Revenue Cycle Management Market growth is majorly attributed to the need for increasing patient volumes, and the growing need to manage unstructured healthcare data. Also, growing regulatory requirements & government initiatives are expected to drive demand growth in the IoT medical devices market during the forecast period.

Currently, Revenue Cycle Management Market is growing at a Compound Annual Growth Rate (CAGR) of 10.6 % to reach USD 67.8 billion by 2026. Revenue cycle management (RCM) is the process used to track the revenue from patients, from their initial appointment or encounter with the healthcare system to their final payment of the balance. This process helps streamline the business operations of healthcare organizations and private practices. RCM solutions help providers manage and enhance revenue cycle functions such as medical coding & billing, patient insurance eligibility verification, electronic health records, clinical documentation, and claims & denials management.

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Growth Drivers

• Growing regulatory requirements & government initiatives to boost the adoption of RCM solutions
• Increasing patient volume and subsequent growth in health insurance
• Loss of revenue due to billing errors and declining reimbursements
• Growing need to manage unstructured healthcare data
• Rising demand for robust process improvements in healthcare

Growth Opportunities

• Increasing outsourcing services in developing countries
• Growing demand for AI & cloud-based deployment

Challenges

• Issues related to data security and confidentiality
• Reluctance to switch from conventional methods

Trends

• Increasing the number of partnerships and collaborations to drive innovation
• Growing adoption of end-to-end RCM solutions

The prominent players operating in the Revenue Cycle Management Market are

R1 RCM (US), Cerner Corporation (US), Optum (US), McKesson Corporation (US), Change Healthcare (US), and 3M (US),

R1 RCM (US) held the leading position in the revenue cycle management market in 2020. It provides comprehensive revenue cycle infrastructure to providers. The company also provides advisory services such as physician advisory services (PAS), practice management (PM), revenue integrity solutions (RIS), patient experience (PX), coding management, and business office services. The company focuses on inorganic growth strategies like collaborations, partnerships, agreements, and acquisitions. Between 2019 and 2021, the company also signed agreements with Mednax and Ascension to expand its role as the provider of key patient experience technologies to improve patient and provider experience.

Cerner Corporation (US) held the second position in the revenue cycle management market in 2020. Cerner operates through seven business segments: Licensed Software, Technology Resale, Subscriptions, Professional Services, Managed Services, Support and Maintenance, and Reimbursed Travel. The company is a provider of end-to-end RCM services. It has consistently focused its efforts on strengthening its competencies in revenue cycle management services and improving its revenue cycle solutions. The company has witnessed an increasing preference for its Millennium platform for revenue cycle management. The company focuses on inorganic growth strategies such as agreements, partnerships, and collaborations with various healthcare providers to keep up with its competitors. Cerner offers a broad portfolio of RCM solutions and has a wide geographic presence with distribution channels across the Americas, Europe, the Asia Pacific, and the Middle East.

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North America is expected to exhibit the highest growth during the forecast period

• Factors such as stringent regulations, increasing volume of claims denials,
• The presence of a high number of private healthcare payers and well-established government payers, and a large number of healthcare IT companies

Recent Developments

• In 2021, R1 and Mednax entered into an agreement to make R1 the primary provider of enterprise revenue cycle management services for Mednax.
• In 2021, Vanderbilt collaborated with McKesson to offer VHRxS’ full suite of specialty pharmacy consulting services to McKessons health system clients.
• In 2020, Cerner and Banner signed an agreement to add Cerner revenue cycle management solutions to Banner Health profile.