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Mid-Revenue Cycle Management Market to be Worth $4.55B by 2027
The mid-revenue cycle management market is projected for significant growth due to the increasing need to manage healthcare data, improve financial outcomes, and resolve medical billing errors.
The mid-revenue cycle management and clinical documentation improvement (CDI) market is expected to be worth $4.55 billion by 2027, according to a recent report by Meticulous Market Research.
Projections expect the market to grow at a compound annual growth rate (CAGR) of 6.6 percent from 2020 to 2027.
“The growth of this market is primarily driven by factors such as rising healthcare expenditure, a growing need to manage unstructured healthcare data, and alterations in revenue due to medical billing errors,” a May 11th press release stated.
The mid-revenue cycle management/CDI market encompasses solutions and services that improve revenue outcomes and quality of care. With value-based care on the rise, data accuracy and improvements with clinical documentation and coding are becoming crucial to maximizing revenue and improving quality of care.
In 2020, the solutions segment, which includes clinical coding, consulting services, and more, controlled the largest share of the mid-revenue cycle management/CDI market.
“The solutions of mid-revenue cycle management being highly capable of improving revenue cycle productivity by eliminating coding errors and manual coding practices and their compatibility with hospital management solutions drive this segment’s growth,” the report stated.
By end-user, the healthcare providers segment (compared to inpatient settings, outpatient settings, and healthcare payers) held the largest share of the mid-revenue cycle management/CDI market in 2020. This is largely due to an uptick by providers in the adoption of revenue cycle management solutions for the purposes of communicating between EHRs and accounting systems, as well as streamlining the management of patient billing records.
Geographically, North America dominated the market in 2020, likely due to advancing technology and increased adoption of healthcare IT solutions, the report said.
“The large share of North America is primarily attributed to the high adoption rate of various mid-RCM solutions by healthcare providers to maintain revenue integrity, a shift towards value-based care, and the need to curb revenue loss due to billing and coding errors,” explained the report.
In addition, most of the key players in the industry are North American companies. Meticulous Market Research expects a few industry giants to dominate the field, including nThrive, Inc., Dolbey Systems, Inc., 3M Company, UnitedHealth Group Inc., Streamline Healthcare Solutions, LLC, Vitalware, LLC, Iodine Software, LLC, Craneware, Epic Systems Corporation, ChartWise Medical Systems, Inc., Nuance Communications, Inc., and Cerner Corporation.
Although the market is expected to grow at a rapid rate, there are some noteworthy constraints that Meticulous Market Research identified that could inhibit growth, including IT infrastructure and data security concerns.
In addition, COVID-19 has had a significant impact on the mid-revenue cycle management/CDI market, in both positive and negative ways.
“The sudden increase in the inpatient volume has created tremendous financial pressures on the hospitals and healthcare systems. These financial challenges have reduced budgets for implementation or upgradation of digital health solutions, negatively impacting the market growth,” the report explained.
While some aspects of the COVID-19 pandemic could stifle growth, the re-opening of outpatient surgery centers has led to a significant increase in revenue, requiring increased usage of mid-revenue cycle management. With a higher number of patients and additional revenue flowing, Meticulous Market Research expects more practitioners to outsource their mid-revenue cycle services, leading to market growth.
In recent years, the healthcare community has started to embrace clinical documentation improvement due to its cost efficiency. In addition, CDI efforts have shown the potential to advance patient care by ensuring that care teams have access to an extremely detailed and accurate patient record. A February 2021 KLAS report indicated that top CDI vendors like Optum, 3M, and Iodine have contributed to an increase in market energy in the past few years, and the growth is expected to continue.
