The global medical billing outsourcing market was valued at USD 14.48 billion in 2023, growing at a CAGR of 12.20% from 2024 to 2033. The market is expected to reach USD 45.77 billion by 2033. Medical billing is an essential component of any clinical practice due to the extensive clinical coding representation for diagnosis and treatment and the presence of different payers. Due to the federal requirement to use EMR to maintain reimbursement levels, the mandatory implementation of the intricate ICD-11 coding systems, and rising healthcare costs, hospitals and physicians are increasingly outsourcing clinical billing services. Integrating advanced technologies like automation, AI and machine learning have transformed the conventional billing processes..
The Revenue Cycle Management (RCM) process, which includes the most intricate and crucial elements of the healthcare IT industry, is involved in medical billing. It entails businesses (organizations, sole proprietors, and partnerships) offering medical billing outsourcing services to other businesses. Products and services exchanged between businesses or offered to final customers are covered. Consumers who used various developing payment options demonstrated excellent satisfaction rates in paying their medical bills, according to a Healthcare Payments Insight Survey Report produced by Elavon in January 2020. 93% of respondents said they were inclined to use Interactive Voice Response (IVR) again after using it to pay a bill. 85% of those who used kiosk networks to make payments described the procedure as quick and straightforward, and 88% said they were inclined to use it again. Additionally, the market experienced a significant impact. Systems for electronic health records were created more for tracking and charging patients than for giving the best care possible, which is now more important than ever due to the rise of COVID-19 patients. Hospitals and other medical facilities are scrambling to guarantee that their billing data can be processed and kept correctly as the ongoing pandemic strains healthcare systems worldwide. Access, triage, and even treatment responses from providers to the COVID-19 issue depend heavily on the 'digital front door'.
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In November 2020, A commercial partnership was announced between Conduent Incorporated and Experian Health, a top supplier of revenue cycle management tools encompassing patient engagement, patient access, and patient collections. As a result of the collaboration, Conduent's digital IntelliHealth platform can connect with Experian's customer data and electronic tool for confirming income to expedite the acceptance of prescription drug assistance, minimize the time it takes to fill prescriptions and accelerate time to therapy.
In June 2020, R1 RCM Inc. announced it would acquire Cerner's RefWorks services division and its commercial, non-federal client relationships. RefWorks worked in the billing and revenue cycle management industries.
In March 2022, Reventics, a creator of revenue cycle management systems that boost physician reimbursement and compliance, was bought by Omega Healthcare, a well-known provider of healthcare management services and solutions.
In July 2021, The completion of R1 RCM Inc.'s acquisition of VisitPay, a provider of digital payment solutions, was announced. R1 RCM Inc. provides technology-driven solutions that improve healthcare providers' patient experiences and financial performance. With the integration of VisitPay's customer payments infrastructure and R1's leading patient access technology, providers can now provide their patients with a straightforward financial experience.
Government Spending- Growing government spending and growing government programmes stifle market expansion. The increased usage of billing and medical coding methodologies in revenue cycle management is predicted to boost market growth. Hospitals are experiencing issues with the billing system as a result of the current situation's increased patient load, which also has an impact on point-of-care delivery. Doctors can better manage their patients and the billing process by outsourcing the medical billing process. In order to make the billing process easier and expand the market, the government is subsidising hospitals and providing them with access to advanced billing systems.
Lack of Skilled Workers- A constraint that makes growing the medical billing outsourcing market during the projected period more challenging is the demand for more skilled individuals. The billing procedure must be streamlined because doctors' and clinics' incomes will likely not be as high as they should be if they do not employ the services of qualified billing companies. This procedure calls specialised specialists. While giving the practitioner the best benefits, the efficiency of the billing process can help the company save money.
Technological Advancements- The healthcare sector's demand for technologically advanced resources will increase as R&D expenditure rises. Growing medical expenses in emerging nations have fueled industry expansion through cutting-edge technology tools like outsourcing medical bills. Over the projected period, segment growth should be fueled by increased patient visits and the advantages of the EHR system in maintaining and managing patient information and assisting with invoicing. Numerous research institutions are predicted to continue to boost their demand for advanced outsourced resources.
The regions analyzed for the market include North America, Europe, South America, Asia Pacific, the Middle East, and Africa. North America emerged as the most significant global medical billing outsourcing market, with a 45.87% market revenue share in 2023.
The rapidly developing healthcare infrastructure in North America and a growth in hospital admissions are driving increasing demand for software solutions, which will likely fuel market expansion along with growing government efforts to manage digital health data. The creation of new technologies and their widespread application are helping the United States' healthcare sector to expand. The primary reason for this industry's expansion is the rising healthcare expense. The healthcare sector in the US is one of the most data-intensive industries. The healthcare sector is heavily committed to implementing cutting-edge solutions to assist the advancement of advanced healthcare and enable improvements in patient care. Additionally, the federal government of the United States and other public players are releasing their enormous knowledge bases on healthcare, including data and details on individuals covered by public insurance programmes.
In March 2018, the demand for healthcare improvement will increase market growth. The MyHealthEData Initiative, which the Trump Administration introduced, promises to give patients more control over their healthcare data and allow them to select how that data will be used, all while maintaining the privacy and security of that data. The Centres for Medicare & Medicaid Services (CMS's) Electronic Health Record Incentive Programmes will also be updated. As a result, encouraging more hospitals and care facilities to digitize their infrastructure and raising demand for outsourced medical billing from these businesses.
North America Region Medical Billing Outsourcing Market Share in 2023 - 45.87%
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The component segment is divided into outsourced and in-house. The outsourced segment dominated the market, with a market share of around 52.12% in 2023. Outsourcing services effectively allows small and medium-sized businesses to cut costs. Physician health operations in clinics and acute care hospitals are experiencing difficult times due to decreasing reimbursements, increasing costs, and the complexity of business brought on by recently imposed laws. According to a Medical Group Management Association (MGMA) survey, billing errors cost a medical practice between 5 and 10% of its income. This is aiding the segment's expansion.
The end-user segment is divided into physician office, hospital, and others. The hospital segment dominated the market, with a market share of around 40.23% in 2023. Throughout the forecast period, the segment is anticipated to continue to dominate. The need for financial services in healthcare institutions is the leading cause. The amalgamation of hospitals further complicates the reimbursement and invoicing procedure. This is fueling the healthcare industry's need for medical billing outsourcing services. The medical billing market has become even more complicated due to the recently released ICD-11, the 10th version of the International Classification of Diseases. As a result, the need for Revenue Cycle Management (RCM) solutions has dramatically expanded. Additionally, doctors are selecting businesses that have the correct mix of RCM and electronic medical records to improve patient outcomes.
Report Description:
Attribute | Description |
---|---|
Market Size | Revenue (USD Billion) |
Market size value in 2023 | USD 14.48 Billion |
Market size value in 2033 | USD 45.77 Billion |
CAGR (2024 to 2033) | 12.2% |
Historical data | 2020-2022 |
Base Year | 2023 |
Forecast | 2024-2033 |
Region | The regions analyzed for the market are Asia Pacific, Europe, South America, North America, and Middle East & Africa. Furthermore, the regions are further analyzed at the country level. |
Segments | Component, End-User |
As per The Brainy Insights, the size of the medical billing outsourcing market was valued at USD 14.48 billion in 2023 to USD 45.77 billion by 2033.
The global medical billing outsourcing market is growing at a CAGR of 12.20% during the forecast period 2024-2033.
North America emerged as the largest medical billing outsourcing market.
Key players in the medical billing outsourcing market are R1RCM Inc., Veradigm, LLC, eClinicalWorks, Oracle, Kareo, Inc., Quest Diagnostics Incorporated, AdvancedMD, Inc., Promantra Inc., and McKesson Corporation.
1. Introduction
1.1. Objectives of the Study
1.2. Market Definition
1.3. Research Scope
1.4. Currency
1.5. Key Target Audience
2. Research Methodology and Assumptions
3. Executive Summary
4. Premium Insights
4.1. Porter’s Five Forces Analysis
4.2. Value Chain Analysis
4.3. Top Investment Pockets
4.3.1. Market Attractiveness Analysis by Component
4.3.2. Market Attractiveness Analysis by End-User
4.3.3. Market Attractiveness Analysis by Region
4.4. Industry Trends
5. Market Dynamics
5.1. Market Evaluation
5.2. Drivers
5.2.1. Government spending
5.3. Restraints
5.3.1. Lack of skilled workers
5.4. Opportunities
5.4.1. Technological advancements
5.5. Challenges
5.5.1. High cost
6. Global Medical Billing Outsourcing Market Analysis and Forecast, By Component
6.1. Segment Overview
6.2. Outsourced
6.3. In-house
7. Global Medical Billing Outsourcing Market Analysis and Forecast, By End-User
7.1. Segment Overview
7.2. Physician Office
7.3. Hospital
7.4. Others
8. Global Medical Billing Outsourcing Market Analysis and Forecast, By Regional Analysis
8.1. Segment Overview
8.2. North America
8.2.1. U.S.
8.2.2. Canada
8.2.3. Mexico
8.3. Europe
8.3.1. Germany
8.3.2. France
8.3.3. U.K.
8.3.4. Italy
8.3.5. Spain
8.4. Asia-Pacific
8.4.1. Japan
8.4.2. China
8.4.3. India
8.5. South America
8.5.1. Brazil
8.6. Middle East and Africa
8.6.1. UAE
8.6.2. South Africa
9. Global Medical Billing Outsourcing Market-Competitive Landscape
9.1. Overview
9.2. Market Share of Key Players in Global Medical Billing Outsourcing Market
9.2.1. Global Company Market Share
9.2.2. North America Company Market Share
9.2.3. Europe Company Market Share
9.2.4. APAC Company Market Share
9.3. Competitive Situations and Trends
9.3.1. Product Launches and Developments
9.3.2. Partnerships, Collaborations, and Agreements
9.3.3. Mergers & Acquisitions
9.3.4. Expansions
10. Company Profiles
10.1. R1RCM Inc.
10.1.1. Business Overview
10.1.2. Company Snapshot
10.1.3. Company Market Share Analysis
10.1.4. Company Product Portfolio
10.1.5. Recent Developments
10.1.6. SWOT Analysis
10.2. Veradigm, LLC
10.2.1. Business Overview
10.2.2. Company Snapshot
10.2.3. Company Market Share Analysis
10.2.4. Company Product Portfolio
10.2.5. Recent Developments
10.2.6. SWOT Analysis
10.3. EClinicalWorks
10.3.1. Business Overview
10.3.2. Company Snapshot
10.3.3. Company Market Share Analysis
10.3.4. Company Product Portfolio
10.3.5. Recent Developments
10.3.6. SWOT Analysis
10.4. Oracle
10.4.1. Business Overview
10.4.2. Company Snapshot
10.4.3. Company Market Share Analysis
10.4.4. Company Product Portfolio
10.4.5. Recent Developments
10.4.6. SWOT Analysis
10.5. Kareo, Inc.
10.5.1. Business Overview
10.5.2. Company Snapshot
10.5.3. Company Market Share Analysis
10.5.4. Company Product Portfolio
10.5.5. Recent Developments
10.5.6. SWOT Analysis
10.6. Quest Diagnostics Incorporated
10.6.1. Business Overview
10.6.2. Company Snapshot
10.6.3. Company Market Share Analysis
10.6.4. Company Product Portfolio
10.6.5. Recent Developments
10.6.6. SWOT Analysis
10.7. AdvancedMD, Inc.
10.7.1. Business Overview
10.7.2. Company Snapshot
10.7.3. Company Market Share Analysis
10.7.4. Company Product Portfolio
10.7.5. Recent Developments
10.7.6. SWOT Analysis
10.8. Promantra Inc.
10.8.1. Business Overview
10.8.2. Company Snapshot
10.8.3. Company Market Share Analysis
10.8.4. Company Product Portfolio
10.8.5. Recent Developments
10.8.6. SWOT Analysis
10.9. McKesson Corporation
10.9.1. Business Overview
10.9.2. Company Snapshot
10.9.3. Company Market Share Analysis
10.9.4. Company Product Portfolio
10.9.5. Recent Developments
10.9.6. SWOT Analysis
List of Table
1. Global Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
2. Global Outsourced, Medical Billing Outsourcing Market, By Region, 2020-2033 (USD Billion)
3. Global In-house, Medical Billing Outsourcing Market, By Region, 2020-2033 (USD Billion)
4. Global Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
5. Global Physician Office, Medical Billing Outsourcing Market, By Region, 2020-2033 (USD Billion)
6. Global Hospital, Medical Billing Outsourcing Market, By Region, 2020-2033 (USD Billion)
7. Global Others, Medical Billing Outsourcing Market, By Region, 2020-2033 (USD Billion)
8. North America Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
9. North America Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
10. U.S. Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
11. U.S. Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
12. Canada Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
13. Canada Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
14. Mexico Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
15. Mexico Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
16. Europe Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
17. Europe Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
18. Germany Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
19. Germany Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
20. France Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
21. France Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
22. U.K. Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
23. U.K. Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
24. Italy Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
25. Italy Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
26. Spain Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
27. Spain Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
28. Asia Pacific Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
29. Asia Pacific Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
30. Japan Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
31. Japan Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
32. China Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
33. China Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
34. India Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
35. India Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
36. South America Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
37. South America Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
38. Brazil Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
39. Brazil Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
40. Middle East and Africa Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
41. Middle East and Africa Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
42. UAE Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
43. UAE Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
44. South Africa Medical Billing Outsourcing Market, By Component, 2020-2033 (USD Billion)
45. South Africa Medical Billing Outsourcing Market, By End-User, 2020-2033 (USD Billion)
List of Figures
1. Global Medical Billing Outsourcing Market Segmentation
2. Global Medical Billing Outsourcing Market: Research Methodology
3. Market Size Estimation Methodology: Bottom-Up Approach
4. Market Size Estimation Methodology: Top-Down Approach
5. Data Triangulation
6. Porter’s Five Forces Analysis
7. Value Chain Analysis
8. Global Medical Billing Outsourcing Market Attractiveness Analysis by Component
9. Global Medical Billing Outsourcing Market Attractiveness Analysis by End-User
10. Global Medical Billing Outsourcing Market Attractiveness Analysis by Region
11. Global Medical Billing Outsourcing Market: Dynamics
12. Global Medical Billing Outsourcing Market Share by Component (2023 & 2033)
13. Global Medical Billing Outsourcing Market Share by End-User (2023 & 2033)
14. Global Medical Billing Outsourcing Market Share by Regions (2023 & 2033)
15. Global Medical Billing Outsourcing Market Share by Company (2023)
This study forecasts global, regional, and country revenue from 2020 to 2033. The Brainy Insights has segmented the global medical billing outsourcing market based on the below-mentioned segments:
Global Medical Billing Outsourcing Market By Component:
Global Medical Billing Outsourcing Market By End-User:
Global Medical Billing Outsourcing Market By Region:
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