According to Arizton’s latest research report, the U.S. revenue cycle management market is growing at a CAGR of 11.55% during 2024-2030.
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Report Scope:
Market Size (2030): $272.78 Billion
Market Size (2024): $141.61 Billion
CAGR (2024-2030): 11.55%
Historic Year: 2021-2023
Base Year: 2024
Forecast Year: 2025-2030
Market Segmentation: Component Type, Delivery Mode, Solution Type, Service Type, and End-User
The US Revenue Cycle Management (RCM) market is expanding due to complexities in healthcare billing, evolving regulations, and the rise of high-deductible health plans. The post-cycle segment, accounting for 57.62% of the market, is growing rapidly due to increased insurance claim rejections and cash flow challenges. Cloud-based RCM platforms, holding 57.47% market share, offer real-time access and efficiency. Integrated solutions, with a 69.63% share, are also in high demand for streamlining financial workflows. The ambulatory care and hospital segments, critical for managing complex billing, are projected to experience significant growth, driven by the need for efficient payment and reimbursement management.
Cloud-Based RCM: Transforming Healthcare Operations with Flexibility and Efficiency
Cloud-based Revenue Cycle Management (RCM) solutions are gaining momentum as healthcare organizations in the US shift away from on-premises systems. This move is fueled by the cost-effectiveness, scalability, and enhanced security of cloud platforms. Cloud RCM provides flexibility, allowing healthcare organizations, particularly small and medium-sized practices, to scale operations with ease and avoid costly IT infrastructure. The shift to the cloud also improves interoperability, enabling seamless integration with systems like Electronic Health Records (EHRs) and Practice Management Systems (PMS), streamlining workflows, reducing data silos, and boosting overall efficiency in an evolving healthcare landscape.
Post-Cycle: A High-Growth Segment with a 12.05% CAGR
The post-cycle Revenue Cycle Management (RCM) in the US healthcare system has seen significant shifts in 2024, driven by evolving regulations, technological innovations, and financial pressures on providers. Key trends include the increasing use of automation and Artificial Intelligence (AI) to reduce claim denials, enhance reimbursement rates, and alleviate administrative burdens. Smaller practices are outsourcing RCM services to third-party providers for expertise in billing and coding, ensuring compliance, and improving cash flow. Denial management is another focal point, with automated systems leveraging Machine Learning (ML) to quickly resolve issues, improving revenue recovery and minimizing delays in the claims process. Technology is central to optimizing post-cycle RCM, balancing financial performance and compliance.
Key Market Developments and Activities in the US Revenue Cycle Management Market
The US revenue cycle management (RCM) market features a competitive landscape with both established corporations and emerging players. Dominant companies like Change Healthcare, Oracle, Epic Systems Corp, Experian, R1 RCM, McKesson Corp, Veradigm, and SSI Group lead the market, benefiting from strong product portfolios. Emerging players such as Akasa, Carecloud, Access Healthcare, and Bizmatics are focusing on launching new products to increase their market share. In 2024, CorroHealth, a leading healthcare technology and RCM company, strengthened its position by acquiring Xtend Healthcare's RCM business from Navient, solidifying its leadership in RCM consultancy and technology.
Market Trends & Drivers in Revenue Cycle Management (RCM)
Shift from Computer-Assisted Coding (CAC) to Autonomous Coding The healthcare industry is increasingly moving from Computer-Assisted Coding (CAC) to Autonomous Coding, driven by advancements in AI and machine learning. Autonomous coding fully automates the process, reducing human involvement and addressing issues like human error and fatigue. This shift aims to enhance efficiency, accuracy, and cost-effectiveness in medical coding. Studies, including a 2023 Frost & Sullivan report, show that over 30% of healthcare organizations are adopting autonomous coding solutions, with systems reducing coding time by up to 50% while improving accuracy. Autonomous coding is set to revolutionize RCM, increasing operational efficiency and revenue collection.
Increasing Adoption of Third-party Managed RCM Solutions The growing financial pressures, regulatory challenges, and shift to value-based care have led to the increasing adoption of third-party managed RCM solutions in the US healthcare market. Outsourcing RCM helps providers streamline operations, improve cash flow, and reduce costs. A 2023 Healthcare IT News survey found that 40% of healthcare providers outsource RCM functions to avoid in-house team costs. Third-party vendors bring specialized expertise in billing, coding, and collections, along with advanced technologies like automation and AI. This trend, highlighted by a KPMG report, reflects the preference for cost-effective solutions that optimize revenue cycles while enabling providers to focus on clinical excellence.
Key Vendors
- Change Healthcare
- Epic Systems Corporation
- Experian
- McKesson Corporation
- Oracle
- R1 RCM
- Veradigm
- SSI Group
- Abax Health
- Access Healthcare
- Acrologic Business Solutions
- AdvancedMD
- Advantum Health
- AdvantEdge Healthcare Solutions
- AKASA
- Bellmedex
- Bizmatics
- Cantata Health Solutions
- CareCloud
- Cognizant
- Cosentus
- Coronis Health
- The Craneware Group
- CorroHealth
- CureMD Healthcare
- Data Marshall
- DrChrono
- EHealthSource
- Greenway Health
- Qualifacts
- IntelliRCM
- Tebra
- Medical Billers and Coders
- MGSI
- MRO Corp
- NextGen Healthcare
- OSP
- Persistent Systems
- PMMC
- Promantra
- Quadax
- QWay Healthcare
- Rectangle Health
- ReMedics
- Revele
- RevenueXL
- Right Medical Billing
- Serbin Medical Billing
- SHOAR
- Synergen Health
- Rectangle Health
- Unified Health Services
- Vee Technologies
- Ventra Health
- Waystar
Segmentation & Forecast
Component Type
- Post-cycle
- Pre-cycle
- Mid-cycle
Delivery Mode
- Cloud-based
- On-premises
Solution Type
- Integrated
- Standalone
Service Type
- Ambulatory Care
- Acute Care
- Post Acute Care
End-User
- Hospitals
- Physician Offices
- Others
What Key Findings Our Research Analysis Reveals?
How big is the U.S. revenue cycle management market?
What is the growth rate of the U.S. revenue cycle management market?
What are the latest trends in the US revenue cycle management market?
Which component has the largest share of the US revenue cycle management market?
Who are the key players in the U.S. revenue cycle management market?
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