The mid-revenue cycle management and clinical documentation improvement market is expected to reach $4.5 billion by 2023, up from $3.1 billion in 2018, at a compound annual growth rate of 7.9 percent.
That's the verdict of a new ResearchAndMarkets.com analysis. It found that market growth is largely being driven by the increasing utilization of mid-RCM solutions to reduce healthcare costs, check the loss of revenue due to medical billing and coding errors, resolve issues raised by the decline in reimbursement rates, manage ever-increasing amounts of unstructured data, and maintain regulatory compliance.
On the other hand, IT infrastructural constraints in developing countries, a scarcity of skilled IT professionals, and the risks associated with healthcare IT solutions in terms of data security and privacy, may restrain the growth of this market to a certain extent.
In 2017, solutions accounted for the largest share of the market. The large share of the solutions segment can be attributed to the benefits offered by mid-revenue cycle solutions when they are integrated with electronic health records, encoder systems, voice/text/speech recognition software, CDI, transcription systems and other hospital information management systems.
These solutions also eliminate the duplication of the administrative work of entering selected codes into each record. They also decrease the potential for data documentation, charge capture, and coding errors, and improve the overall mid-revenue cycle process.
The healthcare providers segment is projected to grow at the highest rate over the next five years. Growth in the market for providers can be attributed to the significant demand for these solutions for improving data accuracy in clinical documentation, maximizing hospital revenues by minimizing coding errors, and shortening the claims reimbursement cycle.
Revenue losses due to medical billing and coding errors, declining reimbursement rates, and the need to reduce rising healthcare costs are other key factors supporting the growth in the demand for these solutions.
Historically, many organizations have gotten caught up in managing and monitoring revenue cycle operations, but experts say the starting point to building a truly efficient and successful revenue cycle begins with shifting the collective mindset from thinking just operationally to taking a more strategic view.
One way to do that is to make the mid-revenue cycle more accurate. How revenue cycle leaders enhance clinical documentation, coding and how they engage their clinicians all can have an impact on the bottom line.