× Industry Reports Services Press Release Contact us About us

By 2026, North America Healthcare Revenue Cycle Management Market Size to Cross USD 48 Bn

 Request a sample

According to the Graphical Research new growth forecast report titled “North America Healthcare Revenue Cycle Management Market Value By Function (Claims & Denial Management, Medical Coding & Billing, Eligibility Verification, Payment Remittance), By End-use (Hospitals, Physicians, Diagnostic & Ambulatory Surgical Centers), By Product (Integrated, Standalone), By Deployment (On-Premise, Cloud Based), Industry Analysis Report, Regional Outlook (U.S., Canada)”, Estimated To Exceed USD 48 Bn By 2026.

Rising demand for health insurance in Canada and the U.S. is anticipated to boost the North America healthcare revenue cycle management market growth in the foreseeable future. Medical policy providers, such as Medicaid and Medicare, implement various initiatives to provide affordable healthcare facilities and services that bolsters the market growth. Management of financial data is imperative for healthcare providers to ensure proper data exchange. Thus, growing trend of health insurance will boost North America healthcare revenue cycle management industry size.

Advancements in big data analytics will act as a major factor that will propel the industry growth in the forthcoming years. Big data analytics is a platform that can manage large databases. Healthcare service providers utilize big data analytic software such as Hadoop as it helps in storing large amount of data and significantly reduces the operational costs. It also helps in decision making by enabling efficient data management, processing and analysis. Such promising scenario will bolster the healthcare revenue cycle management market growth.

By product, the North America healthcare revenue cycle management market is bifurcated into standalone and integrated. Standalone healthcare revenue cycle management market was valued at over USD 2.6 billion in 2019. The advantages of standalone solutions such as claim settlement process management and payment collection optimization will foster the segment growth. Standalone solutions also help to curtail the overall expenditure and streamlines the financial data that supports efficient revenue cycle management.

By function, the North America healthcare revenue cycle management market is further segmented into claims & denial management, payment remittance, medical coding, eligibility verification, and others. Medical coding and billing segment of healthcare revenue cycle management market is forecasted to grow at around 11% CAGR. The growth of the medical coding and billing segment is attributable to the growing cases of insurance issues pertaining to misinterpretation of medical documents. Medical coding helps the healthcare providers to transform diagnosis and healthcare procedure data into universal medical alphanumeric codes, thus ensuring streamlined and effective data management.  

By deployment, the North America healthcare revenue cycle management market is bifurcated into on-premise and cloud-based. On-premise healthcare revenue cycle management market accounted for around 22% revenue share in 2019. On-premise solutions provide benefits such as low cost of software ownership and less or no annual subscription fees. Furthermore, it offers better data security and prevention from unauthorized access, thereby bolstering the segment growth.

By end-use, the North America healthcare revenue cycle management market is bifurcated into physicians, hospitals, diagnostic & ambulatory surgical centers, and others. The hospital segment of healthcare revenue cycle management market accounted for more than USD 7 billion in 2019. The rising patient population in hospitals, owing to the growing prevalence of diseases, propels the cash flow in hospitals. This compels healthcare service providers to leverage effective revenue cycle management system for patient data collection during all stages of service. This will foster the segment growth.

The Canada healthcare revenue cycle management market accounted for around 10% CAGR over the forecast timeframe. Canada healthcare revenue cycle management business is forecasted to follow U.S. Healthcare expenditure in Canada is constantly growing and the trend is expected to remain same. Additionally, rising number of healthcare service providers and growing adoption of advanced medical billing solutions in Canada will foster the country growth.

Some of the eminent market players in North America healthcare revenue cycle management market include R1 RCM, AGS Health, Allscripts Healthcare, Athenahealth, CareCloud Corporation (MTBC), Cerner Corporation, Conifer Health Solutions, Change Healthcare, Experian Information Solutions, Formativ Health, GeBBS Healthcare Solutions, Kareo, McKesson Corporation, Medical Information Technology, Advisory Board (OptumInsight), and SSI Group, among other industry participants. These market players are undertaking strategies such as mergers and partnerships to expand their market presence. For instance, in January 2020, Allscripts Healthcare Solutions extended their partnership with PIH Health. The partnership allowed both the companies to drive comprehensive care for the patients and to expand their customer base.

North America healthcare revenue cycle management market research report includes in-depth coverage of the industry with estimates & forecast in terms of revenue in USD million from 2015 to 2026, for the following segments:

North America Healthcare Revenue Cycle Management Market Forecast, By End-use, 2015 to 2026, (USD Million)

  • Hospitals
  • Physicians
  • Diagnostic & Ambulatory Surgical Centers
  • Others

North America Healthcare Revenue Cycle Management Market Share, By Product, 2015 to 2026, (USD Million)

  • Integrated
  • Standalone

North America Healthcare Revenue Cycle Management Market Value, By Deployment, 2015 to 2026, (USD Million)

  • On Premise
  • Cloud Based

North America Healthcare Revenue Cycle Management Market Size, By Function, 2015 to 2026, (USD Million)

  • Claims & Denial Management 
  • Medical Coding & Billing
  • Eligibility Verification
  • Payment Remittance
  • Others

The above information is provided for the following region and countries:

  • North America
    • U.S.
    • Canada