The growth of the market can be attributed to the transition to ICD-10 coding standards from ICD-9 in North America, the growing demand for CAC solutions, the growing need within the global healthcare system to curtail increasing healthcare costs, improve coding accuracy, and streamline the revenue cycle management procedures.
The computer-assisted coding market is expanding with the emergence of new products and applications. These computer assisted coding solutions being used in many applications such as automated computer-assisted encoding, management reporting & analytics, and clinical coding auditing.
Market Growth Overview
The global computer assisted coding market is valued at USD 2.76 billion in 2017 and is expected to register a CAGR of 11.5% to reach to USD 4.75 billion by 2022.
The computer assisted coding market in APAC is expected to grow at the highest CAGR during the forecast period. The growth of this region is primarily driven by the escalating demand to reduce the burden of the healthcare systems, curtail healthcare delivery costs, increasing implementation of Healthcare IT solutions, and the various government initiatives for enabling efficient, affordable, and on-time delivery of quality care. As a result, APAC holds a significant share of the overall computer assisted coding market.
Implementation of ICD-10 Drive the Global Computer Assisted Coding Market
Many hospitals, especially in North America, are adopting CAC systems to manage the increasing load of coding resulting from the adoption of ICD-10 standards. Major health plans like Medicare have reported a smooth transition to ICD-10 due to rigorous testing for over six years. The ICD-10 coding system requires the use of 72,000 procedure codes and 68,000 CM codes, as opposed to the 4,000 and 14,000 codes, respectively, in the ICD-9 system. The requirement of managing a high volume of codes in the ICD-10 system is in turn driving the demand for automation.
The US is expected to dominate the global CAC market due to the mandated switchover to ICD-10 coding standards in October 2015. This transition may result in a decline in coders’ productivity, thereby resulting in lower profitability for hospitals. The implementation of CAC systems can resolve this issue as they enable healthcare organizations to work more efficiently while complying with procedural coding standards as per ICD-10 guidelines. This trend is expected to provide a strong stimulus to the growth of the CAC market in North America in the coming years.
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Increasing Consolidations in the Market – Opening New Avenues for Growth in Computer-Assisted Coding Market
Over the last three years, leading players have focused on expanding their presence by acquiring small, regional/local players. For instance, in 2014, 3M HIS (US) acquired Treo Solutions (US) to expand its real-time data analytics and payment redesign businesses. This acquisition helped 3M in broadening its end-user base for its 360 Encompass System. Product portfolio expansion, product integration, and geographic expansion are some of the key objectives behind such acquisitions. The acquisition of smaller players in the high-growth Asian and Central & Eastern European markets is also a key area of focus for market players. This is because having a direct presence in these countries will prove to be considerably beneficial once developed markets become saturated.
Apart from acquisitions, leading market players are pursuing the strategy of partnerships with small and medium-sized companies in order to offer innovative and comprehensive solutions to their customers. The growing focus on improving the interoperability of CAC solutions is a key factor driving partnerships in this market.
Applications such as automated computer-assisted encoding, management reporting & analytics, and clinical coding auditing drive the growth of computer assisted coding market
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Automated Computer-assisted Encoding
Automated computer-assisted encoding is one of those applications enables compliance with regulatory standards for clinical coding, thus ensuring that the information exchanged between different healthcare organizations is consistent, comparable, and meaningful.
Management Reporting & Analytics
The healthcare IT industry is facing challenges to make data accessible, sharable, and actionable. The management reporting and analytics modules of computer-assisted coding are designed to enable coding and revenue managers to monitor and track coding processes throughout the workflow. These tools help in tracking the various stages of coding procedures such as case assignment, recording the point and time of modifications to original coding, and the duration for which the chart was open. With analytics tools, coding data can be examined and used more efficiently in making critical decisions.
Clinical Coding Auditing
Clinical coding auditing reduces regulatory compliance risks by identifying potential patterns for fraud and enables healthcare organizations to maximize reimbursement by improving coding accuracy. Clinical coding audits include a statistical audit, subset audit, percentage audit, and a complete audit. They are aimed at providing a more comprehensive overview of the areas of concern using a more extensive data set. The complete clinical code audit uses all relevant data available to ensure a thorough audit. However, there are a number of solutions in the market that provide customizable auditing options, enabling users to define specific parameters for the information to be used. Such solutions help accelerate the auditing process.
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