Global medical billing outsourcing market was valued at USD 10.2 Billion in 2020. It is expected to grow at a compound annual rate (CAGR of 12.66%) between 2021 and 2028. The revenue cycle management (RCM), which is the most critical and complex component of healthcare IT, includes medical billing. Due to a lack of experience in managing new revenue models and revenue management tools, the current revenue management systems are slowly becoming obsolete. Market growth will also be supported by the increased use of billing and medical code procedures in revenue cycle management. The market is also driven by frequent changes in medical coding classifications.
The sector has been negatively affected by the spread of the new coronavirus. COVID-19 was given new codes. The International Classification of Diseases (ICD-11), which was created by the World Health Organization, will be in effect from January 2022. A new trend has emerged that favors medical billing outsourcing by many healthcare providers, due to the increasing technological options, changing government requirements, bad debt, and uncollectible accounts.
Coronavirus has had a devastating impact on our daily lives and the global economy. Healthcare systems all over the globe are now facing a significant burden. The COVID-19 pandemic, which has adversely affected and is likely to negatively affect the medical billing outsourcing industry by reducing service or patient volumes and payment capability, has already had a significant impact on healthcare systems around the world. To overcome these difficulties, healthcare providers must reevaluate their financial plans in order to reduce the COVID-19 impact on revenue. Telemedicine solutions, on the other hand can increase patient volumes, improve patient experience and satisfaction, and ultimately propel revenues.
Outsourcing medical billing increases cash flow, reduces the cost of software and equipment, and lowers employee costs. In the next few years, the market for medical billing outsourcing will be driven by the expanding geographical reach of key companies through mergers or acquisitions. To increase its offerings in Australia, Allscripts purchased Core Medical Solutions, an Australian IT software provider for healthcare, in December 2016.
Pandemic Impact |
Outlook after COVID |
In 2020, the medical billing outsourcing market saw a 9.38% increase in year-on-year growth compared to 10.01% for 2019. |
Due to rising healthcare costs and the complexity of medical billing, there has been an increase in outsourcing revenue cycle management services. This will likely to increase growth over the next few years. |
Due to the reduction in patient volumes or payment ability, the COVID-19 pandemic had a negative effect on the medical billing outsourcing industry. |
The market will grow at a rate of 10.30% between 2020-2021, reaching USD 11.2 Billion in 2021. |
North America was the leading regional market for medical billing outsourcing, and it is expected to continue its dominance over the next few years. The high level of awareness about healthcare IT outsourcing and the strong presence in the market of well-known players in the region are the main reasons for this success. Becker's Hospital Review ranked around 210 revenue management solutions in the global market and named Athenahealth (U.S.), Accenture, R1 RCM(U.S.), Atos France (France) and Experian Health USA (U.S.).
Europe is a significant market for healthcare outsourcing services. This is due to the need to reduce overall healthcare delivery costs. There is high potential for growth in the region due to factors such as consolidation of large health care providers, changes in pricing and reimbursement policies, increasing pressure on European healthcare providers and building more sustainable healthcare systems.
Outsourced segments had the largest revenue share at over 50% in 2020. They are expected to record the highest CAGR between 2021 and 2028. Outsourced and in-house are the main components of the market for medical bill outsourcing. Outsourcing medical billing reduces costs and is a good fit to small and medium practices.
The last five years have been difficult for physician practices (acute-care hospitals and clinics/physicians). As reimbursements have fallen and costs have risen, business has become more complicated. In the coming years, medical billing outsourcing will be more in demand.
In 2020, the top-end segment held 35.0% of the market. The front-end service segment includes processes such as scheduling, preregistration and registration, eligibility, verification of insurance, and preauthorization. The main function of medical billing outsourcing is the front-end service.
Front-end services are slowly experiencing a decrease in revenue growth because of market saturation and increased competition. The entry of new market players, and growing awareness among healthcare professionals, will drive the fastest growth for middle-end services in the forecast period.
In 2020, the hospital segment accounted for 45.0% of total revenue. This was because hospitals are prime users of these services due to their high claim volume. The complexity of reimbursement and billing is further complicated by the consolidation of hospitals. Hospitals are in high demand.
In 2020, the physician office segment was second in revenue and is expected to grow at a faster rate during the forecast period. The segment will see an increase in healthcare spending by small and medium-sized healthcare providers, due to the increasing emphasis on regulatory compliance and risk management. It is also expected to experience a rise in staffing and technology requirements.
North America accounted for the largest percentage, with over 45.0% in 2020. A number of U.S. healthcare providers have turned their attention to outsourcing firms to manage their billing processes. Providers are now relying on outsourcing firms to manage high-volume transactions and maximize their operating margins. As outsourcing practices become more standardized around the world, developing regions like Asia Pacific and Latin America will see a lucrative CAGR over the next few years.
Medical billing has become more complicated due to the new International Classification of Diseases-10th Revised (ICD-11). This has led to a dramatic increase in the demand for revenue cycle management (RCM). Providers are also choosing companies that offer the best combination of RCM and electronic medical records (EMR), in order to improve patient outcomes.
RCM services are offered by companies like AthenaHealth, Inc., and eClinicalWorks that provide EHR software. Other major EMR providers, such as McKesson, GE Healthcare, and Allscripts Healthcare Solutions, Inc., have also begun to offer RCM services. Kareo, Inc., a provider of practice management software, has released a free EMR that offers RCM services for physicians.
To expand their service offerings and geographic reach, key companies use partnerships, mergers and acquisitions as well as technological advances. Cerner Corporation, for instance, partnered with Amazon Web Services in July 2019 to gain access to its global infrastructure and cloud space to support healthcare IT innovation. This partnership will improve healthcare organizations' clinical efficiency and reduce operational costs.
Veritas Capital purchased athenahealth. Inc. in February 2019 as a minority investor with Evergreen Coast Capital. Veritas Capital's subsidiary Virence Health merged with athenahealth in order to access its network-enabled services to hospital and ambulatory patients. Veritas Capital also acquired GE Healthcare’s Enterprise Financial Management asset in July 2018. This asset includes its RCM business and Ambulatory Care Management assets, as well as Workforce Management assets. The following are some of the most prominent players in global medical billing outsourcing:
R1 RCM, Inc.
Cerner Corporation
Allscripts Healthcare Solutions, Inc.
Experian Information Solutions, Inc.
eClinicalWorks
GE Healthcare
Genpact
HCL Technologies Limited
Kareo, Inc.
McKesson Corporation
Quest Diagnostics
Athenahealth Inc.
The SSI Group, LLC.
Up Market Research published a new report titled “Medical Billing Outsourcing Market research report which is segmented by Service (Middle End, Back End, Front End), by Component (Outsourced, In-house), By Players/Companies GE Healthcare, eClinicalWorks, Allscripts Healthcare Solutions Inc, Kareo Inc, Athenahealth Inc, The SSI Group LLC, Experian Information Solutions Inc, Genpact, HCL Technologies Limited, Cerner Corporation, R1 RCM Inc, McKesson Corporation, Quest Diagnostics”. As per the study the market is expected to grow at a CAGR of XX% in the forecast period.
Report Attributes | Report Details |
Report Title | Medical Billing Outsourcing Market Research Report |
By Service | Middle End, Back End, Front End |
By Component | Outsourced, In-house |
By Companies | GE Healthcare, eClinicalWorks, Allscripts Healthcare Solutions Inc, Kareo Inc, Athenahealth Inc, The SSI Group LLC, Experian Information Solutions Inc, Genpact, HCL Technologies Limited, Cerner Corporation, R1 RCM Inc, McKesson Corporation, Quest Diagnostics |
Regions Covered | North America, Europe, APAC, Latin America, MEA |
Base Year | 2020 |
Historical Year | 2018 to 2019 (Data from 2010 can be provided as per availability) |
Forecast Year | 2028 |
Number of Pages | 248 |
Number of Tables & Figures | 174 |
Customization Available | Yes, the report can be customized as per your need. |
The report covers comprehensive data on emerging trends, market drivers, growth opportunities, and restraints that can change the market dynamics of the industry. It provides an in-depth analysis of the market segments which include products, applications, and competitor analysis.
The market is segmented by Service (Middle End, Back End, Front End), by Component (Outsourced, In-house).
Medical Billing Outsourcing Market research report delivers a close watch on leading competitors with strategic analysis, micro and macro market trend and scenarios, pricing analysis and a holistic overview of the market situations in the forecast period. It is a professional and a detailed report focusing on primary and secondary drivers, market share, leading segments and geographical analysis. Further, key players, major collaborations, merger & acquisitions along with trending innovation and business policies are reviewed in the report.
Key Benefits for Industry Participants & Stakeholders:
Based on region, the market is segmented into North America, Europe, Asia Pacific, Latin America and Middle East & Africa (MEA). North America region is further bifurcated into countries such as U.S., and Canada. The Europe region is further categorized into U.K., France, Germany, Italy, Spain, Russia, and Rest of Europe. Asia Pacific is further segmented into China, Japan, South Korea, India, Australia, South East Asia, and Rest of Asia Pacific. Latin America region is further segmented into Brazil, Mexico, and Rest of Latin America, and the MEA region is further divided into GCC, Turkey, South Africa, and Rest of MEA.
We have studied the Medical Billing Outsourcing Market in 360 degrees via. both primary & secondary research methodologies. This helped us in building an understanding of the current market dynamics, supply-demand gap, pricing trends, product preferences, consumer patterns & so on. The findings were further validated through primary research with industry experts & opinion leaders across countries. The data is further compiled & validated through various market estimation & data validation methodologies. Further, we also have our in-house data forecasting model to predict market growth up to 2028.
How you may use our products:
Reasons to Purchase the Medical Billing Outsourcing Market Report:
Some other reports from this category!