DUBLIN, Jan. 11, 2019 /PRNewswire/ --
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The mid-revenue cycle management/clinical documentation improvement market is expected to reach USD 4.5 billion by 2023 from USD 3.1 billion in 2018, at a CAGR of 7.9%.
Market growth is largely driven by the increasing utilization of mid-RCM solutions to reduce healthcare costs, check the loss of revenue due to medical billing and coding errors, resolve issues raised by the decline in reimbursement rates, manage ever-increasing amounts of unstructured data, and maintain regulatory compliance. On the other hand, IT infrastructural constraints in developing countries, a scarcity of skilled IT professionals, and the risks associated with HCIT solutions in terms of data security & privacy may restrain the growth of this market to a certain extent.
The solutions segment accounted for the largest share of the market.
In 2017, solutions accounted for the largest share of the market. The large share of the solutions segment can be attributed to the benefits offered by mid-revenue cycle solutions when they are integrated with EHRs/EMRs, encoder systems, voice/text/speech recognition software, CDI, transcription systems, and other hospital information management systems. Moreover, these solutions also eliminate the duplication of administrative work of entering selected codes into each record. They also decrease the potential for data documentation, charge capture, and coding errors, and improve the overall mid-revenue cycle process.
The healthcare providers segment is projected to witness the highest growth during the forecast period.
The healthcare providers segment is projected to grow at the highest rate over the next five years. Growth in the mid-revenue cycle management solutions market for healthcare providers can be attributed to the significant demand for these solutions from healthcare providers for improving data accuracy in clinical documentation, maximizing hospital revenues by minimizing coding errors, and shortening the claims reimbursement cycle. Revenue losses due to medical billing and coding errors, declining reimbursement rates, and the need to reduce the rising healthcare cost are other key factors supporting the growth in the demand for these solutions.
APAC is projected to witness the highest growth during the forecast period.
The APAC region is projected to grow at the highest rate over the next five years. The improving healthcare infrastructure and the rising healthcare insurance coverage and medical tourism are supporting the growth of the mid-revenue cycle management solutions market in the APAC.
Prominent players in this market are 3M Company (US), Optum (US), Nuance (US), M*Modal (US), nThrive (US), Dolbey Systems (US), Streamline Health (US), Vitalware (US), Chartwise (US), Craneware (US), Epic Systems (US), Cerner (US), eZDI Inc. (US), Iodine Software (US), Flash Code (US), and TruCode (US).
Key Topics Covered:
1.1 Objectives of the Study
1.2 Market Definition
1.3 Market Scope
2 Research Methodology
2.1 Research Approach
2.2 Market Size Estimation
2.3 Market Breakdown and Data Triangulation
2.4 Assumptions for the Study
3 Executive Summary
4 Premium Insights
4.1 Mid-Revenue Cycle Management Solutions Market Overview
4.2 North American Mid-Revenue Cycle Management Solutions Market
4.3 Mid-Revenue Cycle Management Solutions Market: Major Geographic Regions
4.4 Geographic Mix: Mid-Revenue Cycle Management Solutions Market
5 Market Overview
5.2 Market Dynamics
5.2.1 Key Market Drivers
22.214.171.124 Increasing Healthcare Expenditure
126.96.36.199 Loss of Revenue Due to Medical Billing and Coding Errors
188.8.131.52 Declining Reimbursements
184.108.40.206 Growing Need to Manage Increasing Unstructured Healthcare Data
5.2.2 Key Market Restraints
220.127.116.11 It Infrastructural Constraints in Developing Countries
5.2.3 Key Market Opportunities
18.104.22.168 Rising Use of NLP in Documentation
5.2.4 Key Market Challenges
22.214.171.124 Data Security Concerns
126.96.36.199 Reluctance to Switch From Conventional Methods
188.8.131.52 Scarcity of Skilled It Professionals
6 Industry Insights
6.2 Coding Guidelines
6.3 Trends in NLP-Enabled Documentation & Coding
7 Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, By Product & Service
7.2.1 Clinical Documentation
184.108.40.206 Advantages of NLP-Enabled Documentation Over Manual Processes is Driving the Adoption of Clinical Documentation Solutions
7.2.2 Clinical Coding
220.127.116.11 NLP Solutions
18.104.22.168.1 NLP Coding Solutions to Dominate the Mid-Revenue Cycle Management Clinical Coding Solutions Market During the Forecast Period
22.214.171.124 Structural Input Solutions
126.96.36.199.1 Structured Input Solutions Help to Improve the Coding Process and Reduce the Coding Procedure Cost
7.2.3 Charge Capture
188.8.131.52 Rising Adoption of Smartphones Among Healthcare Professionals to Drive the Adoption of Charge Capture Solutions
7.2.4 Clinical Documentation Improvement
184.108.40.206 CDI Solutions to Witness the Highest Growth During the Forecast Period Primarily Due to A Decrease in DNFB and Increase in Coding Accuracy
7.2.5 Diagnosis-Related Grouping
220.127.116.11 DRG Solutions Improve Pricing and Reimbursement Accuracy
7.2.6 Pre-Bill Review
18.104.22.168 Declining Reimbursement Rates Have Triggered Awareness of the Pre-Bill Review Process
7.3 Consulting Services
7.3.1 Consulting Services to Witness the Highest Growth Rate in the Mid-Revenue Cycle Management Solutions Market From 2018 to 2023
8 Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, By End User
8.2 Healthcare Providers
8.2.1 Inpatient Settings
22.214.171.124 Mid-Rcm Solutions Play an Integral Role in Inpatient Settings, Improving Quality and Growing RevenuesA Key Growth Driver
8.2.2 Outpatient Settings
126.96.36.199 Growing Preference for Outpatient Facilities to Reduce the Cost of Care to Drive Market Growth
8.3 Healthcare Payers
188.8.131.52 Advantages Such as the Increased Productivity and Profitability of Coding Operations are Driving the Adoption of Mid-Rcm Solutions By Healthcare Payers
9 Mid-Revenue Cycle Management/Clinical Documentation Improvement Market, By Region
9.2 North America
9.4 Asia Pacific
9.5 Rest of the World
10 Competitive Landscape
10.2 Market Leadership Analysis
10.3 Competitive Scenario
10.3.1 Agreements, Collaborations, & Partnerships
10.3.2 Product Launches and Enhancements
11 Company Profiles
11.1 3M Company
11.2 Optum, Inc. (A Subsidiary of Unitedhealth Group, Inc.)
11.3 Nuance Communications, Inc.
11.5 Dolbey Systems
11.6 Nthrive, Inc.
11.7 Streamline Health Solutions, LLC
11.8 Vitalware, LLC.
11.9 Chartwise Medical Systems, Inc.
11.10 Iodine Software
11.11 Other Leading Players
11.11.2 EPIC Systems Corporation
11.11.3 Cerner Corporation
11.11.4 EZDI, Inc.
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