The US$7.5-8.5 billion Revenue Cycle Management (RCM) outsourcing services market represents a significant opportunity with 11-14% anticipated CAGR.
Market for the traditionally outsourced RCM functions, such as post-service (medical billing and denial management) is now maturing. However, opportunities in pre-service (eligibility verification and appointment scheduling) and service functions (coding and charge capture) are gaining traction.
A key driver for growth in the market is the incident of rising administrative cost, which is significantly affecting profitability of the hospitals.
Automation is becoming the flavor of the industry, with buyers asking for solutions that are integrated across different functions and involve automation. Also, buyers are no longer looking for multiple vendors for different functions, with the trend becoming more prominent in case of large hospitals.
Content
This report provides comprehensive coverage of the RCM outsourcing services market, including adoption trends across geographies, key solution characteristics, drivers & challenges, and service provider landscape. It will assist key stakeholders (buyers, service providers, and technology providers) to understand the changing dynamics of the RCM services market and identify the upcoming trends. Some of the findings in this report are:
- Outsourcing in the RCM market is gaining traction as the continuously rising administrative expenses are putting significant pressure on the profitability of the hospitals
- With the profitability of healthcare providers taking a hit due to industry shift towards value-based payment systems, outsourcing in the segment is growing at a fast pace. The market is expected to reach US$7.5-8.5 billion in value in 2016
- Post-service functions, such as Account Receivables (AR) and collection processes, continue to be heavily outsourced
- Output-based pricing models occupy the largest share in the RCM BPO deals landscape
- Over 90% of the FTEs delivering RCM BPO services are offshore-based
- Onshore specialists, such as Conifer, Athena Health, Advisory Board, Optum, and Parallon, that play on technology lead the market
Membership(s)
Healthcare & Life Sciences Business Process Outsourcing
