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U.S. Revenue Cycle Management Market Size, Share & Trends Analysis Report By End-use, By Product Type, By Component, By Delivery Mode, By Physician Specialty, By Sourcing, By Function, And Segment Forecasts, 2024 - 2030

May 2024 | 100 pages | ID: U5CF95180A65EN
Grand View Research, Inc.

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U.S. Revenue Cycle Management Market Growth & Trends

The U.S. revenue cycle management market size is expected to reach USD 308.12 billion by 2030, growing at a CAGR of 10.18% over the forecast period, according to a new report by Grand View Research, Inc. The rapidly transforming healthcare system and adoption of digitalization are paving a path for implementing healthcare IT services such as Revenue Cycle Management (RCM) systems to organize and streamline workflows of healthcare organizations using synchronized management software solutions.

Moreover, healthcare systems in the U.S. are experiencing substantial changes with the adoption of electronic procedures for managing claims and reimbursements. The presence of numerous distinguished healthcare establishments, rising healthcare consciousness & expenditure, and increasing digital literacy are anticipated to boost market growth. Supportive regulatory alterations from government bodies and consistent technological advancements by market stakeholders are projected to further propel growth. The growing need for ongoing technological advancements is compelling the participants to revise their product development approaches to enhance the provider-patient connection within healthcare institutions. Key stakeholders are concentrating on alliances, acquisitions, and strategic collaborations with other industry participants to merge expertise & expand their market presence.

In January 2024, Veradigm LLC announced the acquisition of Koha Health, a full-service RCM provider. The acquisition added further expertise in the Musculoskeletal Medicine (MSK) specialty to the Veradigm Network while also strengthening its capacity to provide revenue cycle services to Ambulatory Surgical Centers (ASCs) and ambulatory healthcare provider practices that use diverse Electronic Health Record (EHR) systems. Veradigm is enhancing its comprehensive revenue cycle services range to offer better value to clients and tap into additional growth opportunities.

U.S. Revenue Cycle Management Market Report Highlights
  • On the basis of product type, the integrated system spearheaded the market in 2023 due to the growing demand from healthcare organizations for a synchronized single platform to manage financial activities.
  • On the basis of delivery mode, the web-based delivery mode segment dominated the market in 2023 due to the cost-effectiveness and rapid deployment of these solutions.
  • On the basis of end-use, the hospitals end-use segment led the market in 2023 due to the presence of well-established hospitals and growing healthcare IT infrastructure.
  • The others physician specialty segment dominated the market in 2023 due to increase in insurance coverage for other healthcare services.
  • The claim management segment led the market in 2023 in the function segment due to the increasing patient volume and the presence of ineffective claim management systems.
  • In September 2022, AGS Health introduced a connected solution that blends automation and Artificial Intelligence (AI) called AGS AI Platform. This solution aims to deliver seamless integration and robust process automation to ease labor shortages and allow flexible, scalable growth.
CHAPTER 1. METHODOLOGY AND SCOPE

1.1. Market Segmentation & Scope
  1.1.1. Segment Definitions
1.2. Estimates and Forecast Timeline
1.3. Research Methodology
1.4. Information Procurement
  1.4.1. Purchased Database
  1.4.2. GVR’s Internal Database
  1.4.3. Secondary Sources
  1.4.4. Primary Research
  1.4.5. Details of Primary Research
  1.4.6. Research Assumption
1.5. Information or Data Analysis
  1.5.1. Data Analysis Models
1.6. Market Formulation & Data Visualization
1.7. Model Details
  1.7.1. Commodity Flow Analysis
1.8. Objectives
1.9. List of Secondary Sources
1.10. List of Secondary Sources

CHAPTER 2. EXECUTIVE SUMMARY

2.1. U.S. Revenue Cycle Management Market
  2.1.1. Market Snapshot
  2.1.2. Segment Snapshot
    2.1.2.1. End-user & product type segment outlook
    2.1.2.2. Component & delivery mode segment outlook
    2.1.2.3. Physician specialty & sourcing segment outlook
    2.1.2.4. Function segment outlook
  2.1.3. Competitive Landscape Snapshot

CHAPTER 3. MARKET VARIABLES, TRENDS, & SCOPE

3.1. Market Lineage Outlook
  3.1.1. Parent Market Outlook
  3.1.2. Related/Ancillary Market Outlook
3.2. Market Trends and Outlook
3.3. Market Dynamics
  3.3.1. Market Driver Analysis
    3.3.1.1. Technological advancements
    3.3.1.2. Increase in outsourcing of RCM
    3.3.1.3. Increasing adoption of mHealth
    3.3.1.4. Growth of High-deductible Health Plans (HDHPs)
  3.3.2. Market Restraint Analysis
    3.3.2.1. Increasing payer partnerships
    3.3.2.2. Lack of Professionals to handle RCM processes
3.4. Regulatory Scenario & Reimbursement Outlook
  3.4.1. Regulatory Scenario
  3.4.2. Reimbursement Framework
3.5. Business Environment Analysis Tools
  3.5.1. Industry Analysis - Porter’s Five Forces Analysis
    3.5.1.1. Supplier power
    3.5.1.2. Buyer power
    3.5.1.3. Substitution threat
    3.5.1.4. Threat of new entrant
    3.5.1.5. Competitive rivalry
  3.5.2. PESTEL Analysis

CHAPTER 4. PRODUCT TYPE BUSINESS ANALYSIS

4.1. U.S. Revenue Cycle Management Market: Product Type Movement Analysis
4.2. U.S. Revenue Cycle Management Market: Product Type Segment Dashboard
4.3. Product Type Movement & Market Share Analysis, 2023 & 2030
4.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Product Type
4.5. Integrated System
  4.5.1. Integrated system market, 2018 - 2030 (USD Billion)
4.6. Standalone System
  4.6.1. Standalone system market, 2018 - 2030 (USD Billion)

CHAPTER 5. COMPONENT BUSINESS ANALYSIS

5.1. U.S. Revenue Cycle Management Market: Component Movement Analysis
5.2. U.S. Revenue Cycle Management Market: Component Segment Dashboard
5.3. Component Movement & Market Share Analysis, 2023 & 2030
5.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Component
5.5. Software Solution
  5.5.1. Software solution market, 2018 - 2030 (USD Billion)
5.6. Services
  5.6.1. Services market, 2018 - 2030 (USD Billion)

CHAPTER 6. DELIVERY MODE BUSINESS ANALYSIS

6.1. U.S. Revenue Cycle Management Market: Delivery Mode Movement Analysis
6.2. U.S. Revenue Cycle Management Market: Delivery Mode Segment Dashboard
6.3. Delivery Mode Movement & Market Share Analysis, 2023 & 2030
6.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Delivery Mode
6.5. On-premise
  6.5.1. On-Premise market, 2018 - 2030 (USD Billion)
6.6. Web-based
  6.6.1. Web-based market, 2018 - 2030 (USD Billion)
6.7. Cloud-based
  6.7.1. Cloud-based market, 2018 - 2030 (USD Billion)

CHAPTER 7. PHYSICIAN SPECIALTY BUSINESS ANALYSIS

7.1. U.S. Revenue Cycle Management Market: Physician Specialty Movement Analysis
7.2. U.S. Revenue Cycle Management Market: Physician Specialty Segment Dashboard
7.3. Physician Specialty Movement & Market Share Analysis, 2023 & 2030
7.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Physician Specialty
7.5. Oncology
  7.5.1. Oncology market, 2018 - 2030 (USD Billion)
7.6. Cardiology
  7.6.1. Cardiology market, 2018 - 2030 (USD Billion)
7.7. Anesthesia
  7.7.1. Anesthesia market, 2018 - 2030 (USD Billion)
7.8. Radiology
  7.8.1. Radiology market, 2018 - 2030 (USD Billion)
7.9. Pathology
  7.9.1. Pathology market, 2018 - 2030 (USD Billion)
7.10. Pain Management
  7.10.1. Pain management market, 2018 - 2030 (USD Billion)
7.11. Emergency Services
  7.11.1. Emergency services market, 2018 - 2030 (USD Billion)
7.12. Others
  7.12.1. Others market, 2018 - 2030 (USD Billion)

CHAPTER 8. SOURCING BUSINESS ANALYSIS

8.1. U.S. Revenue Cycle Management Market: Sourcing Movement Analysis
8.2. U.S. Revenue Cycle Management Market: Sourcing Segment Dashboard
8.3. Sourcing Movement & Market Share Analysis, 2023 & 2030
8.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Sourcing
8.5. In-house
  8.5.1. In-house market, 2018 - 2030 (USD Billion)
8.6. External RCM Apps/Software
  8.6.1. External RCM Apps/Software market, 2018 - 2030 (USD Billion)
8.7. Outsourced RCM Services
  8.7.1. Outsourced RCM services market, 2018 - 2030 (USD Billion)

CHAPTER 9. FUNCTION BUSINESS ANALYSIS

9.1. U.S. Revenue Cycle Management Market: Function Movement Analysis
9.2. U.S. Revenue Cycle Management Market: Function Segment Dashboard
9.3. Function Movement & Market Share Analysis, 2023 & 2030
9.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by Function
9.5. Product Development
  9.5.1. Product development market, 2018 - 2030 (USD Billion)
9.6. Product Development
  9.6.1. Product development market, 2018 - 2030 (USD Billion)
9.7. Member Engagement
  9.7.1. Member engagement market, 2018 - 2030 (USD Billion)
9.8. Network Management
  9.8.1. Network management market, 2018 - 2030 (USD Billion)
9.9. Care Management
  9.9.1. Care management market, 2018 - 2030 (USD Billion)
9.10. Claim Management
  9.10.1. Claim management market, 2018 - 2030 (USD Billion)
9.11. Risk and Compliances
  9.11.1. Risk and compliances market, 2018 - 2030 (USD Billion)

CHAPTER 10. END-USER BUSINESS ANALYSIS

10.1. U.S. Revenue Cycle Management Market: End-User Movement Analysis
10.2. U.S. Revenue Cycle Management Market: End-User Segment Dashboard
10.3. End-User Movement & Market Share Analysis, 2023 & 2030
10.4. U.S. Revenue Cycle Management Market Estimates & Forecast, by End use
10.5. Hospitals
  10.5.1. Hospitals market, 2018-2030 (USD Billion)
10.6. Physician & Clinical Services
  10.6.1. Physician & clinical services market, 2018-2030 (USD Billion)

CHAPTER 11. COMPETITIVE LANDSCAPE

11.1. Company Categorization
11.2. Company Market Position Analysis
11.3. Strategy Mapping
  11.3.1. Partnership/Collaboration/Alliance
  11.3.2. New Product Launch
  11.3.3. Mergers & Acquisitions
  11.3.4. Others
11.4. Company Profiles/Listing
  11.4.1. athenahealth, Inc.
    11.4.1.1. Overview
    11.4.1.2. Financial performance
    11.4.1.3. Product benchmarking
    11.4.1.4. Strategic initiatives
  11.4.2. Cerner Corporation
    11.4.2.1. Overview
    11.4.2.2. Financial performance
    11.4.2.3. Product benchmarking
    11.4.2.4. Strategic initiatives
  11.4.3. eClinicalWorks
    11.4.3.1. Overview
    11.4.3.2. Financial performance
    11.4.3.3. Product benchmarking
    11.4.3.4. Strategic initiatives
  11.4.4. Epic Systems Corporation
    11.4.4.1. Overview
    11.4.4.2. Financial performance
    11.4.4.3. Product benchmarking
    11.4.4.4. Strategic initiatives
  11.4.5. McKesson Corporation
    11.4.5.1. Overview
    11.4.5.2. Financial performance
    11.4.5.3. Product benchmarking
    11.4.5.4. Strategic initiatives
  11.4.6. NXGN Management, LLC
    11.4.6.1. Overview
    11.4.6.2. Financial performance
    11.4.6.3. Product benchmarking
    11.4.6.4. Strategic initiatives
  11.4.7. Oncospark, Inc.
    11.4.7.1. Overview
    11.4.7.2. Financial performance
    11.4.7.3. Product benchmarking
    11.4.7.4. Strategic initiatives
  11.4.8. R1 RCM, Inc.
    11.4.8.1. Overview
    11.4.8.2. Financial performance
    11.4.8.3. Product benchmarking
    11.4.8.4. Strategic initiatives
  11.4.9. The SSI Group, Inc.
    11.4.9.1. Overview
    11.4.9.2. Financial performance
    11.4.9.3. Product benchmarking
    11.4.9.4. Strategic initiatives
  11.4.10. Veradigm LLC (Allscripts Healthcare LLC)
    11.4.10.1. Overview
    11.4.10.2. Financial performance
    11.4.10.3. Product benchmarking
    11.4.10.4. Strategic initiatives
LIST OF TABLES


Table 1 List of secondary sources
Table 2 List of abbreviations
Table 3 U.S. revenue cycle management market, by product type, 2018 - 2030 (USD Million)
Table 4 U.S. revenue cycle management market, by component, 2018 - 2030 (USD Million)
Table 5 U.S. revenue cycle management market, by delivery mode, 2018 - 2030 (USD Million)
Table 6 U.S. revenue cycle management market, by physician specialty, 2018 - 2030 (USD Billion)
Table 7 U.S. revenue cycle management market, by sourcing, 2018 - 2030 (USD Billion)
Table 8 U.S. revenue cycle management market, by function, 2018 - 2030 (USD Billion)
Table 9 U.S. revenue cycle management market, by end use, 2018 - 2030 (USD Billion)
LIST OF FIGURES


Fig. 1 U.S. revenue cycle management market segmentation
Fig. 2 Market research process
Fig. 3 Information procurement
Fig. 4 Primary research pattern
Fig. 5 Market research approaches
Fig. 6 Value-chain-based sizing & forecasting
Fig. 7 QFD modeling for market share assessment
Fig. 8 Market formulation & validation
Fig. 9 Market snapshot
Fig. 10 Segment outlook
Fig. 11 Segment outlook
Fig. 12 Competitive scenario
Fig. 13 U.S. revenue cycle management market trends & outlook
Fig. 14 Market driver relevance analysis (Current & future impact)
Fig. 15 Market restraint relevance analysis (Current & future impact)
Fig. 16 U.S. revenue cycle management market: Porter’s Five Forces analysis
Fig. 17 U.S. revenue cycle management market: PESTLE analysis
Fig. 18 U.S. revenue cycle management market: Product type segment dashboard
Fig. 19 U.S. revenue cycle management market: by Product type: Market share analysis, 2023 & 2030
Fig. 20 Integrated market, 2018 - 2030 (USD Billion)
Fig. 21 Standalone market, 2018 - 2030 (USD Billion)
Fig. 22 U.S. revenue cycle management market: Component segment dashboard
Fig. 23 U.S. revenue cycle management market: by Component: Market share analysis, 2023 & 2030
Fig. 24 Software market, 2018 - 2030 (USD Billion)
Fig. 25 Services market, 2018 - 2030 (USD Billion)
Fig. 26 U.S. revenue cycle management market: Delivery mode segment dashboard
Fig. 27 U.S. revenue cycle management market: by Delivery mode: Market share analysis, 2023 & 2030
Fig. 28 On Premise market, 2018 - 2030 (USD Billion)
Fig. 29 Web Based market, 2018 - 2030 (USD Billion)
Fig. 30 Cloud Based market, 2018 - 2030 (USD Billion)
Fig. 31 U.S. revenue cycle management market: Physician specialty segment dashboard
Fig. 32 U.S. revenue cycle management market: by Physician specialty: Market share analysis, 2023 & 2030
Fig. 33 Oncology market, 2018 - 2030 (USD Billion)
Fig. 34 Cardiology market, 2018 - 2030 (USD Billion)
Fig. 35 Anesthesia market, 2018 - 2030 (USD Billion)
Fig. 36 Radiology market, 2018 - 2030 (USD Billion)
Fig. 37 Pathology market, 2018 - 2030 (USD Billion)
Fig. 38 Pain management market, 2018 - 2030 (USD Billion)
Fig. 39 Emergency services market, 2018 - 2030 (USD Billion)
Fig. 40 Others market, 2018 - 2030 (USD Billion)
Fig. 41 U.S. revenue cycle management market: Sourcing segment dashboard
Fig. 42 U.S. revenue cycle management market: by Sourcing: Market share analysis, 2023 & 2030
Fig. 43 In-house market, 2018 - 2030 (USD Billion)
Fig. 44 External RCM Apps/Software market, 2018 - 2030 (USD Billion)
Fig. 45 Outsourced RCM services market, 2018 - 2030 (USD Billion)
Fig. 46 U.S. revenue cycle management market: Function segment dashboard
Fig. 47 U.S. revenue cycle management market: by Function: Market share analysis, 2023 & 2030
Fig. 48 Product development market, 2018 - 2030 (USD Billion)
Fig. 49 Member engagement market, 2018 - 2030 (USD Billion)
Fig. 50 Network management market, 2018 - 2030 (USD Billion)
Fig. 51 Care management market, 2018 - 2030 (USD Billion)
Fig. 52 Claims management market, 2018 - 2030 (USD Billion)
Fig. 53 Risk and compliance market, 2018 - 2030 (USD Billion)
Fig. 54 U.S. revenue cycle management market: End-user segment dashboard
Fig. 55 U.S. revenue cycle management market: by End-user: Market share analysis, 2023 & 2030
Fig. 56 Hospitals market, 2018 - 2030 (USD Billion)
Fig. 57 Physician and clinical services market, 2018 - 2030 (USD Billion)
Fig. 58 Competition categorization
Fig. 59 Company market position analysis
Fig. 60 Strategy mapping


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