Global Revenue Cycle Management Market Size

Revenue Cycle Management(RCM) Market Analysis

The Global Revenue Cycle Management Market is expected to register a CAGR of 12.26% during the forecast period.

The revenue cycle management market was valued at USD 9,196.63 million in the base year and is poised to grow at a CAGR of 12.26% over the forecast period.

A profound impact on the revenue cycle management market was observed. During the COVID-19 pandemic, reduced inpatient and outpatient volumes for elective care and the higher cost of care for every COVID-19 patient resulted in declining revenue. Healthcare providers and healthcare payers struggled through several challenges impacting their revenue earnings and inpatient volume. Medical billing complexity and rising healthcare costs created a drastic rise in demand for outsourcing revenue cycle management solutions across the globe. Moreover, the Centers for Medicare & Medicaid Services (CMS) announced temporary payment parity for virtual care visits, but many commercial payers reimbursed virtual care services at lower rates. Thus, COVID-19 is expected to have a significant impact on the growth of the studied market during the pandemic. However, uplifting the lockdown, stabilizing cases of COVID-19 in 2021, and introducing of advanced software to manage revenue is expected to bring the market growth to the pre-pandemic level.

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

Revenue for healthcare providers depends on the accurate processing of medical claims. For improving the financial outcome, a healthcare organization needs to 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 allowed 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 of the care providers are now addressing the challenge by working with third-party medical billing professionals, who are experts in overall revenue cycle management.

Moreover, in July 2021, Revenue cycle management (RCM) vendor Waystar announced its plans to acquire Patientco, in the latest deal between an RCM vendor and a patient payment company. The RCM vendor intends for the combination to boost the patient's financial experience by offering users consumer-friendly options for paying medical bills. Similarly, in July 2020, athenahealth, Inc. announced that Centricity Business will be renamed athenaIDX. Through the operational integration between Virence Health and athenahealth, 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.

RCM systems are becoming increasingly popular as the healthcare industry is moving toward digitization. A lot of government initiatives, such as encouraging physicians to adopt electronic health records, investing in training healthcare information technology workers, and establishing regional extension centers to provide technical and other advice, are triggering the RCM market's growth. For instance, in March 2021, the European Commission adopted a recommendation for a European electronic health record exchange format to unlock the flow of health data across borders. This policy helps European citizens to securely access and exchange their health data wherever they are in Europe.

Thus, owing to the factors mentioned above, it can be concluded that the revenue loss to hospitals due to billing errors can be prevented by specialty revenue cycle management service providers. However, high pricing and maintenance of RCM solutions, and lack of roper IT infrastructure is expected to hinder the growth of the market over the forecast period.