US Physician Revenue Cycle Management

Overview and Outlook, 2012–2017

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This study provides a roadmap for understanding technology applications and collection services used in the physician revenue cycle management (RCM) market. Included is an overview of trends in physician demographics and medical practice organization, national health expenditures, and healthcare reform. The study discusses physicians' adoption of health information technology including EHRs and practice management systems used for revenue cycle and outlines key trends in next generation RCM technology. Competitive market issues including business and pricing approaches and profiles of key competitors are provided. Market forecasts for the total market and key market segments (applications and services) for 2012

Table of Contents

Executive SummaryExecutive Summary Executive Summary (continued)Executive Summary (continued) Executive Summary—Market Engineering MeasurementsExecutive Summary—Market Engineering Measurements (continued)Executive Summary—CEO’s PerspectiveStudy Scope and Research MethodologyDefinitions and Scope of StudyKey Issues This Study Will AddressMarket Segmentation for Physician RCM SolutionsResearch MethodologyResearch Methodology (continued)Research Methodology (continued)Macro Trends: National Health Expenditures and Physician DemographicsOverview of National Health ExpendituresNational Health Expenditures by Category, 2001 and 2011Definition of Hospital Care and Physician and Clinical Services Definition of Hospital Care and Physician and Clinical Services (continued) Total National Health Expenditure ForecastHospital Care Expenditure ForecastPhysician and Clinical Services Expenditure ForecastGrowth Rate Forecast Comparison for NHE, Hospital Care, and Physician and Clinical ServicesShifts in Percent Allocation of NHE from 1980 to 2012Trends in Hospital Expenditures by Source of FundsTrends in Expenditures for Physicians and Clinical Services by Source of FundsSummary of NHE Forecast Highlights from 2011 through 2021Overview of Physician DemographicsMarket Segmentation of US PhysiciansNumber of Office-Based Physicians by Medical SpecialtyNumber of Office-Based Physicians by Medical Specialty (continued)Percent of Office-Based Physicians by Medical SpecialtyPercent of US Physicians by AgePercent of US Physicians and Enrolled Medical Students by SexThe United States Faces a Growing Shortage of PhysiciansQuantifying the Shortage of Physicians in the United StatesPercent of Physicians by OwnershipPhysicians’ Attitude About the Current and Future State of the Medical ProfessionIntroduction to Physician RCMWhat is RCM?Reimbursement of Physician ServicesThe Changing Reimbursement EnvironmentThe Physician RCM PathwayPatient AccessRegistration and Charge Capture Billing and CollectionEnveloping Elements Impacting Physician RCMInformation Technology Systems in Physician PracticesThe Evolution of the Use of Health Information TechnologyGrowing Adoption of EHRPercent of Physicians Using EHRsPercent of Physicians Using Any and Basic EHRsEHR Technology Platforms Used by PhysiciansIntroduction to Physician Practice Management Systems Common Capabilities Included in Practice Management Systems*Stand Alone Versus Integrated SystemsIntegrated Practice Management Systems with Clinical SystemsPractice Management Systems that Include EHRsFeatures of Physician Practice Management SystemOn Premise Versus Hosted Practice Management SoftwarePercent of Medical Practice Management Software and Medical Billing Software Products Hosted Software Versus Cloud ComputerNext Generation RCM Information Technology SolutionsNext Generation RCMExternal Challenges: Drivers and Restraints—Total Physician Revenue Cycle Management MarketDrivers and RestraintsDrivers ExplainedDrivers Explained (continued)Drivers Explained (continued)Drivers Explained (continued)Drivers Explained (continued)Restraints Explained Restraints Explained (continued)Restraints Explained (continued)Market Impact of Top TrendsHealthcare Reform Will Exert the Greatest Impact on the Physician RCM MarketCompetitive Market Structure—Total Physician Revenue Cycle Management MarketCompetitive Market ForcesCompetitive EnvironmentCompetitive Environment (continued)Competitive Environment (continued)Competitive Environment (continued)Competitive Environment (continued)Competitor ProfilesCompany Profile—ADP AdvancedMD, Inc.Company Profile—Allscripts Healthcare Solutions, Inc.Company Profile—athenahealth, Inc.Company Profile—Cerner CorporationCompany Profile—Epic Systems CorporationCompany Profile—eClinicalWorks, LLCCompany Profile—e-MDs, Inc.Company Profile—GE HealthcareCompany Profile—Greenway Medical Technologies, Inc.Company Profile—McKesson CorporationCompany Profile—NextGen Healthcare Information Systems, LLCCompany Profile—Practice Fusion, Inc.Company Profile—Pulse Systems Inc.Company Profile—RemitDATA, Inc.Company Profile—Vitera Healthcare Solutions, LLCForecast and Trends—Total Physician Revenue Cycle Management MarketMarket Engineering MeasurementsMarket Engineering Measurements (continued)Total Physician RCM Market—Revenue Forecast AssumptionsTotal Physician RCM Market—Revenue ForecastTotal Physician RCM Market—Revenue Forecast DiscussionTotal Physician RCM Market—Revenue Forecast by Segment Type Total Physician RCM Market—Applications Revenue Forecast Assumptions and DiscussionTotal Physician RCM Market—Revenue Forecast by ApplicationsTotal Physician RCM Market—Services Revenue Forecast Assumptions and DiscussionTotal Physician RCM Market—Revenue Forecast by Services Total Physician RCM Market—Revenue Forecast by Segment TypeTotal Physician RCM Market—Percent of Revenue by Segment TypeDemand AnalysisTotal Physician RCM Market—Applications Penetration AnalysisTotal Physician RCM Market—Services Penetration AnalysisThe Last WordThe Last Word—Three Big PredictionsThe Last Word—DiscussionThe Last Word—Discussion (continued)The Last Word—Discussion (continued)The Last Word—Discussion (continued)Legal DisclaimerAppendixMarket Engineering MethodologySourcesSources (continued)Sources (continued)Table of Acronyms UsedLearn More—Next Steps

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