Revenue cycle management is the process of managing claims process, payment and revenue generation. Revenue cycle management improves access management, improving payer performance and accelerating cash collection. It also provides real time access to claim management and allows companies and hospitals to manage their work in proper channel during registration, scheduling and payment and claim processing. Revenue cycle management helps a medical practice to increase their revenue by proper claim management. There are four key player involved in the revenue cycle management of healthcare system: patients, healthcare providers, billing company and insurance provider.
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Hospital revenue cycle management includes all clinical and managerial functions related to the management, collection of patient care revenue, and generation. In Revenue cycle management, the claims are being processed faster, there is a prompt denial management and the resolution rate of claims processing is around 99%. This allows the clients to experience increased cash flow and decreased claims in accounts receivable. Revenue cycle management solutions allows to monitor key business segment at any point of time, identify areas for improvement and increasing the revenue of the hospital/organization. Increase revenue generation, increased efficiency, accuracy and access of healthcare IT systems are the factors likely to drive the market in the forecast period. With the rising administrative and operational costs of the healthcare organizations, managements need to find cost-effective alternatives in order to sustain in the market. Revenue cycle management offers viable solutions by replacing the traditional paper-based systems to optimize cost.
The revenue cycle management market has been segmented by platform, by deployment, by solutions, by end-user and by geography. In terms of product, the revenue cycle management market has been categorized into integrated and standalone systems. Based on deployment, the market has been segmented into cloud-based and on-premise. Based on solutions, the market has been segmented into out-source and in-house. In-house segment is further classified into hardware, software and services. Based on end-user, the market has been segmented into provider and payers. Provider segment is further classified into hospitals, ambulatory surgical centers & clinics and other segment. Whereas payers segment is further classified into insurance companies, government agencies and others.
Geographically, revenue cycle management market can be segmented into five regions: North America, Europe, Asia Pacific, Middle East and Africa and Latin America. North America was observed to be the largest revenue cycle management market owing to the favorable government policies, increased incentives and fastest adaptation of revenue cycle management. Countries such as the U.S. and Canada have been successful in implementing healthcare IT in their healthcare system, which as a result would boost the market growth. Moreover, presence of developed IT and healthcare infrastructure, promising government initiatives in executing revenue cycle management, highly regulated and maintained regulatory framework, and continued innovation in the region would further propel the market growth. Europe was observed to be the second largest market in the revenue cycle management owing to enhanced digitization and increasing focus on data integration, data quality, management and data governance.
Asia Pacific is expected to be the fastest growing market during the forecast period. The major factor that would drive the market in Asia Pacific include technological advancements, growth in infrastructure and increased adoption of revenue cycle management in healthcare facilities in the region. China, Japan and India are the key countries in the region that are increasingly adopting these management products and services and hence would fuel the market of global revenue cycle management market. Latin American countries such as Brazil and Mexico have significant potential for growth due to evolving medical structure, high disposable income and increasing focus of multi-national companies, that have established their operational set ups in Latin America.
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The major players operating in this market include DST Systems, Inc., 3M Company, McKesson Corporation, Allscripts Healthcare solutions, Inc., Cerner Corporation, Optum Health, Inc., TriZetto Corporation, GE Healthcare, Computer Programs and Systems, Inc. and others.