The acceleration of technological advancement, paired with rising healthcare spending, are the key factors driving the growth of the healthcare revenue cycle management market, which is projected to be worth $104 billion globally by 2025, according to ResearchandMarkets.com.
Increasing government spending is partially driving the market's growth, along with initiatives to encourage the adoption of third-party revenue cycle solutions.
Medical claims processing was found to have a large influence on hospitals' revenue management generally, especially with the need to uphold quality insurance billing to achieve the best financial outcomes. A revenue cycle management team needs to be well-versed with accounts receivable management and denial management, as hospiralsd feel the pressure to reduce costs due to revenue lost through claim failure and denials.
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That in turn has increased the market opportunity for specialty firms to provide revenue cycle management services, ultimately fueling growth in that space.
WHAT'S THE IMPACT
Revenue cycle management can be a tricky beast, and whether to seek help from an outside vendor is a question with which many health systems struggle. While it may not be the best fit for every hospital or system, there are certain signs that using a third party may be the way to go -- and looking at key performance indicators can often be what tips the scale.
The most common billing errors faced by hospitals are filing an incomplete claim, failure to verify insurance, lack of specificity, missing filing deadlines and errors in coding, the report found. Because of that, many hospitals have long been dependent on third-party service providers for denial management.
One of the reasons the market outlook is so strong is because partnerships with third-party vendors have been working: About 90% of claim denials are prevented with help from service providers.
Yet despite this, 25.5% of U.S. hospitals lack revenue cycle management services, due in part to a lack of awareness of the technology that now exists. The percentage of hospitals without these services has gone down over the years, however; in 2012, 35% of hospitals either lacked revenue cycle management services or were unaware of them.
The major players operating in the healthcare revenue cycle management market identified in the report are General Electric Company; Siemens Healthcare; Epic Systems; Allscripts; Cerner Corporation; Quest Diagnostics; McKesson Corporation; 4medica; Abeo; Accenture; Access Healthcare; AccessOne; and ACI Worldwide.
THE LARGER TREND
Increasing healthcare spending and the growing prevalence of chronic diseases, which is expected to raise hospital admissions and healthcare expenditures, will drive the growth of the market.