1 エグゼクティブ・サマリー
2 序文
2.1 概要
2.2 ステークホルダー
2.3 調査範囲
2.4 調査方法
2.4.1 データマイニング
2.4.2 データ分析
2.4.3 データの検証
2.4.4 リサーチアプローチ
2.5 リサーチソース
2.5.1 一次調査ソース
2.5.2 セカンダリーリサーチソース
2.5.3 前提条件
3 市場動向分析
3.1 はじめに
3.2 推進要因
3.3 抑制要因
3.4 機会
3.5 脅威
3.6 製品分析
3.7 エンドユーザー分析
3.8 新興市場
3.9 Covid-19の影響
4 ポーターズファイブフォース分析
4.1 供給者の交渉力
4.2 買い手の交渉力
4.3 代替品の脅威
4.4 新規参入の脅威
4.5 競争上のライバル関係
5 収益サイクル管理の世界市場、製品別
5.1 はじめに
5.2 統合ソリューション
5.3 スタンドアローン・ソリューション
5.3.1 フロントエンドソリューション
5.3.1.1 患者スケジューリング
5.3.1.2 保険確認
5.3.1.3 資格と承認
5.3.1.4 患者アクセス
5.3.2 ミッドエンドソリューション
5.3.2.1 クレームスクラビングと編集
5.3.2.2 チャージマスター管理
5.3.2.3 請求書の提出
5.3.2.4 送金処理
5.3.2.5 拒否管理
5.3.3 バックエンドソリューション
5.3.3.1 売掛金管理
5.3.3.2 回収管理
5.3.3.3 収益の整合性
5.3.3.4 財務分析
5.3.3.5 患者財務サービス
6 収益サイクル管理の世界市場、サービス別
6.1 導入
6.2 インプリメンテーション
6.3 サポートとメンテナンス
6.4 トレーニングと教育
6.5 コンサルティング
6.6 マネージドRCMサービス
7 収益サイクル管理の世界市場、展開別
7.1 導入
7.2 オンプレミス型
7.3 クラウドベース
7.4 ハイブリッド
8 収益サイクル管理の世界市場:価格モデル別
8.1 はじめに
8.2 サブスクリプション型
8.3 トランザクションごと
8.4 バリューベース
9 収益サイクル管理の世界市場:エンドユーザー別
9.1 はじめに
9.2 病院
9.2.1 小規模病院
9.2.2 中規模病院
9.2.3 大規模病院
9.2.4 大学病院
9.3 医師
9.4 診断および外来ケアセンター
9.5 長期ケアセンター
9.6 その他のエンドユーザー
9.6.1 歯科医院
9.6.2 動物病院
9.6.3 小売クリニック
10 収益サイクル管理の世界市場、地域別
10.1 はじめに
10.2 北アメリカ
10.2.1 アメリカ
10.2.2 カナダ
10.2.3 メキシコ
10.3 ヨーロッパ
10.3.1 ドイツ
10.3.2 イギリス
10.3.3 イタリア
10.3.4 フランス
10.3.5 スペイン
10.3.6 その他のヨーロッパ
10.4 アジア太平洋
10.4.1 日本
10.4.2 中国
10.4.3 インド
10.4.4 オーストラリア
10.4.5 ニュージーランド
10.4.6 韓国
10.4.7 その他のアジア太平洋地域
10.5 南アメリカ
10.5.1 アルゼンチン
10.5.2 ブラジル
10.5.3 チリ
10.5.4 その他の南アメリカ地域
10.6 中東/アフリカ
10.6.1 サウジアラビア
10.6.2 アラブ首長国連邦
10.6.3 カタール
10.6.4 南アフリカ
10.6.5 その他の中東/アフリカ地域
11 主要開発
11.1 契約、パートナーシップ、提携、合弁事業
11.2 買収と合併
11.3 新製品上市
11.4 事業拡大
11.5 その他の主要戦略
12 会社プロフィール
12.1 R1 RCM
12.2 Oracle
12.3 Optum
12.4 McKesson Corporation
12.5 Change Healthcare
12.6 Cerner Corporation
12.7 Allscripts Healthcare Solutions, Inc.
12.8 Athenahealth, Inc.
12.9 Epic Systems Corporation
12.10 GE Healthcare
12.11 Experian plc
12.12 Conifer Health Solutions
12.13 Veradigm
12.14 3M
12.15 Cognizant
12.16 SSI Group LLC
12.17 Huron Consulting Group
12.18 eClinicalWork
表一覧
表1 収益サイクル管理の世界市場展望、地域別(2022-2030年)(MNドル)
表2 収益サイクル管理の世界市場展望、製品別(2022-2030年) ($MN)
表3 収益サイクル管理の世界市場展望:統合ソリューション別(2022-2030年) ($MN)
表4 収益サイクル管理の世界市場展望:スタンドアロンソリューション別(2022-2030年) ($MN)
表5 収益サイクル管理の世界市場展望、フロントエンドソリューション別 (2022-2030) ($MN)
表6 収益サイクル管理の世界市場展望:ミッドエンドソリューション別(2022-2030年) ($MN)
表7 収益サイクル管理の世界市場展望、バックエンドソリューション別 (2022-2030) ($MN)
表8 収益サイクル管理の世界市場展望、サービス別 (2022-2030) ($MN)
表9 収益サイクル管理の世界市場展望:実装別(2022-2030年) ($MN)
表10 収益サイクル管理の世界市場展望:サポート・メンテナンス別(2022-2030年) ($MN)
表11 収益サイクル管理の世界市場展望:トレーニング・教育別(2022-2030年) ($MN)
表12 収益サイクル管理の世界市場展望、コンサルティング別 (2022-2030) ($MN)
表13 収益サイクル管理の世界市場展望:マネージドRCMサービス別 (2022-2030) ($MN)
表14 収益サイクル管理の世界市場展望、展開別 (2022-2030) ($MN)
表15 収益サイクル管理の世界市場展望:オンプレミス別 (2022-2030) ($MN)
表16 収益サイクル管理の世界市場展望、クラウドベース別 (2022-2030) ($MN)
表17 収益サイクル管理の世界市場展望、ハイブリッド別 (2022-2030) ($MN)
表18 収益サイクル管理の世界市場展望:価格設定モデル別(2022-2030年) ($MN)
表19 収益サイクル管理の世界市場展望、サブスクリプションベース別 (2022-2030) ($MN)
表20 収益サイクル管理の世界市場展望、トランザクションごと(2022-2030年)別 ($MN)
表21 収益サイクル管理の世界市場展望、金額ベース別(2022-2030年) ($MN)
表22 収益サイクル管理の世界市場展望:エンドユーザー別 (2022-2030) ($MN)
表23 収益サイクル管理の世界市場展望:病院別(2022-2030年) ($MN)
表24 収益サイクル管理の世界市場展望:小規模病院別 (2022-2030) ($MN)
表25 収益サイクル管理の世界市場展望:中規模病院別(2022-2030年) ($MN)
表26 収益サイクル管理の世界市場展望、大規模病院別 (2022-2030) ($MN)
表27 収益サイクル管理の世界市場展望:学術医療センター別 (2022-2030) ($MN)
表28 収益サイクル管理の世界市場展望:医師別 (2022-2030) ($MN)
表29 収益サイクル管理の世界市場展望:診断・外来医療センター別(2022-2030年) ($MN)
表30 収益サイクル管理の世界市場展望:長期ケアセンター別 (2022-2030) ($MN)
表31 収益サイクル管理の世界市場展望、その他のエンドユーザー別 (2022-2030) ($MN)
表32 収益サイクル管理の世界市場展望:歯科診療所別 (2022-2030) ($MN)
表33 収益サイクル管理の世界市場展望:動物診療所別 (2022-2030) ($MN)
表34 収益サイクル管理の世界市場展望:小売クリニック別 (2022-2030) ($MN)
注:北アメリカ、ヨーロッパ、APAC、南アメリカ、中東/アフリカ地域の表も上記と同様に表記しています。
According to data from the National Center for Health Statistics, healthcare spending in the United States reached $4.1 trillion in 2020, accounting for 19.7% of the country's Gross Domestic Product (GDP).
Market Dynamics:
Driver:
Increasing healthcare costs
Rising healthcare costs are a major driver for the Revenue Cycle Management (RCM) market. As medical expenses continue to climb, healthcare providers are under pressure to optimize their revenue cycles and improve financial performance. RCM solutions help organizations streamline billing processes, reduce claim denials, and accelerate cash flow. By implementing effective RCM systems, providers can capture more revenue, minimize losses, and better manage the financial challenges posed by escalating healthcare costs. This drives demand for sophisticated RCM technologies and services.
Restraint:
Regulatory compliance
Providers must constantly adapt their revenue cycle processes to comply with complex billing rules, coding requirements, and privacy laws like HIPAA. Staying compliant requires ongoing investments in technology upgrades and staff training. The fear of penalties for non-compliance may make some organizations hesitant to adopt new RCM solutions. Navigating the regulatory landscape adds complexity and costs to RCM implementations, potentially slowing market growth.
Opportunity:
Increasing adoption of cloud technology
Cloud platforms offer healthcare providers more flexibility, scalability, and cost-effectiveness compared to on-premise systems. They enable easier integration of RCM processes across multiple facilities and allow real-time access to financial data. Cloud-based RCM solutions also reduce IT infrastructure costs and simplify system maintenance. As more providers recognize these benefits, the demand for cloud RCM technologies is expected to surge, driving market expansion.
Threat:
Cybersecurity risks
Cybersecurity threats pose a significant risk to the RCM market. As healthcare organizations increasingly digitize their revenue cycle processes and store sensitive financial and patient data electronically, they become more vulnerable to cyberattacks. Data breaches can lead to financial losses, regulatory penalties, and damage to reputation. The need for robust security measures adds complexity and cost to RCM implementations. Concerns about data protection may make some providers hesitant to adopt new RCM technologies, potentially limiting market growth.
Covid-19 Impact:
The COVID-19 pandemic significantly impacted the RCM market. It accelerated the adoption of telehealth and digital payment solutions, driving demand for integrated RCM systems. However, reduced patient volumes and elective procedures initially decreased revenues for many providers. The pandemic highlighted the importance of efficient RCM processes to maintain financial stability during crises.
The cloud-Based segment is expected to be the largest during the forecast period
The cloud-based segment is projected to dominate the RCM market due to its numerous advantages. Cloud solutions offer greater flexibility, scalability, and cost-effectiveness compared to on-premise systems. They enable healthcare providers to access RCM tools and data from anywhere, facilitating remote work and multi-facility management. Cloud platforms also simplify system updates and maintenance. As more organizations recognize these benefits and seek to modernize their RCM processes, the adoption of cloud-based solutions is expected to surge, driving this segment's growth.
The managed RCM services segment is expected to have the highest CAGR during the forecast period
The managed RCM services segment is anticipated to experience the highest CAGR in the revenue cycle management market. This growth is driven by the increasing complexity of healthcare billing and reimbursement processes, coupled with a shortage of skilled RCM professionals. Managed RCM services offer healthcare providers a cost-effective way to outsource their revenue cycle operations to specialized experts. These services can help improve financial performance, reduce administrative burden, and allow healthcare organizations to focus on their core mission of patient care while propelling segment growth.
Region with largest share:
During the forecast period, the North American region is expected to dominate the revenue cycle management market. This dominance can be attributed to the presence of advanced healthcare infrastructure, high healthcare spending, and the early adoption of healthcare IT solutions. The region also has a complex reimbursement landscape and stringent regulatory requirements, driving the need for sophisticated RCM solutions. Additionally, the presence of major RCM vendors and ongoing healthcare reforms contribute to North America's leading position in the market.
Region with highest CAGR:
During the forecast period, the Asia Pacific region is expected to witness rapid growth in the revenue cycle management market. This growth is driven by factors such as increasing healthcare expenditure, growing adoption of digital health solutions, and government initiatives to improve healthcare infrastructure. The region's large population and rising prevalence of chronic diseases are also contributing to the demand for efficient RCM solutions. As healthcare providers in Asia Pacific seek to optimize their financial processes and improve patient care, the adoption of RCM technologies is expected to accelerate, leading to high market growth rates.
Key players in the market
Some of the key players in Revenue Cycle Management market include R1 RCM, Oracle, Optum, McKesson Corporation, Change Healthcare, Cerner Corporation, Allscripts Healthcare Solutions, Inc., Athenahealth, Inc., Epic Systems Corporation, GE Healthcare, Experian plc, Conifer Health Solutions, Veradigm, 3M, Cognizant, SSI Group LLC, Huron Consulting Group, and eClinicalWorks.
Key Developments:
In August 2024, The US Oncology Network (The Network), the largest organization of its kind dedicated to advancing local cancer care and better patient outcomes, announced today that Tennessee Cancer Specialists (TCS) has joined The Network, effective August 1, 2024. The practice is the largest community-based oncology provider in eastern Tennessee and the third largest oncology practice in the state. With the addition of TCS, The Network significantly extends its reach into eastern Tennessee while the practice enhances its ability to provide cancer patients in the region convenient access to high-quality, cutting-edge cancer care.
In February 2024, Minneapolis-based Allina Health is partnering with Optum to improve care for patients and providers across Minnesota and Western Wisconsin. Around 2,000 Allina information systems and revenue cycle management employees will transition employment to Optum, part of UnitedHealth Group, beginning May 5, but will continue to support Allina Health's patients and providers under the partnership. The Allina partnership comes after Optum and St. Louis-based SSM Health recently ended their administrative partnership around inpatient care management, digital transformation and revenue cycle management. The deal included the hiring of about 2,100 SSM employees by Optum.
Products Covered:
• Integrated Solutions
• Standalone Solutions
Services Covered:
• Implementation
• Support and Maintenance
• Training and Education
• Consulting
• Managed RCM Services
Deployments Covered:
• On-Premise
• Cloud-Based
• Hybrid
Pricing Models Covered:
• Subscription-based
• Per-transaction
• Value-based
End Users Covered:
• Hospitals
• Physicians
• Diagnostic and Ambulatory Care Centers
• Long-Term Care Centers
• Other End Users
Regions Covered:
• North America
US
Canada
Mexico
• Europe
Germany
UK
Italy
France
Spain
Rest of Europe
• Asia Pacific
Japan
China
India
Australia
New Zealand
South Korea
Rest of Asia Pacific
• South America
Argentina
Brazil
Chile
Rest of South America
• Middle East & Africa
Saudi Arabia
UAE
Qatar
South Africa
Rest of Middle East & Africa
What our report offers:
- Market share assessments for the regional and country-level segments
- Strategic recommendations for the new entrants
- Covers Market data for the years 2022, 2023, 2024, 2026, and 2030
- Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and recommendations)
- Strategic recommendations in key business segments based on the market estimations
- Competitive landscaping mapping the key common trends
- Company profiling with detailed strategies, financials, and recent developments
- Supply chain trends mapping the latest technological advancements
1 Executive Summary
2 Preface
2.1 Abstract
2.2 Stake Holders
2.3 Research Scope
2.4 Research Methodology
2.4.1 Data Mining
2.4.2 Data Analysis
2.4.3 Data Validation
2.4.4 Research Approach
2.5 Research Sources
2.5.1 Primary Research Sources
2.5.2 Secondary Research Sources
2.5.3 Assumptions
3 Market Trend Analysis
3.1 Introduction
3.2 Drivers
3.3 Restraints
3.4 Opportunities
3.5 Threats
3.6 Product Analysis
3.7 End User Analysis
3.8 Emerging Markets
3.9 Impact of Covid-19
4 Porters Five Force Analysis
4.1 Bargaining power of suppliers
4.2 Bargaining power of buyers
4.3 Threat of substitutes
4.4 Threat of new entrants
4.5 Competitive rivalry
5 Global Revenue Cycle Management Market, By Product
5.1 Introduction
5.2 Integrated Solutions
5.3 Standalone Solutions
5.3.1 Front-End Solutions
5.3.1.1 Patient Scheduling
5.3.1.2 Insurance Verification
5.3.1.3 Eligibility and Authorization
5.3.1.4 Patient Access
5.3.2 Mid-End Solutions
5.3.2.1 Claims Scrubbing and Editing
5.3.2.2 Chargemaster Management
5.3.2.3 Claims Submission
5.3.2.4 Remittance Processing
5.3.2.5 Denial Management
5.3.3 Back-End Solutions
5.3.3.1 Accounts Receivable Management
5.3.3.2 Collections Management
5.3.3.3 Revenue Integrity
5.3.3.4 Financial Analytics
5.3.3.5 Patient Financial Services
6 Global Revenue Cycle Management Market, By Services
6.1 Introduction
6.2 Implementation
6.3 Support and Maintenance
6.4 Training and Education
6.5 Consulting
6.6 Managed RCM Services
7 Global Revenue Cycle Management Market, By Deployment
7.1 Introduction
7.2 On-Premise
7.3 Cloud-Based
7.4 Hybrid
8 Global Revenue Cycle Management Market, By Pricing Models
8.1 Introduction
8.2 Subscription-based
8.3 Per-transaction
8.4 Value-based
9 Global Revenue Cycle Management Market, By End User
9.1 Introduction
9.2 Hospitals
9.2.1 Small Hospitals
9.2.2 Medium-Sized Hospitals
9.2.3 Large Hospitals
9.2.4 Academic Medical Centers
9.3 Physicians
9.4 Diagnostic and Ambulatory Care Centers
9.5 Long-Term Care Centers
9.6 Other End Users
9.6.1 Dental Clinics
9.6.2 Veterinary Clinics
9.6.3 Retail Clinics
10 Global Revenue Cycle Management Market, By Geography
10.1 Introduction
10.2 North America
10.2.1 US
10.2.2 Canada
10.2.3 Mexico
10.3 Europe
10.3.1 Germany
10.3.2 UK
10.3.3 Italy
10.3.4 France
10.3.5 Spain
10.3.6 Rest of Europe
10.4 Asia Pacific
10.4.1 Japan
10.4.2 China
10.4.3 India
10.4.4 Australia
10.4.5 New Zealand
10.4.6 South Korea
10.4.7 Rest of Asia Pacific
10.5 South America
10.5.1 Argentina
10.5.2 Brazil
10.5.3 Chile
10.5.4 Rest of South America
10.6 Middle East & Africa
10.6.1 Saudi Arabia
10.6.2 UAE
10.6.3 Qatar
10.6.4 South Africa
10.6.5 Rest of Middle East & Africa
11 Key Developments
11.1 Agreements, Partnerships, Collaborations and Joint Ventures
11.2 Acquisitions & Mergers
11.3 New Product Launch
11.4 Expansions
11.5 Other Key Strategies
12 Company Profiling
12.1 R1 RCM
12.2 Oracle
12.3 Optum
12.4 McKesson Corporation
12.5 Change Healthcare
12.6 Cerner Corporation
12.7 Allscripts Healthcare Solutions, Inc.
12.8 Athenahealth, Inc.
12.9 Epic Systems Corporation
12.10 GE Healthcare
12.11 Experian plc
12.12 Conifer Health Solutions
12.13 Veradigm
12.14 3M
12.15 Cognizant
12.16 SSI Group LLC
12.17 Huron Consulting Group
12.18 eClinicalWorks
List of Tables
Table 1 Global Revenue Cycle Management Market Outlook, By Region (2022-2030) ($MN)
Table 2 Global Revenue Cycle Management Market Outlook, By Product (2022-2030) ($MN)
Table 3 Global Revenue Cycle Management Market Outlook, By Integrated Solutions (2022-2030) ($MN)
Table 4 Global Revenue Cycle Management Market Outlook, By Standalone Solutions (2022-2030) ($MN)
Table 5 Global Revenue Cycle Management Market Outlook, By Front-End Solutions (2022-2030) ($MN)
Table 6 Global Revenue Cycle Management Market Outlook, By Mid-End Solutions (2022-2030) ($MN)
Table 7 Global Revenue Cycle Management Market Outlook, By Back-End Solutions (2022-2030) ($MN)
Table 8 Global Revenue Cycle Management Market Outlook, By Services (2022-2030) ($MN)
Table 9 Global Revenue Cycle Management Market Outlook, By Implementation (2022-2030) ($MN)
Table 10 Global Revenue Cycle Management Market Outlook, By Support and Maintenance (2022-2030) ($MN)
Table 11 Global Revenue Cycle Management Market Outlook, By Training and Education (2022-2030) ($MN)
Table 12 Global Revenue Cycle Management Market Outlook, By Consulting (2022-2030) ($MN)
Table 13 Global Revenue Cycle Management Market Outlook, By Managed RCM Services (2022-2030) ($MN)
Table 14 Global Revenue Cycle Management Market Outlook, By Deployment (2022-2030) ($MN)
Table 15 Global Revenue Cycle Management Market Outlook, By On-Premise (2022-2030) ($MN)
Table 16 Global Revenue Cycle Management Market Outlook, By Cloud-Based (2022-2030) ($MN)
Table 17 Global Revenue Cycle Management Market Outlook, By Hybrid (2022-2030) ($MN)
Table 18 Global Revenue Cycle Management Market Outlook, By Pricing Models (2022-2030) ($MN)
Table 19 Global Revenue Cycle Management Market Outlook, By Subscription-based (2022-2030) ($MN)
Table 20 Global Revenue Cycle Management Market Outlook, By Per-transaction (2022-2030) ($MN)
Table 21 Global Revenue Cycle Management Market Outlook, By Value-based (2022-2030) ($MN)
Table 22 Global Revenue Cycle Management Market Outlook, By End User (2022-2030) ($MN)
Table 23 Global Revenue Cycle Management Market Outlook, By Hospitals (2022-2030) ($MN)
Table 24 Global Revenue Cycle Management Market Outlook, By Small Hospitals (2022-2030) ($MN)
Table 25 Global Revenue Cycle Management Market Outlook, By Medium-Sized Hospitals (2022-2030) ($MN)
Table 26 Global Revenue Cycle Management Market Outlook, By Large Hospitals (2022-2030) ($MN)
Table 27 Global Revenue Cycle Management Market Outlook, By Academic Medical Centers (2022-2030) ($MN)
Table 28 Global Revenue Cycle Management Market Outlook, By Physicians (2022-2030) ($MN)
Table 29 Global Revenue Cycle Management Market Outlook, By Diagnostic and Ambulatory Care Centers (2022-2030) ($MN)
Table 30 Global Revenue Cycle Management Market Outlook, By Long-Term Care Centers (2022-2030) ($MN)
Table 31 Global Revenue Cycle Management Market Outlook, By Other End Users (2022-2030) ($MN)
Table 32 Global Revenue Cycle Management Market Outlook, By Dental Clinics (2022-2030) ($MN)
Table 33 Global Revenue Cycle Management Market Outlook, By Veterinary Clinics (2022-2030) ($MN)
Table 34 Global Revenue Cycle Management Market Outlook, By Retail Clinics (2022-2030) ($MN)
Note: Tables for North America, Europe, APAC, South America, and Middle East & Africa Regions are also represented in the same manner as above.