According to Nova one advisor’s the global Medical Billing Outsourcing market size was estimated at USD 11.2 billion in 2021 and is expected to surpass around USD 30.8 billion by 2030 and poised to grow at a compound annual growth rate (CAGR) of 12.06% during the forecast period 2022 to 2030.
According to Nova one advisor’s the global Medical Billing Outsourcing market size was estimated at USD 11.2 billion in 2021 and is expected to surpass around USD 30.8 billion by 2030 and poised to grow at a compound annual growth rate (CAGR) of 12.06% during the forecast period 2022 to 2030.
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The market is driven primarily by factors such as the increasing importance of regulatory compliance and risk management, the growing need to streamline the medical billing process, and efforts to reduce internal processing costs.
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. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to the 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 is expected to have a significant impact on the market, although 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 need for proactive action and the construction of a comprehensive, collaborative, scalable, and adaptable digital healthcare infrastructure has been emphasized by the pandemic crisis. As a result, many organizations are developing a new strategy that includes digitization and outsourcing non-core functions such as billing and accounting, which is expected to boost the market growth.
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. This integration creates a need for revenue cycle management (RCM), which, in turn, demands additional expertise and trained personnel to manage the same. Thus, the consolidation of large healthcare practices is also expected to be one of the factors fueling market growth.
Report Scope of the Medical Billing Outsourcing Market
| Report Coverage | Details |
| Market Size | US$ 30.8 Billion by 2030 |
| Growth Rate | CAGR of 12.06% from 2022 to 2030 |
| Largest Market | North America |
| Fastest Growing Market | Asia Pacific |
| Base Year | 2021 |
| Forecast Period | 2022 to 2030 |
| Segments Covered | Component, service, end-use and Region, |
Key Takeaways:
- By Component, the U.S. Medical Billing Outsourcing market was valued at USD 4.9 Billion in 2021 and expected to witness growth at a CAGR of 11.4% from 2022 to 2030.
- Based on the components, the outsourced segment held the largest revenue market share in 2021 due to the rising preference of hospitals, physician offices, and startups for outsourced medical billing services for hassle-free claim management at a low cost
- The front-end services segment held the largest revenue market share in 2021. However, the middle-end services segment is expected to register the highest CAGR during the forecast period due to the growing demand for Revenue Cycle Management (RCM) services offering Electronic Health Records (EHR) software
- North America held the largest revenue share in 2021. It is projected to expand further as the U.S. has witnessed a change in the healthcare system with the introduction of ICD-11 coding in 2019 and pressure from the government to incorporate the Electronic Medical Record (EMR) management system
- In November 2020, Conduent Incorporated announced a commercial agreement with Experian Health, a leading provider of RCM solutions that spans patient retention, patient access, and patient collection. The agreement will enable Conducent’s IntelliHealth Digital Platform to connect with Experian’s consumer data and electronic revenue verification tools to accelerate prescription drug approval and reduce the time to prescription drug fulfillment and treatment
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Regional Insights
North America held the largest revenue share of over 47.6% 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 Companies & Market Share Insights
The market is highly competitive, with many large, as well as medium and small-sized companies competing with each other. Partnerships, mergers and acquisitions, and technological advancements are some of the key business strategies undertaken by key companies to expand their market position. For instance, in February 2022, National Medical Billing Services, a well-known healthcare RCM company, completed the acquisition of National Billing Partners, a provider of RCM services to surgical practices and ASCs. Additionally, in March 2022, Omega Healthcare, a prominent healthcare management solution company leading the vast healthcare ecosystem acquired Reventics, a revenue cycle management solution developer that provides provider engagement solutions to improve physician reimbursement and compliance. Some of the prominent players in the global medical billing outsourcing market include:
- R1RCM Inc.
- Allscripts Healthcare, LLC
- Cerner Corporation
- eClinicalWorks
- Kareo, Inc.
- McKesson Corporation
- Quest Diagnostics Incorporated
- Promantra Inc.
- AdvancedMD, Inc.
Segments Covered in the Report
This report forecasts revenue growth at global, regional, and country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2017 to 2030. For this study, Nova one advisor, Inc. has segmented the global Medical Billing Outsourcing market
- Component
- In-house
- Outsourced
- Service
- Front-end services
- Middle-end services
- Back-end services
- End-use
- Hospital
- Physician Office
- Others
Regional Segmentation
- Asia-Pacific [China, Southeast Asia, India, Japan, Korea, Western Asia]
- Europe [Germany, UK, France, Italy, Russia, Spain, Netherlands, Turkey, Switzerland]
- North America [United States, Canada, Mexico]
- South America [Brazil, Argentina, Columbia, Chile, Peru]
- Middle East & Africa [GCC, North Africa, South Africa]
Objectives of the Study
- To define, describe, and forecast the Medical Billing Outsourcing market based on type, technology, application, end user, and region
- To provide detailed information regarding the major factors influencing market growth (such as drivers, restraints, opportunities, and challenges)
- To strategically analyze micromarkets with respect to individual growth trends, prospects, and contributions to the total market
- To analyze opportunities in the market for stakeholders and provide details of the competitive landscape for market leaders
- To forecast the size of the market segments with respect to five major regions, namely, North America, Europe, the Asia Pacific, Latin America, and the Middle East and Africa
- To profile key market players and comprehensively analyze their product portfolios, market shares, and core competencies
- To track and analyze competitive developments, such as product launches, expansions, acquisitions, agreements, and collaborations in the Medical Billing Outsourcing market
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