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Revenue cycle management market expected to boom in coming years

Factors driving the growth of the market include decreasing reimbursements, loss of revenue due to billing errors, and regulatory mandates.

Jeff Lagasse, Associate Editor

Hospitals and health systems are increasingly turning to revenue cycle management software solutions to shore up their finances, and this is reflected in the most recent projections of where the market is heading. According to Research and Markets, the market for these solutions is expected to be worth more than $90 billion worldwide by 2022, up from about $51 billion in 2017.

Hospitals use revenue cycle management systems to reduce the number of denied insurance claims, speeding up the explanation of benefits, improving the quality of information, streamlining denial management and automating processes.

[Also: Cleveland Clinic's remote revenue cycle program saves money and makes employees more productive]

Factors driving the growth of the RCM market include decreasing reimbursements in the healthcare industry, regulatory mandates for the adoption of electronic health and medical records, government initiatives to boost the adoption of RCM solutions, loss of revenue due to billing errors, and process improvements in healthcare organizations, according to the analysis.

In the report, the market has been categorized based on product, deployment, function, end user and region. Based on function, the market is segmented into claim and denial management, medical billing and coding, patient insurance eligibility check, payment remittance, electronic health record and clinical documentation improvement, among others. 

The claim and denial management segment is expected to account for the largest share of the global market and is expected to witness the highest compound annual growth rate over the next few years. The growing demand for claims and denial management due to the dynamic reimbursement structure, plus the increasing instances of claim denials, are the major factors driving the growth of that segment.

When it comes to product, the market is broadly split up into integrated and standalone solutions. The integrated solutions portion is expected to account for the largest share of the global revenue cycle management market in 2017 and is projected to register the highest CAGR; this, the report said, can be attributed to the rising adoption of value-based payment systems and the growing demand for cost-saving data management solutions.

There are a couple of potential restraints on this market growth, including the high price and costly maintenance of RCM solutions, and the scarcity of skilled IT professionals.

Some of the leading RCM vendors at the moment include McKesson, Cerner, EPIC Systems, Conifer Health Solutions, Athenahealth, Allscripts Healthcare Solutions and Quest Diagnostics.

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