The global medical billing outsourcing market size is projected to reach USD 23.1 billion by 2027, expanding at a CAGR of 12.3%, based on a new report by Radiant Insights, Inc. A large amount of clinical code representation for diagnosis and treatment coupled with the presence of multiple payers, renders medical billing an intricate part of any clinical practice, posing significant challenges. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to obligatory implementation of complex ICD-10 coding systems, increasing healthcare costs, and a federal mandate to implement electronic medical records (EMR) to maintain reimbursement levels.
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Furthermore, clinics/physician offices are gradually outsourcing their revenue management to cut unnecessary costs and prevent the burden of managing an administrative team to ensure effective handling of in-house billing functions. In addition, multispecialty healthcare groups are implementing consolidation requiring EHR integration and building large healthcare networks. This integration creates a need for revenue cycle management (RCM), which, in turn, demands additional expertise and trained personnel to manage the same. Thus, the consolidation of large healthcare practices is also expected to be one of the factors fueling market growth.
Further key findings from the study suggest:
• The outsourced segment accounted for the largest market share in the component segment in 2019 and is expected to witness a high CAGR attributed to rising preference of hospitals, physician office, and startups opting for outsourced medical billing services for hassle-free claim management at low cost
• Front-end services led the market in 2019. However, the middle-end services segment is expected to register the highest CAGR over the forecast period due to the growing demand for revenue cycle management (RCM) services offering electronic health records (HER) software
• Hospitals, possessing higher claim volumes, accounted for the largest revenue share in the market in 2019 and is estimated to maintain the dominance even during the forecast years
• North America held the largest share of the global medical billing outsourcing market. It is projected to expand further as U.S. has witnessed a change in the healthcare system with the implementation of ICD-10 coding and pressure from the government to incorporate the EMR management system
• Some of the key firms in this industry include R1 RCM, Inc.; Allscripts Healthcare Solutions, Inc.; Cerner Corporation; eClinicalWorks, LLC; Experian Information Solutions, Inc.; GE Healthcare; Genpact; HCL; Kareo, Inc.; McKesson Corporation; Quest Diagnostics; and The SSI Group, LLC.
• Medical billing and revenue cycle management (RCM) companies such as AetnaHealth, are offering successful implementation of EMR at the practice level and are expected to transform the market.
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Table of Contents
Chapter 1 Research Objective
1.1 Objective - 1
1.2 Objective - 2
1.3 Objective - 3
1.4 Objective - 4
Chapter 2 Executive Summary
2.1 Market Outlook
2.2 Segment Outlook
2.2.1 Component
2.2.2 Service
2.2.3 End use
2.2.4 Region
2.3 Competitive Insights
2.4 Medical Billing Outsourcing Market Snapshot
Chapter 3 Medical Billing Outsourcing Market Variables, Trends & Scope
3.1 Market Lineage Outlook
3.1.1 Parent market outlook
3.1.2 Related/ancillary market outlook
3.2 Market Segmentation
3.3 Analysis
3.4 Penetration and Growth Prospect Mapping
3.4.1 Analysis
3.5 Market Dynamics
3.5.1 Market driver analysis
3.5.1.1 Growing focus on increasing the profitability and revenue generated by the business
3.5.1.2 Federal mandate to implement digital record keeping by healthcare providers
3.5.1.3 Rapidly changing healthcare regulations
3.5.2 Market restraint analysis
3.5.2.1 High threat to data breaching
Continued…
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