U.S. Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-house, Outsourced), By Service (Front-end, Middle-end, Back-end), By End-use, And Segment Forecasts, 2022 - 2030
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U.S. Medical Billing Outsourcing Market Growth & Trends
The U.S. medical billing outsourcing market size is expected to reach USD 12.3 billion by 2030, based on a new report by Grand View Research, Inc. It is expected to expand at a CAGR of 11.34% from 2022 to 2030. Increasing complexity in health reimbursement and high chances of claim denials are expected to drive the market. The growing burden of the patient pool, patient data, and billing volumes during and after the pandemic forced the hospital industry to outsource medical billing services. This is expected to propel the growth of the market during the forecast period.
Additionally, challenges faced by the in-house billing service during the pandemic era increased the need for an alternative i.e. outsourcing the billing services. The challenge mounts when the billing process mandates adherence to the International Classification of Diseases-11th (ICD-11) code along with dealing with rising healthcare costs and declining reimbursements. In order to curb or alleviate these challenges, several healthcare providers, such as acute care hospitals and clinics/physician offices, prefer outsourcing their billing processes. According to the Medical Group Management Association, around 73% of physicians found a reduction in the ARA days due to the addition of outsourcing and posed the higher collections.
Acceptance of Revenue Cycle Management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing of medical billing services include improvement in the billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.
Moreover, the pandemic drastically impacted the U.S. market for medical billing outsourcing. The reduction in hospital revenue and patient volumes slowed down the market growth. New billing and telehealth codes were introduced during the pandemic. The growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. The medical billing providers have spent significant amounts on the billing resources and technology, which can be utilized by the healthcare providers after outsourcing the billing process.
U.S. Medical Billing Outsourcing Market Report Highlights
U.S. Medical Billing Outsourcing Market Growth & Trends
The U.S. medical billing outsourcing market size is expected to reach USD 12.3 billion by 2030, based on a new report by Grand View Research, Inc. It is expected to expand at a CAGR of 11.34% from 2022 to 2030. Increasing complexity in health reimbursement and high chances of claim denials are expected to drive the market. The growing burden of the patient pool, patient data, and billing volumes during and after the pandemic forced the hospital industry to outsource medical billing services. This is expected to propel the growth of the market during the forecast period.
Additionally, challenges faced by the in-house billing service during the pandemic era increased the need for an alternative i.e. outsourcing the billing services. The challenge mounts when the billing process mandates adherence to the International Classification of Diseases-11th (ICD-11) code along with dealing with rising healthcare costs and declining reimbursements. In order to curb or alleviate these challenges, several healthcare providers, such as acute care hospitals and clinics/physician offices, prefer outsourcing their billing processes. According to the Medical Group Management Association, around 73% of physicians found a reduction in the ARA days due to the addition of outsourcing and posed the higher collections.
Acceptance of Revenue Cycle Management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing of medical billing services include improvement in the billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.
Moreover, the pandemic drastically impacted the U.S. market for medical billing outsourcing. The reduction in hospital revenue and patient volumes slowed down the market growth. New billing and telehealth codes were introduced during the pandemic. The growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. The medical billing providers have spent significant amounts on the billing resources and technology, which can be utilized by the healthcare providers after outsourcing the billing process.
U.S. Medical Billing Outsourcing Market Report Highlights
- Based on component, the outsourced segment is expected to witness the highest growth during the forecast period owing to the growing focus on minimizing the cost of healthcare delivery and improving patient and physician relationship
- By service, the front-end services segment dominated the market in 2021 as these services increase downstream cash flow and decrease rework and cost to collect
- The middle-end services segment is expected to register the fastest growth rate during the forecast period. This is attributed to the growing awareness about billing outsourcing among healthcare practitioners and the rising adoption of the middle-end services among them
- By end-use, the hospitals segment accounted for the largest revenue share in 2021 owing to the high claim volumes and rising patient burden. Additionally, errorless billing procedures and minimization of loss due to denial of payments are the benefits associated with the medical billing outsourcing, which leads to the rising adoption in multispecialty hospitals
CHAPTER 1 REPORT SCOPE AND OBJECTIVES
1.1 Market Segmentation
1.2 Regional Scope
1.3 Estimates and Forecast Timeline
1.4 Research Objectives
1.4.1 Objective -
1.4.2 Objective -
1.4.3 Objective -
CHAPTER 2 METHODOLOGY
2.1 Research Methodology
2.1.1 Information procurement
2.1.2 Purchased Database
2.1.3 GVR’s Internal Database
2.1.4 Secondary Sources
2.1.5 Primary Research
2.2 Information or Data Analysis
2.2.1 Data Analysis Models
2.3 Market Formulation & Validation
2.4 Model Details
2.4.1 Commodity Flow Analysis
2.4.2 Volume price analysis
2.5 List of Secondary Sources
2.6 List of Abbreviations
CHAPTER 3 EXECUTIVE SUMMARY
3.1 Market Outlook
3.2 Segment Outlook
3.2.1 Component
3.2.2 Service
3.2.3 End-use
3.3 Competitive Insights
CHAPTER 4 MARKET VARIABLES, TRENDS & SCOPE
4.1 Market Lineage Outlook
4.1.1 Parent Market Outlook
4.1.2 Related/Ancillary Market Outlook
4.2 U.S. Medical Billing Outsourcing Market Dynamics
4.2.1 Market Driver Analysis
4.2.1.1 Growing focus on increasing the profitability and revenue generated by the business
4.2.1.2 Federal mandate to implement digital record keeping by healthcare providers
4.5.1.3 Rapidly changing healthcare regulations
4.2.2 Market Restraint Analysis
4.2.2.1 High threat of data breaching
4.3 U.S. Medical Billing Outsourcing Market: Business Environment Analysis Tools
4.3.1 Porter’s Five Forces Analysis
4.3.1.1 Threat of new entrants
4.3.1.2 Bargaining power of buyers
4.3.1.3 Competitive rivalry
4.3.1.4 Threat of substitutes
4.3.2 PESTLE Analysis
4.3.2.1 Political & legal
4.3.2.2 Economic & Social
4.3.2.3 Technological
4.4 Penetration & Growth Prospect Mapping
4.5 Qualitative Analysis: Impact of COVID-19
CHAPTER 5 U.S. MEDICAL BILLING OUTSOURCING MARKET: COMPONENT ANALYSIS
5.1 U.S. Medical Billing Outsourcing Component Market Share Analysis, 2021 & 2030
5.2 U.S. Medical Billing Outsourcing Component Market: Segment Dashboard
5.3 Market Size & Forecasts and Trend Analyses, 2017 - 2030 for the Component Segment
5.3.1 In-house
5.3.1.1 In-house market, 2017 - 2030 (USD Million)
5.3.2 Outsourced
5.3.2.1 Outsourced market, 2017 - 2030 (USD Million)
CHAPTER 6 U.S. MEDICAL BILLING OUTSOURCING MARKET: SERVICE ANALYSIS
6.1 U.S. Medical Billing Outsourcing Services Market Share Analysis, 2021 & 2030
6.2 U.S. Medical Billing Outsourcing Services Market: Segment Dashboard
6.3 Market Size & Forecasts and Trend Analyses, 2017 - 2030 for the Service Segment
6.3.1 Front-end Services
6.3.1.1 Front-end services market, 2017 - 2030 (USD Million)
6.3.2 Middle-end Services
6.3.2.1 Middle-end services market, 2017 - 2030 (USD Million)
6.3.3 Back-end Services
6.3.3.1 Back-end services market, 2017 - 2030 (USD Million)
CHAPTER 7 U.S. MEDICAL BILLING OUTSOURCING MARKET: END-USE ANALYSIS
7.1 U.S. Medical Billing Outsourcing End-use Market Share Analysis, 2021 & 2030
7.2 U.S. Medical Billing Outsourcing End-use Market: Segment Dashboard
7.3 Market Size & Forecasts and Trend Analyses, 2017 - 2030 for the End-use Segment
7.3.1 Hospitals
7.3.1.1 Hospitals arket, 2017 - 2030 (USD Million)
7.3.2 Physician Offices
7.3.2.1 Physician offices market, 2017 - 2030 (USD Million)
7.3.3 Others
7.3.3.1 Others market, 2017 - 2030 (USD Million)
CHAPTER 8 COMPETITIVE ANALYSIS
8.1 Recent Developments & Impact Analysis, by Key Market Participants
8.2 Competition Categorization (Key Innovators, Market Leaders, Emerging Players)
8.3 Company Market Position Analysis
8.4 Company Profiles
8.4.1 R1RCM, Inc.
8.4.1.1 Company overview
8.4.1.2 Financial performance
8.4.1.3 Product benchmarking
8.4.1.4 Strategic initiatives
8.4.1.5 SWOT analysis
8.4.2 Allscripts Healthcare, LLC
8.4.2.1 Company overview
8.4.2.2 Financial performance
8.4.2.3 Product benchmarking
8.4.2.4 Strategic initiatives
8.4.2.5 SWOT analysis
8.4.3 Quest Diagnostics Incorporated
8.4.3.1 Company overview
8.4.3.2 Financial performance
8.4.3.3 Product benchmarking
8.4.3.4 Strategic initiatives
8.4.4 Promantra, Inc.
8.4.4.1 Company overview
8.4.4.2 Product benchmarking
8.4.4.3 Strategic initiatives
8.4.5 Kareo, Inc.
8.4.5.1 Company overview
8.4.5.2 Financial performance
8.4.5.3 Product benchmarking
8.4.5.4 Strategic initiatives
8.4.6 Cerner Corporation
8.4.6.1 Company overview
8.4.6.2 Financial performance
8.4.6.3 Product benchmarking
8.4.6.4 Strategic initiatives
8.4.7 Mckesson Corporation
8.4.7.1 Company overview
8.4.7.2 Financial performance
8.4.7.3 Product benchmarking
8.4.7.4 Strategic initiatives
8.4.8 eClinicalWorks
8.4.8.1 Company overview
8.4.8.2 Financial performance
8.4.8.3 Product benchmarking
8.4.8.4 Strategic initiatives
8.4.9 AdvancedMD, Inc.
8.4.9.1 Company overview
8.4.9.2 Product benchmarking
8.4.9.3 Strategic initiatives
1.1 Market Segmentation
1.2 Regional Scope
1.3 Estimates and Forecast Timeline
1.4 Research Objectives
1.4.1 Objective -
1.4.2 Objective -
1.4.3 Objective -
CHAPTER 2 METHODOLOGY
2.1 Research Methodology
2.1.1 Information procurement
2.1.2 Purchased Database
2.1.3 GVR’s Internal Database
2.1.4 Secondary Sources
2.1.5 Primary Research
2.2 Information or Data Analysis
2.2.1 Data Analysis Models
2.3 Market Formulation & Validation
2.4 Model Details
2.4.1 Commodity Flow Analysis
2.4.2 Volume price analysis
2.5 List of Secondary Sources
2.6 List of Abbreviations
CHAPTER 3 EXECUTIVE SUMMARY
3.1 Market Outlook
3.2 Segment Outlook
3.2.1 Component
3.2.2 Service
3.2.3 End-use
3.3 Competitive Insights
CHAPTER 4 MARKET VARIABLES, TRENDS & SCOPE
4.1 Market Lineage Outlook
4.1.1 Parent Market Outlook
4.1.2 Related/Ancillary Market Outlook
4.2 U.S. Medical Billing Outsourcing Market Dynamics
4.2.1 Market Driver Analysis
4.2.1.1 Growing focus on increasing the profitability and revenue generated by the business
4.2.1.2 Federal mandate to implement digital record keeping by healthcare providers
4.5.1.3 Rapidly changing healthcare regulations
4.2.2 Market Restraint Analysis
4.2.2.1 High threat of data breaching
4.3 U.S. Medical Billing Outsourcing Market: Business Environment Analysis Tools
4.3.1 Porter’s Five Forces Analysis
4.3.1.1 Threat of new entrants
4.3.1.2 Bargaining power of buyers
4.3.1.3 Competitive rivalry
4.3.1.4 Threat of substitutes
4.3.2 PESTLE Analysis
4.3.2.1 Political & legal
4.3.2.2 Economic & Social
4.3.2.3 Technological
4.4 Penetration & Growth Prospect Mapping
4.5 Qualitative Analysis: Impact of COVID-19
CHAPTER 5 U.S. MEDICAL BILLING OUTSOURCING MARKET: COMPONENT ANALYSIS
5.1 U.S. Medical Billing Outsourcing Component Market Share Analysis, 2021 & 2030
5.2 U.S. Medical Billing Outsourcing Component Market: Segment Dashboard
5.3 Market Size & Forecasts and Trend Analyses, 2017 - 2030 for the Component Segment
5.3.1 In-house
5.3.1.1 In-house market, 2017 - 2030 (USD Million)
5.3.2 Outsourced
5.3.2.1 Outsourced market, 2017 - 2030 (USD Million)
CHAPTER 6 U.S. MEDICAL BILLING OUTSOURCING MARKET: SERVICE ANALYSIS
6.1 U.S. Medical Billing Outsourcing Services Market Share Analysis, 2021 & 2030
6.2 U.S. Medical Billing Outsourcing Services Market: Segment Dashboard
6.3 Market Size & Forecasts and Trend Analyses, 2017 - 2030 for the Service Segment
6.3.1 Front-end Services
6.3.1.1 Front-end services market, 2017 - 2030 (USD Million)
6.3.2 Middle-end Services
6.3.2.1 Middle-end services market, 2017 - 2030 (USD Million)
6.3.3 Back-end Services
6.3.3.1 Back-end services market, 2017 - 2030 (USD Million)
CHAPTER 7 U.S. MEDICAL BILLING OUTSOURCING MARKET: END-USE ANALYSIS
7.1 U.S. Medical Billing Outsourcing End-use Market Share Analysis, 2021 & 2030
7.2 U.S. Medical Billing Outsourcing End-use Market: Segment Dashboard
7.3 Market Size & Forecasts and Trend Analyses, 2017 - 2030 for the End-use Segment
7.3.1 Hospitals
7.3.1.1 Hospitals arket, 2017 - 2030 (USD Million)
7.3.2 Physician Offices
7.3.2.1 Physician offices market, 2017 - 2030 (USD Million)
7.3.3 Others
7.3.3.1 Others market, 2017 - 2030 (USD Million)
CHAPTER 8 COMPETITIVE ANALYSIS
8.1 Recent Developments & Impact Analysis, by Key Market Participants
8.2 Competition Categorization (Key Innovators, Market Leaders, Emerging Players)
8.3 Company Market Position Analysis
8.4 Company Profiles
8.4.1 R1RCM, Inc.
8.4.1.1 Company overview
8.4.1.2 Financial performance
8.4.1.3 Product benchmarking
8.4.1.4 Strategic initiatives
8.4.1.5 SWOT analysis
8.4.2 Allscripts Healthcare, LLC
8.4.2.1 Company overview
8.4.2.2 Financial performance
8.4.2.3 Product benchmarking
8.4.2.4 Strategic initiatives
8.4.2.5 SWOT analysis
8.4.3 Quest Diagnostics Incorporated
8.4.3.1 Company overview
8.4.3.2 Financial performance
8.4.3.3 Product benchmarking
8.4.3.4 Strategic initiatives
8.4.4 Promantra, Inc.
8.4.4.1 Company overview
8.4.4.2 Product benchmarking
8.4.4.3 Strategic initiatives
8.4.5 Kareo, Inc.
8.4.5.1 Company overview
8.4.5.2 Financial performance
8.4.5.3 Product benchmarking
8.4.5.4 Strategic initiatives
8.4.6 Cerner Corporation
8.4.6.1 Company overview
8.4.6.2 Financial performance
8.4.6.3 Product benchmarking
8.4.6.4 Strategic initiatives
8.4.7 Mckesson Corporation
8.4.7.1 Company overview
8.4.7.2 Financial performance
8.4.7.3 Product benchmarking
8.4.7.4 Strategic initiatives
8.4.8 eClinicalWorks
8.4.8.1 Company overview
8.4.8.2 Financial performance
8.4.8.3 Product benchmarking
8.4.8.4 Strategic initiatives
8.4.9 AdvancedMD, Inc.
8.4.9.1 Company overview
8.4.9.2 Product benchmarking
8.4.9.3 Strategic initiatives
LIST OF TABLES
Table 1 List of secondary sources
Table 2 List of abbreviation
Table 3 U.S. medical billing outsourcing market, by component, 2017 - 2030 (USD Million)
Table 4 U.S. medical billing outsourcing market, by service 2017 - 2030 (USD Million)
Table 5 U.S. medical billing outsourcing market, by end-use 2017 - 2030 (USD Million
Table 1 List of secondary sources
Table 2 List of abbreviation
Table 3 U.S. medical billing outsourcing market, by component, 2017 - 2030 (USD Million)
Table 4 U.S. medical billing outsourcing market, by service 2017 - 2030 (USD Million)
Table 5 U.S. medical billing outsourcing market, by end-use 2017 - 2030 (USD Million
LIST OF FIGURES
Fig. 1 Market trends & outlook
Fig. 2 Market segmentation & scope
Fig. 3 Market driver relevance analysis (Current & future impact)
Fig. 4 Market restraint relevance analysis (Current & future impact)
Fig. 5 Penetration & Growth Prospect Mapping
Fig. 6 Medical billing outsourcing market, by component outlook: Key takeaways
Fig. 7 In-house billing market, 2017 - 2030 (USD Million)
Fig. 8 Outsourced billing market, 2017 - 2030 (USD Million)
Fig. 9 Medical billing outsourcing market: Service analysis
Fig. 10 Medical billing outsourcing market, by service outlook: Key takeaways
Fig. 11 Front-end service market, 2017 - 2030 (USD Million)
Fig. 12 Middle-end service market, 2017 - 2030 (USD Million)
Fig. 13 Back-end service market, 2017 - 2030 (USD Million)
Fig. 14 Medical billing outsourcing market, by end-use outlook: Key takeaways
Fig. 15 Hospital market, 2017 - 2030 (USD Million)
Fig. 16 Physician offices market, 2017 - 2030 (USD Million)
Fig. 17 Others market, 2017 - 2030 (USD Million)
Fig. 18 Recent Developments and Impact Analysis, by Key Market Participants
Fig. 19 Strategy framework
Fig. 20 Company Market position analysis
Fig. 21 Market research process
Fig. 22 Information procurement
Fig. 23 Primary research pattern
Fig. 24 Market research approaches
Fig. 25 Value-chain-based sizing & forecasting
Fig. 26 QFD modelling for market share assessment
Fig. 27 Market formulation & validation
Fig. 1 Market trends & outlook
Fig. 2 Market segmentation & scope
Fig. 3 Market driver relevance analysis (Current & future impact)
Fig. 4 Market restraint relevance analysis (Current & future impact)
Fig. 5 Penetration & Growth Prospect Mapping
Fig. 6 Medical billing outsourcing market, by component outlook: Key takeaways
Fig. 7 In-house billing market, 2017 - 2030 (USD Million)
Fig. 8 Outsourced billing market, 2017 - 2030 (USD Million)
Fig. 9 Medical billing outsourcing market: Service analysis
Fig. 10 Medical billing outsourcing market, by service outlook: Key takeaways
Fig. 11 Front-end service market, 2017 - 2030 (USD Million)
Fig. 12 Middle-end service market, 2017 - 2030 (USD Million)
Fig. 13 Back-end service market, 2017 - 2030 (USD Million)
Fig. 14 Medical billing outsourcing market, by end-use outlook: Key takeaways
Fig. 15 Hospital market, 2017 - 2030 (USD Million)
Fig. 16 Physician offices market, 2017 - 2030 (USD Million)
Fig. 17 Others market, 2017 - 2030 (USD Million)
Fig. 18 Recent Developments and Impact Analysis, by Key Market Participants
Fig. 19 Strategy framework
Fig. 20 Company Market position analysis
Fig. 21 Market research process
Fig. 22 Information procurement
Fig. 23 Primary research pattern
Fig. 24 Market research approaches
Fig. 25 Value-chain-based sizing & forecasting
Fig. 26 QFD modelling for market share assessment
Fig. 27 Market formulation & validation
