Revenue Cycle Management Market Insights and Growth by 2031
【研究报告】收入周期管理市场预计将从2022年的983.4亿美元增长到2030年的2446.4亿美元;预计 2022 年至 2030 年复合年增长率为 12.1%。
分析师观点:< /p>
政府鼓励使用收入周期管理解决方案的举措的增加是推动收入周期管理市场增长的主要因素之一。此外,医疗机构的计费错误和流程改进导致的收入损失增加正在推动收入周期管理市场的增长。正确处理医疗索赔对于医疗保健提供者的收入来源至关重要。医疗机构必须继续保持高质量的保险计费和收入周期,以改善其财务业绩。大多数医疗保健提供者因索赔被拒绝以及未能提交或推迟被拒绝的索赔而蒙受损失,这给医院削减开支带来了越来越大的压力。这为市场参与者创造了机会,为医院提出先进的解决方案,以应对收入周期的上述挑战。此外,为了实现收入周期的高效管理,市场上的各个主要参与者正在整合人工智能(AI)和机器学习(ML)技术,这将进一步推动收入周期管理市场的增长。< /p>
市场概览:
医疗机构利用收入周期管理 (RCM),这是一种跟踪患者护理的财务流程使用医疗计费软件,从登记和预约安排到最后一次支付余额。为了存储和管理患者账单记录,医疗保健提供商经常投资收入周期管理系统。当患者完成治疗过程时,高效的 RCM 系统可以与其他健康 IT 系统(例如电子健康记录 (EHR) 和医疗计费系统)连接,以缩短提供服务和获得付款之间的时间。医疗保健公司还可以通过自动化员工以前在 RCM 系统的帮助下执行的任务来节省时间。管理任务包括通知患者即将进行的预约、提醒付款人和患者未清余额以及在索赔被拒绝时联系保险公司进行具体询问。 RCM 系统还可以通过向提供商提供有关拒绝索赔背后原因的信息来帮助提供商节省资金。这使提供商可以更好地了解某些索赔被拒绝的原因,从而使他们能够解决问题并避免必须重新提交索赔。
战略见解强>
市场驱动力:
人工智能和机器学习技术的集成是为收入周期管理市场的增长创造机会
人工智能和机器学习技术继续获得动力,并证明了其在收入管理系统开发中的潜力。许多组织仍然依赖手动错误检查和报告来进行异常检测,这使得很难确定根本原因,并且成为一个耗时的过程。机器学习和人工智能可帮助组织主动识别计费和收入管理解决方案中的异常模式。此外,由于定期更新,该模型随着时间的推移不断改进,从而实现准确的计费和自动检测异常。人工智能和机器学习还可以加速根本原因分析,减少调查时间和成本,并使用收入管理系统提供更快的解决方案。因此,计费和收入管理方面不断增长的技术进步可能会推动预测期内收入周期管理市场的增长。
细分分析:
根据组件,收入周期管理市场分为解决方案和服务。到 2022 年,解决方案细分市场将占据收入周期管理市场的最大份额,而服务细分市场预计在预测期内将在收入周期管理市场中实现最高的复合年增长率。 RCM 软件在医疗保健行业的采用率不断上升,特别是为了避免医疗保健欺诈和降低管理成本。此外,市场上的各个主要参与者正在不断致力于提供先进的解决方案,以改善医院、医疗机构等的收入周期管理。此外,预计由于基于云的RCM需求上升以及对专业服务需求的增加,服务细分市场将以收入周期管理市场中最高的复合年增长率增长。 p>
区域分析:
医疗保健行业北美正在迅速变化,数字化使得安装医疗保健 IT 服务变得更加容易,例如收入周期管理 (RCM) 系统,该系统使用同步管理软件解决方案来组织和简化医疗保健业务的活动。此外,医疗保健行业越来越关注加强患者护理,同时利用该地区各个市场参与者提供的这些尖端创新 RCM 解决方案的经济效益和有效性,这正在推动市场的增长。此外,由于多种因素,美国的医疗保健行业正在迅速扩张和变化,包括医疗保健成本上升、信誉良好的医疗机构数量增加、医疗保健 IT 支出增加、医疗保健 IT 基础设施改善以及对医疗保健的日益重视。患者与提供者的关系。根据美国医疗保险和医疗中心医疗补助服务、国民医疗支出 (NHE) 到 2021 年增长 2.7%,达到 4.3 万亿美元(人均 12,914 美元),占 GDP 的 18.3%。此外,2021 年医疗保险支出增长 8.4%,达到 9008 亿美元,占 NHE 总额的 21%。 2021 年,医疗补助支出增长 9.2%,达到 7,340 亿美元,占 NHE 总额的 17%。随着美国医疗保健支出的大幅增长,医疗服务提供商在计费和精准支付方面面临着复杂的挑战,进一步提高了对更先进的 RCM 系统的需求。
此外,该地区的各个市场参与者正在不断致力于提供先进的解决方案。例如,2023 年,医疗保健财务管理协会 (HFMA) 宣布与医疗保健收入周期管理软件即服务 (SaaS) 提供商 FinThrive, Inc. 建立战略联盟,共同推出经过同行评审的、五阶段收入周期管理技术采用模型 (RCMTAM) 旨在帮助卫生系统利用行业基准来评估其 RCM 技术成熟度的当前状态,并制定最佳实践计划以优化收入周期结果。因此,上述所有因素都在推动北美收入周期管理市场的增长。
主要参与者分析:
Athenahealth Inc.、Experian Information Solutions Inc.、GE Healthcare、McKesson Corporation、NXGN Management LLC、Optum Inc.、Oracle Corporation、R1 RCM Inc.、SSI Group 和 Veradigm LLC 均在其中主要收入周期管理市场参与者。这些收入周期管理市场参与者专注于持续的产品开发和创新。
近期发展:
< p>收入周期管理市场中的公司高度采用并购等无机和有机策略。下面列出了最近的一些收入周期管理市场发展:- 2023 年 10 月,Omega Healthcare 宣布推出 Omega数字平台 (ODP) 旨在帮助医疗保健组织减轻管理负担,同时提高财务绩效。 ODP 利用先进的专有技术来简化工作流程并提高财务绩效。它利用机器人流程自动化 (RPA)、人工智能和人工智能领域的深厚领域和技术专业知识。机器学习、机器人和自然语言处理 (NLP),使解决方案能够提高效率和准确性。
- 2021 年 6 月,领先的运营管理和分析公司 EXL 宣布推出EXL Health 部门推出新的综合收入管理解决方案。 EXL Health 与 REVELOHEALTH 合作,REVELOHEALTH 是一家致力于将医疗保健数据转换为可操作信息的解决方案提供商。 EXL Health 和 REVELOHEALTH 结合了各自的知识和专业知识,提供新的解决方案,提供全面的、数据驱动的支付处理和收入分析功能。这一新功能旨在帮助提供商优化收入周期管理、运营目标和合规性。
- 2021 年 6 月,领先的咨询和专业服务组织 Vee Technologies 宣布推出 Sona产品套件及其旗舰 RCM 工作流程工具 Sona PROMISE。 RCM 解决方案旨在增强运营工作流程并实现商业智能功能,并且能够成为管理医院、专科诊所、医疗诊所、门诊手术中心等的独立工具。该解决方案旨在简化业务运营并提供更高的业务分析,以增加收入和增长潜力。
- 2021 年 1 月,领先的技术支持收入周期管理 (RCM) 服务 R1 RCM Inc医疗保健行业的提供商,为大型独立诊所和医院拥有的医疗集团推出了新的医生收入周期管理解决方案 R1 Professional。新解决方案得到了专门构建的技术平台、大规模自动化、符合消费者期望的数字化患者财务体验以及经过验证的绩效改进能力的支持,这些能力增强了大型医疗保健组织的财务可见性。
Report Coverage
Revenue forecast, Company Analysis, Industry landscape, Growth factors, and Trends
Segment Covered
This text is related
to segments covered.
Regional Scope
North America, Europe, Asia Pacific, Middle East & Africa, South & Central America
Country Scope
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to country scope.
The List of Companies
1. Allscripts Healthcare Solutions, Inc.
2. Athenahealth, Inc.
3. Cerner Corporation
4. Eclinicalworks, LLC
5. Epic Systems Corporation
6. Experian PLC
7. GE Healthcare
8. Gebbs Healthcare Solutions
9. Mckesson Corporation
10. Quest Diagnostics Incorporated
The Insight Partners performs research in 4 major stages: Data Collection & Secondary Research, Primary Research, Data Analysis and Data Triangulation & Final Review.
- Data Collection and Secondary Research:
As a market research and consulting firm operating from a decade, we have published and advised several client across the globe. First step for any study will start with an assessment of currently available data and insights from existing reports. Further, historical and current market information is collected from Investor Presentations, Annual Reports, SEC Filings, etc., and other information related to company’s performance and market positioning are gathered from Paid Databases (Factiva, Hoovers, and Reuters) and various other publications available in public domain.
Several associations trade associates, technical forums, institutes, societies and organization are accessed to gain technical as well as market related insights through their publications such as research papers, blogs and press releases related to the studies are referred to get cues about the market. Further, white papers, journals, magazines, and other news articles published in last 3 years are scrutinized and analyzed to understand the current market trends.
- Primary Research:
The primarily interview analysis comprise of data obtained from industry participants interview and answers to survey questions gathered by in-house primary team.
For primary research, interviews are conducted with industry experts/CEOs/Marketing Managers/VPs/Subject Matter Experts from both demand and supply side to get a 360-degree view of the market. The primary team conducts several interviews based on the complexity of the markets to understand the various market trends and dynamics which makes research more credible and precise.
A typical research interview fulfils the following functions:
- Provides first-hand information on the market size, market trends, growth trends, competitive landscape, and outlook
- Validates and strengthens in-house secondary research findings
- Develops the analysis team’s expertise and market understanding
Primary research involves email interactions and telephone interviews for each market, category, segment, and sub-segment across geographies. The participants who typically take part in such a process include, but are not limited to:
- Industry participants: VPs, business development managers, market intelligence managers and national sales managers
- Outside experts: Valuation experts, research analysts and key opinion leaders specializing in the electronics and semiconductor industry.
Below is the breakup of our primary respondents by company, designation, and region:
Once we receive the confirmation from primary research sources or primary respondents, we finalize the base year market estimation and forecast the data as per the macroeconomic and microeconomic factors assessed during data collection.
- Data Analysis:
Once data is validated through both secondary as well as primary respondents, we finalize the market estimations by hypothesis formulation and factor analysis at regional and country level.
- Macro-Economic Factor Analysis:
We analyse macroeconomic indicators such the gross domestic product (GDP), increase in the demand for goods and services across industries, technological advancement, regional economic growth, governmental policies, the influence of COVID-19, PEST analysis, and other aspects. This analysis aids in setting benchmarks for various nations/regions and approximating market splits. Additionally, the general trend of the aforementioned components aid in determining the market's development possibilities.
- Country Level Data:
Various factors that are especially aligned to the country are taken into account to determine the market size for a certain area and country, including the presence of vendors, such as headquarters and offices, the country's GDP, demand patterns, and industry growth. To comprehend the market dynamics for the nation, a number of growth variables, inhibitors, application areas, and current market trends are researched. The aforementioned elements aid in determining the country's overall market's growth potential.
- Company Profile:
The “Table of Contents” is formulated by listing and analyzing more than 25 - 30 companies operating in the market ecosystem across geographies. However, we profile only 10 companies as a standard practice in our syndicate reports. These 10 companies comprise leading, emerging, and regional players. Nonetheless, our analysis is not restricted to the 10 listed companies, we also analyze other companies present in the market to develop a holistic view and understand the prevailing trends. The “Company Profiles” section in the report covers key facts, business description, products & services, financial information, SWOT analysis, and key developments. The financial information presented is extracted from the annual reports and official documents of the publicly listed companies. Upon collecting the information for the sections of respective companies, we verify them via various primary sources and then compile the data in respective company profiles. The company level information helps us in deriving the base number as well as in forecasting the market size.
- Developing Base Number:
Aggregation of sales statistics (2020-2022) and macro-economic factor, and other secondary and primary research insights are utilized to arrive at base number and related market shares for 2022. The data gaps are identified in this step and relevant market data is analyzed, collected from paid primary interviews or databases. On finalizing the base year market size, forecasts are developed on the basis of macro-economic, industry and market growth factors and company level analysis.
- Data Triangulation and Final Review:
The market findings and base year market size calculations are validated from supply as well as demand side. Demand side validations are based on macro-economic factor analysis and benchmarks for respective regions and countries. In case of supply side validations, revenues of major companies are estimated (in case not available) based on industry benchmark, approximate number of employees, product portfolio, and primary interviews revenues are gathered. Further revenue from target product/service segment is assessed to avoid overshooting of market statistics. In case of heavy deviations between supply and demand side values, all thes steps are repeated to achieve synchronization.
We follow an iterative model, wherein we share our research findings with Subject Matter Experts (SME’s) and Key Opinion Leaders (KOLs) until consensus view of the market is not formulated – this model negates any drastic deviation in the opinions of experts. Only validated and universally acceptable research findings are quoted in our reports.
We have important check points that we use to validate our research findings – which we call – data triangulation, where we validate the information, we generate from secondary sources with primary interviews and then we re-validate with our internal data bases and Subject matter experts. This comprehensive model enables us to deliver high quality, reliable data in shortest possible time.