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Source: businesswire | Published on: Wednesday, 29 January 2025
DUBLIN--(BUSINESS WIRE)--The "U.S. Revenue Cycle Management Market - Focused Insights 2025-2030" report has been added to ResearchAndMarkets.com's offering.
The U.S. Revenue Cycle Management Market was valued at USD 141.61 billion in 2024, and is expected to reach USD 272.78 billion by 2030, rising at a CAGR of 11.55%.
The U.S. revenue cycle management market report consists of exclusive data on 55 vendors. The market is a dynamic and competitive landscape characterized by a growing demand for technology-driven solutions, consolidation among players, and the emergence of new entrants leveraging advanced technologies like artificial intelligence (AI) and automation.
Companies like Change Healthcare, Epic Systems Corporation, Experian, McKesson Corporation, Oracle, R1 RCM, Veradigm, and SSI Group dominate the RCM market, offering end-to-end solutions for billing, claims management, and regulatory compliance. These companies have longstanding relationships with large healthcare providers and are expanding their portfolios through acquisitions and partnerships to stay ahead in the market.
MARKET TRENDS & DRIVERS
Shift from Computer-Assisted Coding (CAC) to Autonomous Coding
The healthcare industry is transitioning from Computer-Assisted Coding (CAC) to Autonomous Coding due to advancements in AI and machine learning. Unlike CAC, which assists coders with code suggestions using NLP, autonomous coding fully automates the process, minimizing human involvement. This shift aims to improve efficiency, accuracy, and cost-effectiveness in medical coding and billing, addressing issues like human error, fatigue, and evolving standards. Studies highlight its growing adoption and benefits.
A 2023 Frost & Sullivan report indicates that over 30% of healthcare organizations are piloting or planning autonomous coding solutions. A TruCode report reveals these systems can reduce coding time by up to 50% while enhancing accuracy. Autonomous coding is poised to revolutionize Revenue Cycle Management (RCM) by increasing operational efficiency, improving compliance, and boosting revenue collection, with AI systems becoming smarter and more adaptable over time.
Increasing Adoption of Third-party Managed RCM Solutions
The adoption of third-party managed Revenue Cycle Management (RCM) solutions is reshaping the U.S. healthcare market as providers face financial pressures, regulatory challenges, and a shift to value-based care. Outsourcing RCM helps healthcare organizations streamline operations, improve cash flow, and reduce costs, allowing them to focus on patient care. A 2023 Healthcare IT News survey found that 40% of healthcare providers outsource RCM functions, primarily to reduce operational expenses by avoiding the costs of maintaining in-house teams.
Third-party vendors bring specialized expertise in billing, coding, and collections, along with advanced technologies like automation and AI, which improve efficiency and reduce errors. A KPMG report highlights that 56% of providers are outsourcing non-core functions like RCM to prioritize clinical excellence. This trend reflects the growing preference for cost-effective, expert-driven solutions to optimize revenue cycles while focusing internal resources on delivering high-quality patient care.
INDUSTRY RESTRAINTS
The Role of Cybersecurity and Data Protection
Cybersecurity and data protection are major challenges in the revenue cycle management (RCM) market due to the sensitive nature of healthcare data and rising cyber threats. RCM systems handle vast amounts of personal, medical, and financial data, making them attractive targets for attacks. Compliance with regulations like HIPAA adds complexity, requiring robust safeguards to protect data and ensure operations.
Many healthcare providers and RCM vendors face difficulties in addressing these risks due to limited budgets, outdated systems, and a lack of cybersecurity expertise. Threats such as ransomware, data breaches, and system downtime can disrupt the revenue cycle, causing financial losses, reputational harm, and potential legal penalties.
RECENT VENDORS ACTIVITIES
KEY TAKEAWAYS
KEY QUESTIONS ANSWERED
Key Attributes:
| Report Attribute | Details |
| No. of Pages | 108 |
| Forecast Period | 2024 - 2030 |
| Estimated Market Value (USD) in 2024 | $141.61 Billion |
| Forecasted Market Value (USD) by 2030 | $272.78 Billion |
| Compound Annual Growth Rate | 11.5% |
| Regions Covered | United States |
COMPETITIVE LANDSCAPE
Key Vendors
Other Prominent Vendors
For more information about this report visit https://www.researchandmarkets.com/r/m2qtrn
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