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US RCM Growth Opportunities
US RCM Growth Opportunities
Internal Challenges due to COVID-19 Accelerated the Shift to Revenue Cycle Management (RCM) Outsourcing
29-Mar-2022
North America
Market Research
Description
This research service provides an overview of the US revenue cycle management, revenue forecast, and competitive analysis of various legacy and modular RCM solutions. This study explores RCM applications across front-end, middle, and back-end processes and the end users are hospitals and ambulatory physician practices. In addition, it offers detailed insight into the RCM outsourcing market in the US.
RCM refers to the several administrative and clinical functions for capturing, managing, and collecting patient service revenue. The RCM process starts with admission (patient access) and continues to accounts receivable (payment and collections). Several RCM solutions (for example, IT applications and services) help healthcare providers perform different functions.
The top three strategic imperatives impacting RCM are:
Internal Challenges: Healthcare organizations are looking for improved efficiency, faster reimbursement, and profitability by reducing billing errors, lowering cost, and optimizing collection during COVID-19. Pent-up demand for elected surgeries, due from the last two years, is further requiring providers to bolster the productivity of their incumbent RCM solutions.
Transformative Mega Trends: COVID-19 pandemic has led to a surge of patients with long-term symptoms that vary from traditional chronic conditions with new comorbidities to the unprecedented prevalence of rare diseases. As a result, robust clinical risk management has become imperative to new-age RCM, leading vendors to transform their RCM platforms’ underlying clinical logic, financial template, and codes.
Customer Value Chain Compression: Providers use and prefer a mix of in-house and outsourced RCM to meet their organizational needs. Vendors for this outsourcing appear to be very fragmented based on expertise in specific areas of need across front-end, middle, and back-end processes.
Author: Koustav Chatterjee
Table of Contents
Why Is It Increasingly Difficult to Grow?
The Strategic Imperative 8™
The Impact of the Top Three Strategic Imperatives on US RCM
Growth Opportunities Fuel the Growth Pipeline Engine™
Scope of Analysis
End User and Product Segmentation of RCM
Summary RCM Process Pathway
Current State of the US RCM
Current State of US RCM—Level of Satisfaction for Incumbent RCM Processes
Current State of US Hospital RCM—Level of Satisfaction for Outsourced RCM Processes
Current State of US Physician Practices RCM—Level of Satisfaction for Outsourced RCM Processes
Impact of COVID-19 on the Shift to RCM Outsourcing
COVID-19’s Impact on RCM & Outsourcing—Discussion
Key Growth Metrics for US RCM
Growth Drivers for US RCM
Growth Restraints for US RCM
Forecast Assumptions, US RCM Market
Revenue Forecast, RCM
Revenue Forecast by Applications, RCM
Revenue Forecast Analysis, US RCM
Pricing Trends and Forecast Analysis, US RCM
Competitive Environment, US RCM Market
Competitive Overview
Competitive Overview (continued)
Key Growth Metrics for Hospital RCM
Market Segmentation
Revenue Forecast by Application, Hospital RCM Software
Revenue Forecast by Application, Hospital RCM Services
Forecast Analysis, Hospital RCM
Key Growth Metrics for Physician Practices RCM
Revenue Forecast, Physician Practices RCM
Revenue Forecast by Application, Physician Practices RCM Software
Revenue Forecast by Application, Physician Practices RCM Services
Forecast Analysis by End User, Physician Practices RCM
Growth Opportunity 1—Big Tech will help Legacy CDI Solution Providers Expand Scope from Disparate OPDs and ICUs to Enterprise-level Case Management
Growth Opportunity 1—Big Tech will help Legacy CDI Solution Providers Expand Scope from Disparate OPDs and ICUs to Enterprise-level Case Management (continued)
Growth Opportunity 2—Overhaul of Front-end RCM Processes for Physician Practices will Improve End-user Satisfaction
Growth Opportunity 2—Overhaul of Front-end RCM Processes for Physician Practices will Improve End-user Satisfaction (continued)
Growth Opportunity 3—Hospital RCM Back-end Processes are Ready for Outsourcing After COVID-19 to Improve Collection and Ratings
Growth Opportunity 3—Hospital RCM Back-end Processes are Ready for Outsourcing After COVID-19 to Improve Collection and Ratings (continued)
Your Next Steps
Why Frost, Why Now?
List of Exhibits
List of Exhibits (continued)
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| Deliverable Type | Market Research |
|---|---|
| No Index | No |
| Podcast | No |
| Author | Koustav Chatterjee |
| Industries | Healthcare |
| WIP Number | K646-01-00-00-00 |
| Is Prebook | No |
| GPS Codes | 9564-B1,9600-B1,9612-B1 |