Back-End Revenue Cycle Management Market Scope
Revenue Cycle Management (RCM) is the process of identifying, collecting, and managing the practice’s revenue from payers based on the services provided. In the healthcare sector, these facilities use to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation. Back-end insurance eligibility verification is one of the most important, and time-consuming aspects of the healthcare revenue cycle. The American Hospital Association found that 43 percent of hospitals have spent more than USD 10,000 in the first quarter of 2016 to manage claim denials and 26 percent have invested over USD 26,000. This has created lucrative opportunities for the back-end revenue cycle management market.
Back-End Revenue Cycle Management research includes a segment specifically devoted to such significant players, where analysts give an insight to each player's financial statements as well as their product benchmarking and SWOT analysis. Key development strategies, market share analysis, and market positioning analysis of the aforementioned competitors internationally are also included in the competitive landscape section Research Analyst at AMA estimates that United States Players will contribute to the maximum growth of Global Back-End Revenue Cycle Management market throughout the predicted period.
Athenahealth (United States), GE Healthcare (United States), Cognizant Technology Solutions (United States), McKesson Corporation (United States), Cerner Corporation (United States), Conifer Health Solutions (United States), GeBBs Healthcare Solutions (United States), The SSI Group (United States), Allscripts Healthcare Solutions, Inc. (United States) and Optum, Inc. (United States) are some of the key players that are part of study coverage. Additionally, the Players which are also part of the research are DST Systems (United States), Quest Diagnostics (United States), eClinicalWorks (United States) and nThrive (United States).
Segmentation Overview
The study have segmented the market of Global Back-End Revenue Cycle Management market , by Application (Healthcare Payer and Healthcare Service Provider) and Region with country level break-up.
On the basis of geography, the market of Back-End Revenue Cycle Management has been segmented into South America (Brazil, Argentina, Rest of South America), Asia Pacific (China, Japan, India, South Korea, Taiwan, Australia, Rest of Asia-Pacific), Europe (Germany, France, Italy, United Kingdom, Netherlands, Rest of Europe), MEA (Middle East, Africa), North America (United States, Canada, Mexico).
Influencing Trend:
Synchronization of Data from EHR with an RCM System to Bridge the Gap between the Clinical and Financial Side of Patient Care
Market Growth Drivers:
Enhanced Profitability, Improved Financial Outcomes and, Improved Patient Satisfaction, Increasing Complex Systems of Billing and Coding, Combined With Narrowing Submission Windows Demanded By Insurers, Frequent Change in Healthcare Regulations and Reimbursement Models and Decreasing Cost of Collections with Increased Automation, and Reduce Redundancies
Challenges:
Selection of Professionally Trained Third Party Which Focuses Solely On Coding, Billing, and Submitting Claims
Restraints:
Outsourcing Cost and Security of Patient Health Information and High Cost of Software Installation
Opportunities:
Growing Automation in Healthcare IT to Improve RCM Measures, Integration of Software with EHRs and Technological Developments such as Big Data Analytics and Health IT Solutions
Market Leaders and their Expansionary Development Strategies
In 2017, nThrive, a leading provider of RCM services featured its Patient-to-PaymentTM suite of solutions at the annual meeting of the Healthcare Financial Management Association (HFMA)
Regulation such as Health Insurance Portability and Accountability Act (HIPAA), Office of Inspector General (OIG), and ICD-10
Key Target Audience
Back-end Revenue Cycle Management Service Providers, Software Developers and Integrators, Software & Service Providers, Healthcare Industries, Partners/Investors, End-Use Industry and Others
About Approach
The research aims to propose a patent-based approach in searching for potential technology partners as a supporting tool for enabling open innovation. The study also proposes a systematic searching process of technology partners as a
preliminary step to select the emerging and key players that are involved in implementing market estimations. While patent analysis is employed to overcome the aforementioned data- and process-related limitations, as expenses occurred in that technology allows us to estimate the market size by evolving segments as target market from the total available market.