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REVENUE CYCLE MANAGEMENT
Lecture 5
Vijay Patil School of Management Prof. Kamlakar Gadegaonkar
Learning objective
• Market segmentation
• Industry Analysis
• Covid Impact
Market Size
Revenue Cycle Management Market
size was valued at US$ 40.9 Bn in
2021 and the total revenue is
expected to grow at 10% through
2021 to 2027, reaching nearly US$
72.46 Bn.
Segmentation of the Global Revenue Cycle Management Market:
Parameter Details
Segments Covered  Product (Software, Services)
 Type (Integrated, Standalone)
 Delivery Mode (On-Premise, Web-
based, Cloud-based)
 End Use (Physician Offices,
Hospitals, Diagnostic Laboratories,
Other Uses)
 Region (North America, Europe,
Asia Pacific, Latin America, Middle
East & Africa)
Segmentation of the Global Revenue Cycle Management Market:
Parameter Details
Regions & Countries Covered • North America - (U.S., Canada,
Mexico)
• Europe - (U.K., France, Germany,
Italy, Spain, Rest Of Europe)
• Asia Pacific - (China, Japan, India,
South Korea, South East Asia, Rest
Of Asia Pacific)
• Latin America - (Brazil, Argentina,
Rest Of Latin America)
• Middle East & Africa - (GCC
Countries, South Africa, Rest Of
Middle East & Africa)
Segmentation of the Global Revenue Cycle Management Market:
Parameter Details
Companies Covered • The SSI Group Inc.
• AllScripts Healthcare LLC
• Experian Health
• R1 RCM Inc
• McKesson Corporation
• Athena Health Inc
• Epic Systems Corporation
• NXGN Management LLC
• CareCloud Corporation
• Quest Diagnostics Inc.
Market segment analysis
• The Software segment is estimated to grab larger market
attention in the Revenue Cycle Management Market.
• The service segment, on the other hand, is likely to grow
at the quickest rate during the forecast period, owing to an
increase in the number of market participants Product
outsourced services to healthcare facilities, which is
expected to promote market growth during the forecast
period.
Market segment analysis
• The integrated segment is supplementing the growth of the Revenue
Cycle Management Market.
• With a revenue share of 71.3 % in 2021, the integrated segment
dominated the revenue cycle management market by type. This
development can be ascribed to some factors, including a
preference for volume-based payments over value-based payments.
Another factor driving this segment's growth is that integrated
solutions offer a streamlined and coordinated approach for several
financial tasks via a single platform, resulting in a consistent data
collecting and analysis procedure.
Market segment analysis
• The physician back-office segment is enhancing the growth of the
Revenue Cycle Management Market.
• The physician back-office sector dominated the worldwide revenue
cycle management market in 2020, accounting for 34.8% of total
revenue.
• The increased focus of various healthcare institutions and
organizations on implementing these systems and increasing the
number of physicians is expected to drive market expansion.
• The Association of American Medical Colleges, for example, is one
such organization working to increase the number of physicians in
the region. Such occurrences are advantageous to the market's
growth.
• The Web-based segment is fueling the growth of the Revenue Cycle
Management Market.
• The web-based category dominated the revenue cycle management
market in 2021, with a revenue share of 46.7%, and is expected to
grow at a steady rate during the forecast period. In the future years,
increasing usage of web-based solutions is expected to fuel overall
market growth.
• Task- who are the web based RCM servcie providers in India ?
Market segment analysis
Market segment analysis
on the basis of the functions, the market is segmented in to
• Claims and denial management,
• Medical coding and billing,
• Clinical documentation improvement (CDI).
• Insurance and others
Market segment analysis
• Claims and denial management holds the dominant position owing to
launch of advanced solutions that reduce the claim denials
• Medical oding and billign holds the second position followed by clinical
documentation improvement
• High gortwh rate in this segment is associated with increasing demand
for coding and billing services and professionals due to complex nature
of the services and transactions
9/17/2022 13
Industry Analysis
U S Largest market
U S. MARKET
• North America dominated the Revenue Cycle Management (RCM)
market in 2020, accounting for 50.6 % of revenue. The existence of
several physician's offices across the United States is one of the
factors responsible for this region's significant market share. In
addition, regulatory changes such as the adoption of ICD-10 in 2015
increased demand for HIT systems, notably revenue cycle
management systems, to improve healthcare delivery efficiency.
Additionally, the presence of big established hospitals and
healthcare infrastructures, favorable regulations, and the rising need
to reduce healthcare costs create profitable growth potential for the
industry.
Competitive Landscape
The key players in the Global Revenue Cycle Management Market include-
• The SSI Group Inc.,
• AllScripts Healthcare LLC,
• Experian Health,
• R1 RCM Inc,
• McKesson Corporation,
• Athena Health Inc,
• Epic Systems Corporation,
• NXGN Management LLC,
• CareCloud Corporation,
• Quest Diagnostics Inc.
and others.
9/17/2022 17
Market Size Impact of Covid
COVID19 revenue cycle management market impact: an increase of 18.4%
market growth between 2019 and 2020
Pandemic Impact Post Covid Outlook
The revenue cycle management
market grew at a rate of 18.4% from
2019 to 2020.
The market is estimated to witness a
year-on-year growth of ranged from
12% to 11% in the next 5 years
The Covid-19 pandemic enforced
governments to impose lockdowns
and travel restrictions which caused
inconsistency in patient volume and
uncertainties in claim volumes. The
rising complexities in RCM positively
impacted the outsourcing of RCM
solutions
The transition of healthcare systems
toward value-based care and the
adoption of virtual engagement
technologies such as telehealth is
anticipated to pave a path for future
growth opportunities for RCM
The rising claim denials, constantly
changing Covid-19 policies, and
development of new codes led to
increased pressure on RCM
professionals and staff. Furthermore,
the sudden adoption of remote
working caused a decline inefficiency
Key participants are focusing on
developing automated RCM solutions
by integrating advanced artificial
intelligence and machine learning
algorithms which are anticipated to
boost the efficiency and productivity of
the process.
Market Snapshot
Forecast Years for Revenue Cycle Management Market: 2022 - 2028
Historical Years for Revenue Cycle Management Market: 2016 - 2021
Revenue 2021 for Revenue Cycle Management Market: USD 238.1 Billion
Revenue 2028 for Revenue Cycle Management: USD 450.1 Billion
Revenue CAGR (2022 - 2028) for Revenue Cycle
Management Market :
11.2%
Fastest Growing Region (2022 - 2028) for Revenue Cycle
Management Market:
Asia Pacific
Largest Region (2021) for Revenue Cycle Management
Market:
North America
Q & A
1. Which region has the largest share in Global Revenue Cycle
Management Market?
Ans: North America region holds the highest share in 2021.
2. What is the growth rate of Global Revenue Cycle Management
Market?
Ans: The Global Revenue Cycle Management Market is growing at a
CAGR of 11% during forecasting period 2022-2027.
3. What is scope of the Global Revenue Cycle Management market
Analysis?
Ans: Global Revenue Cycle Management Market analysis helps with the
PESTEL, PORTER, COVID-19 Impact analysis, impact on industry
growth and revenue
4. Who are the key players in Global Revenue Cycle Management market?
Ans: The important key players in the Global Revenue Cycle Management
Market are – The SSI Group, Inc., AllScripts Healthcare, LLC, McKesson
Corporation, athenahealth, Inc., Epic Systems Corporation, NXGN
Management, LLC, CareCloud Corporation, Quest Diagnostics, Inc., R1 RCM
Inc., Experian plc, Conifer Health Solutions, GE Healthcare, Cognizant,
Athenahealth, SSI Group LLC, Huron Consulting Group, and Cognizant
5. What is the study period of this market?
Ans: The Global Revenue Cycle Management Market is studied from 2021 to
2027.
6. What are the driving factors fuelign the growth of the market ?
Ans. The driving factors of the Revenue Cycle Management include
Growing regulatory requirements & government initiatives to boost the
adoption of RCM solutions
THANKS

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RCM Lecture 6.pptx

  • 1. REVENUE CYCLE MANAGEMENT Lecture 5 Vijay Patil School of Management Prof. Kamlakar Gadegaonkar
  • 2. Learning objective • Market segmentation • Industry Analysis • Covid Impact
  • 3. Market Size Revenue Cycle Management Market size was valued at US$ 40.9 Bn in 2021 and the total revenue is expected to grow at 10% through 2021 to 2027, reaching nearly US$ 72.46 Bn.
  • 4. Segmentation of the Global Revenue Cycle Management Market: Parameter Details Segments Covered  Product (Software, Services)  Type (Integrated, Standalone)  Delivery Mode (On-Premise, Web- based, Cloud-based)  End Use (Physician Offices, Hospitals, Diagnostic Laboratories, Other Uses)  Region (North America, Europe, Asia Pacific, Latin America, Middle East & Africa)
  • 5. Segmentation of the Global Revenue Cycle Management Market: Parameter Details Regions & Countries Covered • North America - (U.S., Canada, Mexico) • Europe - (U.K., France, Germany, Italy, Spain, Rest Of Europe) • Asia Pacific - (China, Japan, India, South Korea, South East Asia, Rest Of Asia Pacific) • Latin America - (Brazil, Argentina, Rest Of Latin America) • Middle East & Africa - (GCC Countries, South Africa, Rest Of Middle East & Africa)
  • 6. Segmentation of the Global Revenue Cycle Management Market: Parameter Details Companies Covered • The SSI Group Inc. • AllScripts Healthcare LLC • Experian Health • R1 RCM Inc • McKesson Corporation • Athena Health Inc • Epic Systems Corporation • NXGN Management LLC • CareCloud Corporation • Quest Diagnostics Inc.
  • 7. Market segment analysis • The Software segment is estimated to grab larger market attention in the Revenue Cycle Management Market. • The service segment, on the other hand, is likely to grow at the quickest rate during the forecast period, owing to an increase in the number of market participants Product outsourced services to healthcare facilities, which is expected to promote market growth during the forecast period.
  • 8. Market segment analysis • The integrated segment is supplementing the growth of the Revenue Cycle Management Market. • With a revenue share of 71.3 % in 2021, the integrated segment dominated the revenue cycle management market by type. This development can be ascribed to some factors, including a preference for volume-based payments over value-based payments. Another factor driving this segment's growth is that integrated solutions offer a streamlined and coordinated approach for several financial tasks via a single platform, resulting in a consistent data collecting and analysis procedure.
  • 9. Market segment analysis • The physician back-office segment is enhancing the growth of the Revenue Cycle Management Market. • The physician back-office sector dominated the worldwide revenue cycle management market in 2020, accounting for 34.8% of total revenue. • The increased focus of various healthcare institutions and organizations on implementing these systems and increasing the number of physicians is expected to drive market expansion. • The Association of American Medical Colleges, for example, is one such organization working to increase the number of physicians in the region. Such occurrences are advantageous to the market's growth.
  • 10. • The Web-based segment is fueling the growth of the Revenue Cycle Management Market. • The web-based category dominated the revenue cycle management market in 2021, with a revenue share of 46.7%, and is expected to grow at a steady rate during the forecast period. In the future years, increasing usage of web-based solutions is expected to fuel overall market growth. • Task- who are the web based RCM servcie providers in India ? Market segment analysis
  • 11. Market segment analysis on the basis of the functions, the market is segmented in to • Claims and denial management, • Medical coding and billing, • Clinical documentation improvement (CDI). • Insurance and others
  • 12. Market segment analysis • Claims and denial management holds the dominant position owing to launch of advanced solutions that reduce the claim denials • Medical oding and billign holds the second position followed by clinical documentation improvement • High gortwh rate in this segment is associated with increasing demand for coding and billing services and professionals due to complex nature of the services and transactions
  • 14. U S Largest market
  • 15. U S. MARKET • North America dominated the Revenue Cycle Management (RCM) market in 2020, accounting for 50.6 % of revenue. The existence of several physician's offices across the United States is one of the factors responsible for this region's significant market share. In addition, regulatory changes such as the adoption of ICD-10 in 2015 increased demand for HIT systems, notably revenue cycle management systems, to improve healthcare delivery efficiency. Additionally, the presence of big established hospitals and healthcare infrastructures, favorable regulations, and the rising need to reduce healthcare costs create profitable growth potential for the industry.
  • 16. Competitive Landscape The key players in the Global Revenue Cycle Management Market include- • The SSI Group Inc., • AllScripts Healthcare LLC, • Experian Health, • R1 RCM Inc, • McKesson Corporation, • Athena Health Inc, • Epic Systems Corporation, • NXGN Management LLC, • CareCloud Corporation, • Quest Diagnostics Inc. and others.
  • 17. 9/17/2022 17 Market Size Impact of Covid
  • 18. COVID19 revenue cycle management market impact: an increase of 18.4% market growth between 2019 and 2020 Pandemic Impact Post Covid Outlook The revenue cycle management market grew at a rate of 18.4% from 2019 to 2020. The market is estimated to witness a year-on-year growth of ranged from 12% to 11% in the next 5 years The Covid-19 pandemic enforced governments to impose lockdowns and travel restrictions which caused inconsistency in patient volume and uncertainties in claim volumes. The rising complexities in RCM positively impacted the outsourcing of RCM solutions The transition of healthcare systems toward value-based care and the adoption of virtual engagement technologies such as telehealth is anticipated to pave a path for future growth opportunities for RCM The rising claim denials, constantly changing Covid-19 policies, and development of new codes led to increased pressure on RCM professionals and staff. Furthermore, the sudden adoption of remote working caused a decline inefficiency Key participants are focusing on developing automated RCM solutions by integrating advanced artificial intelligence and machine learning algorithms which are anticipated to boost the efficiency and productivity of the process.
  • 19. Market Snapshot Forecast Years for Revenue Cycle Management Market: 2022 - 2028 Historical Years for Revenue Cycle Management Market: 2016 - 2021 Revenue 2021 for Revenue Cycle Management Market: USD 238.1 Billion Revenue 2028 for Revenue Cycle Management: USD 450.1 Billion Revenue CAGR (2022 - 2028) for Revenue Cycle Management Market : 11.2% Fastest Growing Region (2022 - 2028) for Revenue Cycle Management Market: Asia Pacific Largest Region (2021) for Revenue Cycle Management Market: North America
  • 20. Q & A 1. Which region has the largest share in Global Revenue Cycle Management Market? Ans: North America region holds the highest share in 2021. 2. What is the growth rate of Global Revenue Cycle Management Market? Ans: The Global Revenue Cycle Management Market is growing at a CAGR of 11% during forecasting period 2022-2027. 3. What is scope of the Global Revenue Cycle Management market Analysis? Ans: Global Revenue Cycle Management Market analysis helps with the PESTEL, PORTER, COVID-19 Impact analysis, impact on industry growth and revenue
  • 21. 4. Who are the key players in Global Revenue Cycle Management market? Ans: The important key players in the Global Revenue Cycle Management Market are – The SSI Group, Inc., AllScripts Healthcare, LLC, McKesson Corporation, athenahealth, Inc., Epic Systems Corporation, NXGN Management, LLC, CareCloud Corporation, Quest Diagnostics, Inc., R1 RCM Inc., Experian plc, Conifer Health Solutions, GE Healthcare, Cognizant, Athenahealth, SSI Group LLC, Huron Consulting Group, and Cognizant 5. What is the study period of this market? Ans: The Global Revenue Cycle Management Market is studied from 2021 to 2027. 6. What are the driving factors fuelign the growth of the market ? Ans. The driving factors of the Revenue Cycle Management include Growing regulatory requirements & government initiatives to boost the adoption of RCM solutions

Editor's Notes

  1. 1