The U.S. revenue cycle management for oncology and urology market was estimated at USD 6.98 billion in 2021 and it is expected to surpass around USD 22.46 billion by 2030, poised to grow at a CAGR of 13.87% from 2022 to 2030.
The market growth can be attributed to the rising adoption of applications that would help in streamlining revenue cycles for various healthcare institutions and technological advancements undertaken by the key players in the market.
Developers and vendors of RCM platforms & solutions are supporting healthcare facilities in accommodating and getting themselves accustomed to the transitions associated with ICD-10. RCM providers are focusing on increasing staff resources & providing adequate training sources and improving customer engagement. For instance, in January 2020, OnQ launched Robotic Process Automation (RPA). The company’s accessible RPA solutions considerably helped in enhancing service quality, improving efficiencies, and shortening medical billing procedures.
According to The State of RPA in the Revenue Cycle survey conducted in 2021, 51% of the healthcare systems in the U.S. are widely adopting Robotic Process Automation (RPA) in improving their RCM platforms. RPA and automation allow to streamline and simplify various aspects of the RCM solution that is repetitive, manual, or rule-based. The survey further states that midsized and large-sized hospitals are using automation across all functions of their RCM platform. The top five RCM processes wherein automation is widely being used are Eligibility (59%), Authorization (57%), Claims/Follow-up (43%), Charge Capture (39%), and Payments/Collections (39%).
Increasing adoption of RCM outsourcing in the U.S. is expected to positively impact the growth of the market during the forecast period. The changing aspects of RCM outsourcing are mainly due to the availability of finances, value addition, and business prospects. Moreover, due to awareness regarding cost savings with respect to the adoption of RCM solutions, efficient and cost-effective services are some of the major advantages of RCM outsourcing. Despite this, the shortage of skilled professionals required for managing the revenue cycle management software is expected to restrain the growth of the market over the forecast period.
Scope of The Report
|Market Size in 2021|
|Revenue Forecast by 2030|
|Growth rate from 2022 to 2030||CAGR of%|
|Forecast Period||2022 to 2030|
The in-house segment held the largest share of 71.6% in 2021. The increasing use of in-house RCM solutions to manage the financials of healthcare facilities contributed to market growth. The in-house solutions offer advantages such as flexibility over functioning, direct control of the platform, and high return on investments which increased the adoption of the in-house RCM solutions. Furthermore, the availability of players providing the solutions such as Flatiron, Connect LLC; Gentem Health, Inc., and BillingParadise has increased the demand for the solutions.
The outsourced RCM services segment is anticipated to witness lucrative growth during the forecast period due to the increased number of healthcare facilities outsourcing RCM services to the market players due to the reduced costs and higher efficiency. Moreover, the incorporation of the ICD-10 coding structure, the shortage of healthcare staff, and the growing expansion of outpatient services boosted the demand for outsourced RCM services. Furthermore, outsourcing RCM lowers staff responsibility and improves collection level & pace by decreasing denials, thereby aiding the segment growth.
The hospitals segment accounted for the largest share of 57.63% in 2021. The RCM solutions help healthcare facilities to manage clinical and administrative functions associated with payment, claims processing, and revenue generation which is expected to contribute to the growth of the segment. Moreover, increasing collaborations of the hospitals with RCM providers in order to implement innovative solutions for effective management of reimbursements and related claims is expected to boost the adoption of RCM solutions in the facilities.
The physicians and clinical services segment is anticipated to witness the fastest growth during the forecast period owing to the increasing adoption of RCM solutions by private physicians in order to manage the medical and financial results. Moreover, the incorporation of RCM helps to reduce operational costs, manage reimbursements and boost patient and provider revenue which is expected to drive the adoption by physicians.