North America Revenue Cycle Management (RCM) Market – Industry Trends and Forecast to 2030

North America Revenue Cycle Management (RCM) Market, By Stage (Front Office, Mid Office and Back Office), Product Type (Integrated RCM, Standalone RCM), Function (Claims and Denial Management, Medical Coding, and Billing, Electronic Health Record (EHR), Clinical Documentation Improvement (CDI), Insurance, Others), Deployment (Web-based, On-premise, Cloud-based), Component (Software, Services), End User (Hospitals, General Physicians, Labs, Others) – Industry Trends and Forecast to 2030.

North America Revenue Cycle Management (RCM) Market Analysis and Size

Revenue cycle management (RCM) software has become necessary in all sectors since it automates employee data, payroll, and benefits administration tasks. The U.S. healthcare industry is continuously progressing and adopting advanced technological solutions. However, the market's recent growth is due to the huge growth opportunities created by enhancing SMEs across regions. Furthermore, it has been noticed that the services segment has been dominating the market in recent years with a high market share.

Data Bridge Market Research analyses that the revenue cycle management (RCM) market, which was USD 96 billion in 2022, would rise to USD 221.24 billion by 2030 and is expected to undergo a CAGR of 11% during the forecast period 2023 to 2030. In addition to the insights on market scenarios such as market value, growth rate, segmentation, geographical coverage, and major players, the market reports curated by the Data Bridge Market Research also include depth expert analysis, patient epidemiology, pipeline analysis, pricing analysis, and regulatory framework.

North America Revenue Cycle Management (RCM) Market Scope and Segmentation

Market Definition

Revenue cycle management is the management of all administrative and clinical operations that lead to patient service and directly or indirectly to revenue to maximize profits. It allows health providers to increase their income by processing claims. Revenue cycle management includes medical coding, patient registration, payment and accounst receivable management, insurance eligibility and verification, and claim processing.

North America Revenue Cycle Management (RCM) Market Dynamics

Drivers

• Growing Demand for Integrated Systems

The increasing demand for integrated systems leads to market enhancement. These end-to-end systems increase an organization's data sharing and interoperability capabilities. These solutions allow the healthcare workforce to improve productivity, reduce costs, and surge the net operating margins. The increasing need to minimize human errors and surge the administrative functions leads to the growth of integrated RCM solutions. Thus, this factor increases the market growth.

• Increasing Adoption of Cloud-deployed RCM

The delivery mode of cloud-deployed RCM is growing because of higher flexibility and higher cost-effectiveness to end-users. Cloud-deployed solutions enabled medical data-sharing to be easy and secure. It automates backend processes and enables the creation and protection of telehealth apps. Additionally, cloud-deployed solutions help healthcare institutes to deal with electronic medical records, patient portals, big data analytics, and mobile applications to prevent additional costs for maintaining servers. Thus, this factor boosts market growth.

Opportunities

• Increasing R&D Activities Associated with RCM

The increasing R&D activities associated with RCM lead to market enhancement. For instance, in 2019, SOC Telemed announced the completion of the pilot stages and beta testing of its RCM service by delivering at strategic partner hospitals around the U.S. The company's RCM service primarily focuses on billing telemedicine services and its associated financial liability from the hospital. This service helps effectively capture the revenue for clinical partners to ensure their telemedicine program's sustainability through cost reduction. Thus, this factor boosts market growth.

• Growing Strategic Initiatives Associated With Revenue Cycle Management (RCM)

There have been increasing initiatives by market players that have led to the market's growth. For instance, revenue cycle management (RCM) vendor Waystar declared to acquire Patientco in 2021 in the recent deal between an RCM vendor and a patient payment company. The RCM vendor aims for the combination to enhance the patient's financial experience by offering users consumer-friendly options for paying medical bills. Therefore, this factor boosts the market growth.

Restraints/Challenges

• Increasing Unwanted Cost Associated with Revenue Cycle Management (RCM)

Numerous consulting firms, even RCM ones, are not so good at charging hidden fees. There can be various hidden costs, such as fees for generating reports, setting up services, printing statements, and canceling services that hinder users' use. Thus, these factors hamper the market growth.

This revenue cycle management (RCM) market report provides details of new recent developments, trade regulations, import-export analysis, production analysis, value chain optimization, market share, impact of domestic and localized market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, strategic market growth analysis, market size, category market growths, application niches and dominance, product approvals, product launches, geographic expansions, technological innovations in the market. To gain more info on the revenue cycle management (RCM) market contact Data Bridge Market Research for an Analyst Brief, our team will help you take an informed market decision to achieve market growth.

Recent Development

• In 2020, Waystar Health launched Hubble, an AI/RPA integrated platform mainly used for revenue cycle process automation. Revenue capture uses predictive analytics and advanced machine learning algorithms through this platform. These advanced add-on integrations automatically recognize missing charges, coding variances, and DRG anomalies based on an organization's past billing practices.

North America Revenue Cycle Management RCM) Market Scope

The revenue cycle management (RCM) market is segmented on the basis of stage, product type, function, organization size, deployment, and end user. The growth amongst these segments will help you analyze meagre growth segments in the industries and provide the users with a valuable market overview and market insights to help them make strategic decisions for identifying core market applications.

Stage

• Front Office
• Mid Office
• Back Office

Product Type

• Integrated RCM
• Standalone RCM

Function

• Claims and denial management
• Medical coding and billing
• Electronic health record (EHR)
• Clinical documentation improvement (CDI)
• Insurance
• Others

Organization size

• Software
• Services

Deployment Model

• Cloud
• On-premise
• Web-based

End-user

• Hospitals
• General physicians
• Others

Revenue Cycle Management (RCM) Market Regional Analysis/Insights

The revenue cycle management (RCM) market is analyzed and market size insights and trends are provided by stage, product type, function, organization size, deployment, and end user , as referenced above.

The countries covered in the revenue cycle management (RCM) market report are U.S., Canada, and Mexico in North America

U.S. dominates the revenue cycle management (RCM) market due to the huge presence of well-established hospitals and healthcare infrastructure and a surging need in this region to minimize healthcare costs. Additionally, favorable regulations are also creating huge growth opportunities for the market in the region.      

The country section of the report also provides individual market impacting factors and changes in regulation in the market domestically that impacts the current and future trends of the market. Data points like down-stream and upstream value chain analysis, technical trends and porter's five forces analysis, case studies are some of the pointers used to forecast the market scenario for individual countries. Also, the presence and availability of north america brands and their challenges faced due to large or scarce competition from local and domestic brands, impact of domestic tariffs and trade routes are considered while providing forecast analysis of the country data.   

Healthcare Infrastructure growth Installed base and New Technology Penetration

The revenue cycle management (RCM) market also provides you with detailed market analysis for every country growth in healthcare expenditure for capital equipment, installed base of different kind of products for revenue cycle management (RCM) market, impact of technology using life line curves and changes in healthcare regulatory scenarios and their impact on the revenue cycle management (RCM) market. The data is available for historic period 2011-2021.

Competitive Landscape and Revenue Cycle Management (RCM) Market Share Analysis

The revenue cycle management (RCM) market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, north america presence, production sites and facilities, production capacities, company strengths and weaknesses, product launch, product width and breadth, application dominance. The above data points provided are only related to the companies' focus related to revenue cycle management (RCM) market.

Some of the major players operating in the revenue cycle management (RCM) market are:

• Cerner Corporation (U.S.)
• General Electric (U.S.)
• McKesson Corporation (U.S.)
• SAP SE (Germany)
• IBM (U.S.)
• NetSuite Inc. (U.S.)
• Workday, Inc. (U.S.)
• ADP, LLC (U.S.)
• Cornerstone OnDemand (U.S.)
• Benefitfocus Inc. (U.S.)
• Zoho Corporation Pvt. Ltd (India)
• Sage Global Services Limited (U.K)
• Epicor Software Corporation (U.S)
• Infor (U.S)
• Kronos Incorporated (U.S)
• The Sage Group plc. (U.S)