Meticulous Research– leading global market research company published a research report titled “Mid-revenue Cycle Management/Clinical Documentation Improvement Market by Product & Service [Solutions (Coding, Charge Capture, DRG Group, Pre-Bill Review), Consulting Services], End User (Providers, Payers), and Geography - Global Forecast to 2027”.
According to this latest publication from Meticulous Research, the mid-revenue cycle management/clinical documentation improvement market is expected to grow at a CAGR of 6.6% from 2020 to reach $4.55 billion by 2027. The rising healthcare expenditure, growing need to manage unstructured healthcare data, and alterations in revenue due to medical billing errors are the factors majorly driving the mid-revenue cycle management/clinical documentation improvement market. The changing scenario in developing economies is driving the adoption of healthcare IT solutions, which is expected to generate market growth opportunities during the forecast period. However, IT infrastructure constraints in developing economies limit the market’s growth. Moreover, data security concerns also hamper the market’s growth to an extent.
Alterations in revenue due to medical billing errors to propel the growth of the mid-revenue cycle management/clinical documentation improvement market
The need to curb revenue loss due to medical billing errors creates a demand for utilization of mid-revenue cycle management/clinical documentation improvement solutions. Poor medical billing practices can lead to the loss of nearly $125 billion annually in the U.S. The most common medical billing errors are generated due to incorrect patient information, non-corresponding treatment codes and diagnosis codes, and the use of manual claims management processes. Some studies have estimated that four out of five bills commonly contain at least a minor error resulting in inflated medical charges. These billing errors can cause a high financial burden for the patient. Hence, implementing the mid-revenue cycle management solutions is becoming essential from the patients’ perspective.
Moreover, as per the American Hospital Association’s (AHA) 2015 fourth quarter RACTrac survey, including 750 U.S. hospitals, it was found that 81% of complex denials were due to inpatient coding errors, with the nationwide dollar amount of each complex claim denial amounting to nearly USD 5,427. Thus, inpatient and outpatient coding errors can result in claim denials. To avoid this, implementing a revenue cycle management solution is gaining momentum in the developed countries.
Mid-Revenue Cycle Management/Clinical Documentation Improvement Market: Future Outlook
The mid-revenue cycle management/clinical documentation improvement market study presents historical market data in terms of values (2018 and 2019), estimated current data (2020), and forecasts for 2027 by product & services [solutions (clinical coding, clinical documentation improvement, charge capture, clinical documentation, diagnosis-related grouping, pre-bill review), consulting services], End User [healthcare providers (inpatient settings, outpatient settings), healthcare payers] and geography. The study also evaluates industry competitors and analyses the market at the regional and country level.
In 2020, based on product, the solutions segment is poised to account for the largest share of the overall market. The capability to improve revenue cycle productivity by eliminating coding errors and manual coding practices and their compatibility with hospital management solutions are the major drivers for this segment.
In 2020, based on end user, the healthcare providers segment is estimated to account for the largest share of the overall market. The growing adoption of revenue cycle solutions for simplifying billing collection cycles, establishing communication between EHRs and accounting systems, the ability of revenue cycle solutions for preserving and managing patient billing records are some of the factors driving this segment.
This research report analyzes major geographies and provides a comprehensive analysis for North America (U.S., Canada, and Mexico), Europe (Germany, France, U.K., Italy, Spain, and Rest of Europe), Asia-Pacific (India, China, Indonesia, Australia & New Zealand, Japan, and RoAPAC), Latin America (Brazil, Argentina, Chile, Rest of Latin America), and the Middle East & Africa.
In 2020, North America is projected to dominate the mid-revenue cycle management/clinical documentation improvement market, followed by Europe and Asia-Pacific. The largest share of this segment is mainly attributed to the growing adoption of various healthcare IT solutions by healthcare providers to meet the heightened regulatory requirements for patient care and safety, increasing utilization of mid-RCM solutions to reduce healthcare costs, the loss of revenue due to medical billing & coding errors, shift towards value-based care, increasing need to curtail the soaring healthcare costs, and growing need to improve the quality of healthcare while maintaining the operational efficiency of healthcare organizations.
The key players operating in the mid-revenue cycle management/clinical documentation improvement market are nThrive, INC. (U.S.), Dolbey Systems, Inc. (U.S.), 3M Company (U.S.), UnitedHealth Group Incorporated (U.S.), Streamline Healthcare Solutions, LLC (U.S.), Vitalware, LLC (U.S.), Iodine Software LLC (U.S.), Craneware PLC (U.K.), Epic Systems Corporation (U.S.), ChartWise Medical Systems, Inc. (U.S.), Nuance Communication, Inc (U.S.), and Cerner Corporation (U.S.).
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