Overview


According to FutureWise analysis the market for healthcare revenue cycle management in 2023 is US$ 29.4 billion, and is expected to reach US$ 81.09 billion by 2031 at a CAGR of 13.52%.

The term "healthcare revenue cycle management" describes the procedure of managing the administrative and clinical functions associated with billing and collecting payments for healthcare services rendered. The process encompasses everything from scheduling appointments to filing insurance claims and following up on payments. The healthcare RCM process typically involves several stages, including patient registration, charge capture, claims submission, payment posting, and denial management. Each of these stages plays a critical role in ensuring that healthcare organizations are able to collect payment for the services they provide.

Patient registration is the initial step in the RCM process and involves gathering patient demographic and insurance information. This information is used to determine the patient's eligibility and ensure that the appropriate insurance company is billed for services rendered. Charge capture involves recording the services provided to the patient and assigning the appropriate billing codes. This information is then used to generate claims for submission to insurance companies. Claims submission is the process of sending claims to insurance companies for payment. This process involves submitting claims electronically or on paper, depending on the insurance company's requirements. Payment posting involves recording payments received from insurance companies and patients and applying those payments to the appropriate accounts. This process also involves reconciling accounts to ensure that all payments have been received and applied correctly. Effective healthcare RCM requires a combination of people, processes, and technology. Healthcare organizations must have trained staff who understand the billing and payment process, as well as robust systems and technologies to support the RCM process.

FutureWise Market Research has published a report that provides an insightful analysis of Healthcare Revenue Cycle Management Market trends that are affecting the overall market growth. This report will provide a detailed analysis of market share, regional insights, and competitor analysis that includes stature of key manufacturers operational in this industry. By the end of the forecast period FutureWise research analysts projects that Healthcare Revenue Cycle Management Market will experience a significant growth. According to the analysis done, this report will help understand the information referring to the total valuation held by this industry. Additionally, this report will help in understanding the growth opportunities held by various segments of this market, further assist in making better strategic and expansion decisions by key stakeholders of an organization.

  • Cerner
  • Mckesson
  • Quest Diagnostics
  • Allscripts Healthcare Solutions
  • Athenahealth
  • Ge Healthcare
  • Eclinicalworks
  • Conifer Health Solutions
  • Epic Systems
  • Gebbs Healthcare Solutions
  • Experian
  • R1 Rcm
  • Constellation Software
  • The Ssi Group
  • Nthrive

Recent developments by key players in Healthcare Revenue Cycle Management Market:

  • In June 2022, Olive, the automation firm advancing the Internet of Healthcare, unveiled its flagship Revenue Cycle Management (RCM) set of products. By utilizing intelligent automation to lessen manual duties, Olive's ARC redefines RCM, allowing healthcare businesses to concentrate more on patient care and reducing employee exhaustion.
  • In October 2022, Radiology departments all throughout the US are now able to use Nym's medical coding engine, which is the industry leader in converting clinical terminology into useful information. This expansion opens up access to the company's market-leading revenue cycle management (RCM) solution, which is enhancing payment cycles for more than 150 top emergency departments and urgent care facilities in the US.

The healthcare RCM market is driven by several factors, including the growing demand for healthcare services, the increasing complexity of medical billing and coding, and the need for healthcare providers to reduce costs and improve efficiency. As medical expenses continue to rise, providers are under increasing pressure to improve their revenue cycle management processes in order to maintain profitability and financial stability. One of the key drivers of the healthcare RCM market is the increasing complexity of medical billing and coding. With the introduction of new medical procedures, treatments, and technologies, the coding and billing process has become more complex, requiring specialized knowledge and expertise. This has increased demand for RCM solutions that can automate and streamline the billing and coding process, reducing errors and improving efficiency. Another factor driving the healthcare RCM market is the growing demand for healthcare services. As the population ages and chronic illnesses become more prevalent, there is a rising demand for healthcare services. This has significantly increased the number of medical claims and billing transactions, creating a need for more efficient and effective revenue cycle management solutions. In addition, healthcare providers are under pressure to reduce costs and improve efficiency, driving the adoption of RCM solutions. The use of technology-based RCM solutions, such as EHRs and automated billing systems, can help providers reduce administrative costs and improve efficiency, allowing them to focus on delivering high-quality patient care.

While the RCM market is expected to continue to grow, there are also some restraints that may impact its growth in the future. One such restraint is the high cost of RCM solutions. Implementing and maintaining RCM solutions can be expensive, and many healthcare organizations may be hesitant to invest in them, particularly smaller organizations with limited financial resources.

By Product

  • Integrated Solutions
  • Standalone Solutions

By Offering

  • Software
  • Services

By Deployment

  • Web-Based
  • On-Premise
  • Cloud-Based

By Function

  • Claims & Denial Management
  • Medical Coding & Billing
  • Patient Insurance Eligibility Verification
  • Payment Remittance
  • Electronic Health Record (Ehr)
  • Clinical Documentation Improvement (Cdi)
  • Other Functions

By End-User

  • Physicians
  • Hospitals
  • Laboratories
  • Other End Users

By Region

  • North America
  • Europe
  • Asia-Pacific
  • Latin America
  • Middle East and Africa

This market research report also emphasis on factors affecting the growth rate in various regions listed above. A deep-down analysis of region will also be provided in the final version of this market which is based on conclusion of primary interviews and secondary data point gathered during the process.

By region, the market is segmented into North America, Latin America, Europe, Asia-Pacific, and Middle East & Africa. North America registered the highest share in the market in 2022. The worldwide market for healthcare revenue cycle management was led by North America, and it is anticipated that this trend will continue over the projected period. This expansion is the result of factors like significant regulatory changes that have greatly impacted the finances, structure, and provision of healthcare services. The majority of healthcare providers are using RCM systems, which shorten the period of time it takes to get reimbursement after delivering a service in the area. The RCM saves time by automating various tasks that were previously performed manually, which is a key element in the market's expansion. To expand market share, the market participants employ a variety of techniques, including acquisitions, collaborations, and partnerships. As an illustration, in September 2022, AGS Health announced the introduction of the AGS AI Platform, an integrated solution that combines artificial intelligence (AI) and automation with renowned human-in-the-loop services and knowledgeable support to improve revenue cycle efficiency in the US. Thus, it is anticipated that the aforementioned factors will fuel the market under study over the forecast period.

  • Tier 1 players- established companies in the market with a major market share
  • Tier 2 players
  • Emerging players which are growing rapidly
  • New Entrants

  • Growth prospects
  • SWOT analysis
  • Key trends
  • Key data-points affecting market growth

  • To provide with an exhaustive analysis on the Healthcare Revenue Cycle Management Market By Product, By Offering, By Deployment, By Function, By End-User and By Region.
  • To cater comprehensive insights on factors such as drivers, restraints, trends, opportunity, and additionally segmental and regional factors impacting market growth.
  • To evaluate current market trends and forecast micro-markets and the overall market projections which are represented in the format of data-sets and ppt.
  • To predict the market size, in key regions— North America, Europe, Asia Pacific, Latin America and Middle East and Africa.
  • To provide information on competitors which includes landscape mapping, technological advancements, R&D spending, news concerning strategic alliances, and new product launches.

  • We have a flexible delivery model and you can suggest changes in the scope/table of content as per your requirement
  • The customization Mobility Care offered are free of charge with purchase of any license of the report
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Table of Contents


  • 1.   Market Introduction
    •   1. Objectives of the Study
        2. Market Definition
        3. Market Scope
         3.1 . Years Considered for the Study
         3.2 . Market Covered
        4. Currency
        5. Limitations
        6. Stakeholders
  • 2.   Research Methodology
    •   1. Research Data
         1.1 . Secondary Data
          1.1.1 . Key Data from Secondary Sources
         1.2 . Primary Data
          1.2.1. Key Data from Primary Sources
        2. Market Size Estimation
        3. Market Breakdown and Data Triangulation
        4. Assumptions for the Study
  • 3.   Executive Summary
    •   1. Market Outlook
        2. Segment Outlook
        3. Competitive Insights
  • 4.   Healthcare Revenue Cycle Management Market Variables, Trends and Scope
    •   1. Market Lineage Outlook
        2. Penetration and Growth Prospect Mapping
        3. Industry Value Chain Analysis
        4. Cost Analysis Breakdown
        5. Technology Overview
        6. Regulatory Framework
         6.1. Reimbursement Framework
         6.2. Standards and Compliances

  • 5.   Market Overview
    •   1. Market Dynamics
         1.1. Market Driver Analysis
          1.1.1. Increasing focus of Healthcare Revenue Cycle Management Companies on Brand Protection
          1.1.2. Untapped Opportunities in Emerging Regions
         1.2. Market Restraint Analysis
          1.2.1. High Cost Associated with Implementation of Predictive Analysis
         1.3. Industry Challenges
          1.3.1. Presence of Ambiguous Regulatory Framework
  • 6.   Healthcare Revenue Cycle Management Market Analysis Tools
    •   1. Industry Analysis - Porter’s
         1.1. Supplier Power
         1.2. Buyer Power
         1.3. Substitution Threat
         1.4. Threat from New Entrants
         1.5. Competitive Rivalry
        2. Pestel Analysis
         2.1. Political Landscape
         2.2. Environmental Landscape
         2.3. Social Landscape
         2.4. Technology Landscape
         2.5. Legal Landscape
        3. Major Deals And Strategic Alliances Analysis
         3.1. Joint Ventures
         3.2. Mergers and Acquisitions
         3.3. Licensing and Partnership
         3.4. Technology Collaborations
         3.5. Strategic Divestments
        4. Market Entry Strategies
        5. Case Studies
  • 7.   Healthcare Revenue Cycle Management Market, By Product Historical Analysis and Forecast 2023-2031 (USD Million)
    •   1. Integrated Solutions
        2. Standalone Solutions

  • 8.   Healthcare Revenue Cycle Management Market, By Offering Historical Analysis and Forecast 2023-2031 (USD Million)
    •   1. Software
        2. Services

  • 9.   Healthcare Revenue Cycle Management Market, By Deployment Historical Analysis and Forecast 2023-2031 (USD Million)
    •   9.1. Web-Based
        9.2. On-Premise
        9.3. Cloud-Based

  • 10.   Healthcare Revenue Cycle Management Market, By Function Historical Analysis and Forecast 2023-2031 (USD Million)
    •   10.1. Claims and Denial Management
        10.2. Medical Coding and Billing
        10.3. Patient Insurance Eligibility Verification
        10.4. Payment Remittance
        10.5. Electronic Health Record (Ehr)
        10.6. Clinical Documentation Improvement (Cdi)
        10.7. Other Functions

  • 11.   Healthcare Revenue Cycle Management Market, By End-User Historical Analysis and Forecast 2023-2031 (USD Million)
    •   11.1. Physicians
        11.2. Hospitals
        11.3. Laboratories
        11.4. Other End Users

  • 12.   North America Healthcare Revenue Cycle Management Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)
    •   12.1. Introduction
        12.2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         12.2.1. U.S.A
         12.2.2. Canada
         12.2.3. Mexico
        12.3. Market Size (USD Million) Forecast for North America 2023-2031

  • 13.   Latin America Healthcare Revenue Cycle Management Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)
    •   13.1. Introduction
        13.2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         13.2.1. Brazil
         13.2.2. Venezuela
         13.2.3. Argentina
         13.2.4. Rest of Latin America
        13.3. Market Size (USD Million) Forecast for Latin America 2023-2031

  • 14.   Europe Healthcare Revenue Cycle Management Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)
    •   14.1. Introduction
        14.2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         14.2.1. Germany
         14.2.2. U.K
         14.2.3. France
         14.2.4. Italy
         14.2.5. Spain
         14.2.6. Russia
         14.2.7. Poland
         14.2.8. Rest of Europe
        14.3. Market Size (USD Million) Forecast for Europe 2023-2031

  • 15.   Asia Pacific Healthcare Revenue Cycle Management Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)
    •   15.1. Introduction
        15.2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         15.2.1. Japan
         15.2.2. China
         15.2.3. India
         15.2.4. Australia and New Zealand
         15.2.5. ASEAN
         15.2.6. Rest of Asia Pacific
        15.3. Market Size (USD Million) Forecast for Asia Pacific 2023-2031

  • 16.   Middle East and Africa Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)
    •   16.1. Introduction
        16.2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         16.2.1. GCC
         16.2.2. Israel
         16.2.3. South Africa
         16.2.4. Rest of MEA
        16.3. Market Size (USD Million) Forecast for MEA 2023-2031

  • 17.   Market Share Analysis and Competitive Landscape
    •   17.1. Global Landscape - Key Players, Revenue and Presence
        17.2. Global Share Analysis - Key Players (Tier 1, Tier 2, Tier 3)
        17.3. Global Emerging Companies
        17.4. North America - Market Share Analysis and Key Regional Players
        17.5. Europe - Market Share Analysis and Key Regional Players
        17.6. Asia Pacific - Market Share Analysis and Key Regional Players
        17.7. Global Key Player - Growth Matrix
  • 18.   Company Profiles (Competition Dashboard, Competitors Deep Dive, Products Offered and Financial Layouts)
    •   1. Cerner
         1.1. Company Overview
         1.2. Product Portfolio
         1.3. SWOT Analysis
         1.4. Financial Overview
         1.5. Strategic Overview
        2. Mckesson
         2.1. Company Overview
         2.2. Product Portfolio
         2.3. SWOT Analysis
         2.4. Financial Overview
         2.5. Strategic Overview
        3. Quest Diagnostics
         3.1. Company Overview
         3.2. Product Portfolio
         3.3. SWOT Analysis
         3.4. Financial Overview
         3.5. Strategic Overview
        4. Allscripts Healthcare Solutions
         4.1. Company Overview
         4.2. Product Portfolio
         4.3. SWOT Analysis
         4.4. Financial Overview
         4.5. Strategic Overview
        5. Athenahealth
         5.1. Company Overview
         5.2. Product Portfolio
         5.3. SWOT Analysis
         5.4. Financial Overview
         5.5. Strategic Overview
        6. Ge Healthcare
         6.1. Company Overview
         6.2. Product Portfolio
         6.3. SWOT Analysis
         6.4. Financial Overview
         6.5. Strategic Overview
        7. Eclinicalworks
         7.1. Company Overview
         7.2. Product Portfolio
         7.3. SWOT Analysis
         7.4. Financial Overview
         7.5. Strategic Overview
        8. Conifer Health Solutions
         8.1. Company Overview
         8.2. Product Portfolio
         8.3. SWOT Analysis
         8.4. Financial Overview
         8.5. Strategic Overview
        9. Epic Systems
         9.1. Company Overview
         9.2. Product Portfolio
         9.3. SWOT Analysis
         9.4. Financial Overview
         9.5. Strategic Overview
          10. Gebbs Healthcare Solutions
         10.1. Company Overview
         10.2. Product Portfolio
         10.3. SWOT Analysis
         10.4. Financial Overview
         10.5. Strategic Overview
          11. Experian
         11.1. Company Overview
         11.2. Product Portfolio
         11.3. SWOT Analysis
         11.4. Financial Overview
         11.5. Strategic Overview
          12. R1 Rcm
         12.1. Company Overview
         12.2. Product Portfolio
         12.3. SWOT Analysis
         12.4. Financial Overview
         12.5. Strategic Overview
          13. Constellation Software
         13.1. Company Overview
         13.2. Product Portfolio
         13.3. SWOT Analysis
         13.4. Financial Overview
         13.5. Strategic Overview
          14. The Ssi Group
         14.1. Company Overview
         14.2. Product Portfolio
         14.3. SWOT Analysis
         14.4. Financial Overview
         14.5. Strategic Overview
          15. Nthrive
         15.1. Company Overview
         15.2. Product Portfolio
         15.3. SWOT Analysis
         15.4. Financial Overview
         15.5. Strategic Overview

  • 19.   Pre and Post COVID-19 Impact
    •   19.1. Positive influence on the healthcare industry
        19.2. The financial disruption of the manufacturing sector
        19.3. Impact of COVID-19 on emerging companies
        19.4. Significant mandates in the healthcare regulations initiated by administrations
        19.5. The overall economic slowdown of the developing and developed nations
  • 20.   FutureWise SME Key Takeaway Points for Client
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