Medical Billing Outsourcing Market (By Component: In-house, Outsourced; By Service: Front End, Middle End, Back End; By End-use: Hospital, Physician Office, Others) - Global Industry Analysis, Size, Share, Growth, Trends, Revenue, Regional Outlook 20222030

The global Medical Billing Outsourcing market size is expected to be worth around US$ 28.9 billion by 2030 from valued at US$ 11.2 billion in 2020 and is anticipated to grow at a CAGR of 13.66% during forecast period 2022 to 2030.

The U.S. medical billing outsourcing market was valued at USD 4.6 billion in 2021 and it is predicted to hit USD 12.3 billion by 2030 with a CAGR of 11.3% from 2022 to 2030.

Growth Factors

A large amount of clinical code representation for diagnosis and treatment coupled with the presence of multiple payers renders medical billing an intricate part of any clinical practice, posing significant challenges. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to obligatory implementation of complex ICD-11 coding systems, increasing healthcare costs, and a federal mandate to implement Electronic Medical Records (EMR) to maintain reimbursement levels.

The COVID-19 pandemic has negatively affected the market. Though, the healthcare industry was trailing in embracing innovative and digital technologies to improve healthcare. The COVID-19 scenario has put an enormous burden on healthcare providers/organizations to become accustomed to the change. The recovery from the financial impact of the coronavirus pandemic could take a long time.     

Furthermore, clinics/physician offices are gradually outsourcing their revenue management to cut unnecessary costs and prevent the burden of managing an administrative team to ensure effective handling of in-house billing functions. In addition, multispecialty healthcare groups are implementing consolidation requiring EHR integration and building large healthcare networks.

Component Insights

The outsourced segment dominated the market for medical billing outsourcing and held the largest revenue share of 52% in 2021. The segment is expected to register the highest CAGR from 2022 to 2030. In-house and outsourced are the major components of the market. It significantly reduces costs and proves a good fit for small and medium practices. Physician practices (acute care hospitals and clinics/physicians) are facing challenging times as reimbursements have declined and costs are rising, and the newly introduced regulations have made business more complex. It is estimated that approximately 20% of physicians' income will be lost due to health billing errors, and on average, healthcare providers or businesses spend 30 to 40% of their revenue on the billing process. This is boosting the segment’s growth.

Some companies are launching or adopting new cloud-based medical billing capabilities for superior security of patient data. For example, eClinicalWorks, a provider of medical billing services, launched a cloud-based revenue cycle management platform in 2018. In addition, outsourcing reduces labor costs by eliminating the need to hire an accounting team. Also, the company does not have to train or stay up to date, saving additional costs.

Service Insights

The front-end services segment dominated the market for medical billing outsourcing and accounted for a revenue share of 38% in 2021. Front-end services consist of processes, such as scheduling, preregistration, registration, eligibility, insurance verification, and pre-authorization. It comprises the main function of medical billing outsourcing.

Managing front-end services well is a key to reducing repetitive work and improving the patient experience with faster service. Therefore, the demand for outsourcing these services is strong. However, the segment is expected to face a decline in revenue growth owing to increased competition and saturation in the market. On the other side, the middle-end services segment is projected to witness lucrative growth over the coming years because of new entrants in the sector as well as the rising awareness of the middle-end service among practitioners.

End-use Insights

The hospital segment dominated the market for medical billing outsourcing and accounted for a revenue share of 47% in 2021. The segment is estimated to maintain its dominance during the forecast period. This is mainly due to the high demand for financing services in hospitals. In addition, hospital consolidation adds to the complexity of the reimbursement and billing process. This is driving the demand for medical billing outsourcing services in the hospital sector.

The newly introduced International Classification of Diseases-10th revision (ICD-11) has made the medical billing business even more complex in nature. Owing to this, the demand for Revenue Cycle Management (RCM) has increased drastically. In addition, providers are choosing the companies offering the right combination of RCM with Electronic Medical Records (EMR) for improved patient outcomes.

The physician office segment is expected to grow at the fastest rate over the forecast period. Rising expenditure on healthcare by small and midsized healthcare providers due to the growing emphasis on risk management and regulatory compliance and complex technology and staffing requirements is expected to drive the segment in the years to come.

Regional Insights

North America held the largest revenue share of over 48% in 2021. The presence of numerous healthcare providers in the U.S. and the shift in their focus on end-to-end outsourcing firms for managing billing processes is augmenting the market in North America. Due to the increased awareness about the benefits offered by outsourcing firms, providers are relying on the companies to maximize operating margins and manage high-volume transactions.

In Asia Pacific, the market for medical billing outsourcing is anticipated to witness remarkable growth during the forecast period. Emerging countries such as Singapore, Australia, India, and China are the most profitable markets due to the expansion of patient pools and improved healthcare facilities. Increasing awareness about clinical billing software and the rising adoption of the latest technology is expected to boost the market. The increasing need to reduce the healthcare delivery cost is favoring the growth of the market in Europe. In Latin America and Middle East and Africa, the market for medical billing outsourcing is likely to propel owing to increasing investment in healthcare by the government and an increasing number of private hospitals.

Key Players

• R1 RCM, Inc.

• Cerner Corporation

• Allscripts Healthcare Solutions, Inc.

• Experian Information Solutions, Inc.

• eClinicalWorks

• GE Healthcare

• Genpact

• HCL Technologies Limited

• Kareo, Inc.

• McKesson Corporation

• Quest Diagnostics

• Athenahealth Inc.

• The SSI Group, LLC. 

Market Segmentation

• Component Outlook

  • In-house

  • Outsourced

• Service Outlook 

  • Front End

  • Middle End

  • Back End

• End-use Outlook

  • Hospital

  • Physician Office

  • Others

• Regional Outlook 

  • North America

    • U.S.

    • Canada

  • Europe

    • Germany

    • U.K.

    • Spain

    • France

    • Italy

  • Asia Pacific

    • China

    • Japan

    • India

  • Latin America

    • Brazil

    • Mexico

  • Middle East & Africa (MEA)

    • South Africa

    • Saudi Arabia

The Medical Billing Outsourcing market research report covers definition, classification, product classification, product application, development trend, product technology, competitive landscape, industrial chain structure, industry overview, national policy and planning analysis of the industry, the latest dynamic analysis, etc., and also includes major. The study includes drivers and restraints of the global market. It covers the impact of these drivers and restraints on the demand during the forecast period. The report also highlights opportunities in the market at the global level.

The report provides size (in terms of volume and value) of Medical Billing Outsourcing market for the base year 2020 and the forecast between 2021 and 2030. Market numbers have been estimated based on form and application. Market size and forecast for each application segment have been provided for the global and regional market.

This report focuses on the global Medical Billing Outsourcing market status, future forecast, growth opportunity, key market and key players. The study objectives are to present the Medical Billing Outsourcing market development in United States, Europe and China.

It is pertinent to consider that in a volatile global economy, we haven’t just conducted Medical Billing Outsourcing market forecasts in terms of CAGR, but also studied the market based on key parameters, including Year-on-Year (Y-o-Y) growth, to comprehend the certainty of the market and to find and present the lucrative opportunities in market.

In terms of production side, this report researches the Medical Billing Outsourcing capacity, production, value, ex-factory price, growth rate, market share for major manufacturers, regions (or countries) and type.

In terms of consumption side, this report focuses on the consumption of Medical Billing Outsourcing by regions (countries) and application.

Buyers of the report will have access to verified market figures, including global market size in terms of revenue and volume. As part of production analysis, the authors of the report have provided reliable estimations and calculations for global revenue and volume by Type segment of the global Medical Billing Outsourcing market. These figures have been provided in terms of both revenue and volume for the period 2017 to 2030. Additionally, the report provides accurate figures for production by region in terms of revenue as well as volume for the same period. The report also includes production capacity statistics for the same period.

With regard to production bases and technologies, the research in this report covers the production time, base distribution, technical parameters, research and development trends, technology sources, and sources of raw materials of major Medical Billing Outsourcing market companies.

Regarding the analysis of the industry chain, the research of this report covers the raw materials and equipment of Medical Billing Outsourcing market upstream, downstream customers, marketing channels, industry development trends and investment strategy recommendations. The more specific analysis also includes the main application areas of market and consumption, major regions and Consumption, major Chinese producers, distributors, raw material suppliers, equipment providers and their contact information, industry chain relationship analysis.

The research in this report also includes product parameters, production process, cost structure, and data information classified by region, technology and application. Finally, the paper model new project SWOT analysis and investment feasibility study of the case model.

Overall, this is an in-depth research report specifically for the Medical Billing Outsourcing industry. The research center uses an objective and fair way to conduct an in-depth analysis of the development trend of the industry, providing support and evidence for customer competition analysis, development planning, and investment decision-making. In the course of operation, the project has received support and assistance from technicians and marketing personnel in various links of the industry chain.

Medical Billing Outsourcing market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, global presence, production sites and facilities, production capacities, company strengths and weaknesses, product launch, product width and breadth, application dominance. The above data points provided are only related to the companies’ focus related to Medical Billing Outsourcing market.

Prominent players in the market are predicted to face tough competition from the new entrants. However, some of the key players are targeting to acquire the startup companies in order to maintain their dominance in the global market. For a detailed analysis of key companies, their strengths, weaknesses, threats, and opportunities are measured in the report by using industry-standard tools such as the SWOT analysis. Regional coverage of key companies is covered in the report to measure their dominance. Key manufacturers of Medical Billing Outsourcing market are focusing on introducing new products to meet the needs of the patrons. The feasibility of new products is also measured by using industry-standard tools.

Key companies are increasing their investments in research and development activities for the discovery of new products. There has also been a rise in the government funding for the introduction of new Medical Billing Outsourcing market. These factors have benefited the growth of the global market for Medical Billing Outsourcing. Going forward, key companies are predicted to benefit from the new product launches and the adoption of technological advancements. Technical advancements have benefited many industries and the global industry is not an exception.

New product launches and the expansion of already existing business are predicted to benefit the key players in maintaining their dominance in the global market for Medical Billing Outsourcing. The global market is segmented on the basis of region, application, en-users and product type. Based on region, the market is divided into North America, Europe, Asia-Pacific, Latin America and Middle East and Africa (MEA).

In this study, the years considered to estimate the market size of Medical Billing Outsourcing are as follows:

• History Year: 2017-2020

• Base Year: 2021

• Forecast Year 2021 to 2030

Reasons to Purchase this Report:

- Market segmentation analysis including qualitative and quantitative research incorporating the impact of economic and policy aspects
- Regional and country level analysis integrating the demand and supply forces that are influencing the growth of the market.
- Market value USD Million and volume Units Million data for each segment and sub-segment
- Competitive landscape involving the market share of major players, along with the new projects and strategies adopted by players in the past five years
- Comprehensive company profiles covering the product offerings, key financial information, recent developments, SWOT analysis, and strategies employed by the major market players

Research Methodology:

In-depth interviews and discussions were conducted with several key market participants and opinion leaders to compile the research report.

This research study involved the extensive usage of both primary and secondary data sources. The research process involved the study of various factors affecting the industry, including the government policy, market environment, competitive landscape, historical data, present trends in the market, technological innovation, upcoming technologies and the technical progress in related industry, and market risks, opportunities, market barriers and challenges. The following illustrative figure shows the market research methodology applied in this report.

Market Size Estimation

Top-down and bottom-up approaches are used to estimate and validate the global market size for company, regional division, product type and application (end users).

The market estimations in this report are based on the selling price (excluding any discounts provided by the manufacturer, distributor, wholesaler or traders). Market share analysis, assigned to each of the segments and regions are achieved through product utilization rate and average selling price.

Major manufacturers & their revenues, percentage splits, market shares, growth rates and breakdowns of the product markets are determined through secondary sources and verified through the primary sources.

All possible factors that influence the markets included in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data. The market size for top-level markets and sub-segments is normalized, and the effect of inflation, economic downturns, and regulatory & policy changes or others factors are accounted for in the market forecast. This data is combined and added with detailed inputs and analysis from Vision Research Reports and presented in this report.

Market Breakdown and Data Triangulation

After complete market engineering with calculations for market statistics; market size estimations; market forecasting; market breakdown; and data triangulation. Extensive primary research was conducted to gather information and verify and validate the critical numbers arrived at. In the complete market engineering process, both top-down and bottom-up approaches were extensively used, along with several data triangulation methods, to perform market estimation and market forecasting for the overall market segments and sub-segments listed in this report.

Secondary Sources

Secondary Sources occupies approximately 25% of data sources, such as press releases, annual reports, Non-Profit organizations, industry associations, governmental agencies and customs data, and so on. This research study includes secondary sources; directories; databases such as Bloomberg Business, Wind Info, Hoovers, Factiva (Dow Jones & Company), TRADING ECONOMICS, and avention; Investing News Network; statista; Federal Reserve Economic Data; annual reports; investor presentations; and SEC filings of companies.

Primary Sources

In the primary research process, various sources from both the supply and demand sides were interviewed to obtain qualitative and quantitative information for this report. The primary sources from the supply side include product manufacturers (and their competitors), opinion leaders, industry experts, research institutions, distributors, dealer and traders, as well as the raw materials suppliers and producers, etc.

The primary sources from the demand side include industry experts such as business leaders, marketing and sales directors, technology and innovation directors, supply chain executive, end users (product buyers), and related key executives from various key companies and organizations operating in the global market.

The study objectives of this report are:

• To analyze and study the global market capacity, production, value, consumption, status (2017-2020) and forecast (2021-2030);
• Focuses on the key manufacturers, to study the capacity, production, value, market share and development plans in future.
• Comprehensive company profiles covering the product offerings, key financial information, recent developments, SWOT analysis, and strategies employed by the major market players
• To define, describe and forecast the market by type, application and region.
• To analyze the global and key regions market potential and advantage, opportunity and challenge, restraints and risks.
• To identify significant trends and factors driving or inhibiting the market growth.
• To analyze the opportunities in the market for stakeholders by identifying the high growth segments.
• To strategically analyze each submarket with respect to individual growth trend and their contribution to the market
• To analyze competitive developments such as expansions, agreements, new product launches, and acquisitions in the market
• To strategically profile the key players and comprehensively analyze their growth strategies.