According to a revenue cycle management market research report published by Research and Markets, the global healthcare RCM market size amounted to USD 20.1 Billion in 2021. Going by the forecasted trends in the research paper, the market size will grow to USD 53.5 Billion by 2027 with a CAGR of 17.6% from 2022 to 2027. The predictive analysis reports combined with the current market research point out that the market share for outsourced medical billing services is on the rise. The figures indicate that the revenue cycle management industry is now predominantly run by the globally experienced RCM companies instead of in-house teams at healthcare organizations.
An interesting observation is that the RCM outsourcing market was just in its infant stages even a decade ago. While there were fewer options in the market to choose from, not all healthcare organizations had equal access to their services. From then to 2022, the outsourced medical billing services have grown by leaps and bounds. The growth has significantly accelerated after the global pandemic. What are the reasons behind this accelerated growth? Which factors are responsible for this change? Learn more about them.
1.Increase in Patient Volumes
Patient volumes have seen several fluctuations since the beginning of the pandemic in the early March of 2020. There are a few things to keep in mind when evaluating the patient volume changes over the last two years. Due to the massive rise of Covid-19 hospitalization cases through 2020 and 2021, the patient volume for emergency cases has been overwhelming. At the same time, elective care in 2022 remains to be at lower levels than in 2019. These values indicate that there will be a significant conflict between demand and supply with elective care returning to the scene after a long-suppressed period.
The healthcare systems had several difficulties managing the diverse cases and massive volumes of patients during such unprecedented situations. The legacy systems and manual processing workflows that existed for a long time could not support the changing needs during that time. Therefore healthcare management leaders are looking for end-to-end solutions that can help them navigate these challenges without disrupting their functions. Outsourced medical billing services offer such solutions focusing on target-based goal fulfillment, making them a good choice for most organizations.
2.Data Analysis Requirements
In the last few years, most healthcare organizations have begun their digital transformation journey. Most organizations do not depend on paper hard copies for their workflow anymore. In-house billing teams or professionals from outsourced medical billing services use software solutions or electronic records to track required information. With the increase in the use of these digital platforms and the elimination of paper documents, healthcare organizations have a significant load of data collected throughout a typical working day.
However, the data should be well documented, stored, filtered, and analyzed to draw conclusive results and business insights. Accurate data entry is hence crucial for the success of this process. Outsourced medical billing services can provide automated data management solutions which will eliminate manual clerical errors and perform data analysis. Data analytics reports are critical to forming the healthcare organization’s future business growth strategies. The need for comprehensive data management has thus been a boosting factor for outsourced medical billing services.
3.Availability of Options
With growing access to the different outsourced medical billing services, demand for such services has been on the rise. Most healthcare organizations were working with their in-house RCM teams a decade ago only. The use of digital tools was not standard, and most organizations used paper documents. It is also why not many healthcare billing services companies were present during that time.
But as the shift towards digital tools and electronic data sharing took place, the organizations needed more assistance in handling the systems and managing the data. In the past few years, more than 50% of healthcare organizations have gone completely digital with their RCM workflow, and more than 90% of the organizations expressed the intent to digitize their workflow management. While some organizations offer only software solutions, others provide end-to-end medical billing services. With the growing number of options in the market, the market for outsourced medical billing services has also grown.
4.Greater Compliance Complexities
The federal and state regulations have changed drastically over the last few years. It is challenging for medical organizations to keep up with the evolving compliance measures and apply them correctly without the proper support. With the growing complexities in compliance regulation and billing rules, more and more healthcare organizations are turning towards outsourced medical billing services for help.
Professional RCM companies conduct regular staff training to keep their staff updated on the latest changes in Government rules. They also provide their clients with repeatable work models which have been tried and tested for revenue cycle management success. With staff shortages rampant throughout the healthcare industry in the last two years, healthcare organizations are looking for outsourced partners for better financial management.
5.Technological Advancement
Artificial intelligence and machine learning have laid a strong foundation in the American healthcare industry, especially in back-end services. Manual and clerical errors are the major issues that healthcare organizations are fighting against with the help of best-in-class AI and ML tools. But all organizations can’t invest heavily into an advanced tool. Companies offering outsourced medical billing services also offer home-grown software solutions to simplify their tasks.
Several organizations choose the end-to-end billing services where the outsourced company takes care of all their work with a dedicated team and software solutions. In some cases, they might offer to deploy their home-grown solution in your organization, customized according to your unique requirements. Experienced RCM companies also support the deployment process in your team with the help of staff training modules. With the outsourced partner taking care of the work, the organizations need not invest in building their own expensive IT infrastructure or spend much to maintain it.
We hope this article helped you understand the critical factors in the market that have boosted the growth in outsourced medical billing services. Please connect with us in the comment section below in case of any queries. Subscribe to our blog for regular articles on the medical billing industry. Follow us on Facebook, Instagram, Twitter, and LinkedIn for more.