Factors such as the growing importance of denials management, increasing patient volume, process improvements in healthcare organizations, and declining reimbursement rates are driving the growth of the market. However, the high cost of deployment, integration of back-end revenue cycle management solutions, data breaches and loss of confidentiality, and lack of skilled IT professionals in healthcare are expected to limit market growth to a certain extent in the coming years.
Growing importance of denials management; -
To reduce costs and maximize profits, insurance companies are increasingly denying claims as well as coverage to patients being treated for chronic or persistent illnesses. This is putting an extra burden on healthcare providers to manage operating costs, and in turn is supporting the adoption of back-end revenue cycle management solutions (with a growing number of healthcare providers focusing on properly analyzing denied claims and appealing them).
Many healthcare providers across the globe still use manual and paper-oriented approaches to manage denials. This results in errors, delayed follow-ups, and miscommunication between healthcare providers and insurance companies. The use of back-end revenue cycle management solutions over manual and paper-oriented approaches can not only help healthcare providers overcome these issues but also help them save significant costs. As a result, the demand for back-end revenue cycle management solutions is expected to increase among end users during the forecast period.
The market is segmented into software and services. The services segment is estimated to witness the highest CAGR during 2018–2023. The high growth of this segment is primarily due to the recurring nature of services such as training and development, installation, software upgrades, consulting, and maintenance.
Back-end Revenue Cycle Management Market Based on software type;
By software, the market is broadly segmented into integrated and standalone software. In 2018, the integrated software segment is expected to account for the largest share of the back-end RCM Market. The large share of this segment can be attributed to the ability of integrated solutions to help users to streamline and coordinate multiple financial functions through a single platform.
Market Based on end-user:
By end user, the market is segmented into healthcare payers and healthcare providers. In 2018, the healthcare payers’ segment is expected to account for the largest share of the back-end RCM Market. Insurance providers need to comply with various federal and regional laws and regulations. Many of these regulations have privacy and security concerns relating to patient information and strict auditing and reporting requirements.
Geographical Segmentation:
North America is expected to account for the largest share in 2018 owing to factors such as growing HCIT investments in the region and the presence of regulatory mandates. North America is followed by Europe and Asia. The market in Asia is relatively nascent; however, it is projected to be the fastest-growing market during the forecast period.
Athenahealth (US), Cerner Corporation (US), Allscripts Healthcare Solutions, Inc. (US), eClinicalWorks (US), Optum, Inc. (US), McKesson Corporation (US), Conifer Health Solutions (US), GeBBs Healthcare Solutions (US), The SSI Group (US), GE Healthcare (US), nThrive (US), DST Systems (US), Cognizant Technology Solutions (US), and Quest Diagnostics (US) are the key players in the back-end revenue cycle management market.
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