Lack of standardization

• Stringent regulatory framework