PUBLISHER: Grand View Research | PRODUCT CODE: 1404738
PUBLISHER: Grand View Research | PRODUCT CODE: 1404738
U.S. Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-House, Outsourced), By End-use (Hospitals, Physician Offices), By Service (Front-end, Back-end), And Segment Forecasts, 2024 - 2030
U.S. Medical Billing Outsourcing Market Growth & Trends:
The U.S. medical billing outsourcing market size is expected to reach USD 12.3 billion by 2030, registering a CAGR of 11.78% from 2024 to 2030, according to a new report by Grand View Research, Inc. Increasing complexity in health reimbursement and high chances of claim denials are expected to drive market growth. The growing burden of the patient pool, patient data, and claims volumes during and after the pandemic forced the hospital industry to outsource services. This is expected to propel market growth during the forecast period.
The challenges faced by in-house billing services during the pandemic increased the need for an alternative, such as outsourcing services. The challenge mounts when the billing process necessitates adherence to the ICD-11 code and dealing with declining reimbursements and rising healthcare costs. Several healthcare providers such as acute care hospitals and clinics/physician offices prefer outsourcing their billing processes to curb or eliminate these challenges.
The healthcare companies are expanding their product offerings to relieve the burden of claims and reimbursement processes. For instance, in April 2023, Concierge Diagnostics Inc., a mobile diagnostic imaging company in South Florida, added medical billing and consulting services to its portfolio of over 100 referral partners. The aim is to enhance revenue and minimize claim denial while reducing costs for physician practices.
Acceptance of revenue cycle management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing medical billing services include improvement in billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.
The COVID-19 pandemic drastically impacted the market. Reduction in hospital revenue and patient volumes slowed down market growth. New billing and telehealth codes were introduced during the pandemic. Growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. Medical billing providers have spent significant amounts on resources and technology, which can be utilized by healthcare providers after outsourcing the billing process.
U.S. Medical Billing Outsourcing Market Report Highlights:
- Based on component, the outsourced segment held the largest revenue share of over 57% in 2023 and is expected to register the fastest growth, owing to a growing focus on minimizing the cost of healthcare delivery and improving the patient and physician relationship
- Based on service, the front-end services segment dominated the market with a revenue share of over 38% in 2023, as these services increase downstream cash flow and decrease rework and cost to collect
- The middle-end services segment is expected to register the fastest CAGR during the forecast period. This is attributed to growing awareness about billing outsourcing among healthcare practitioners and rising adoption of middle-end services among them
- Based on end-use, the hospital segment accounted for the largest revenue share of over 46% in 2023 owing to high claim volumes and rising patient burden. In addition, errorless procedures and minimization of loss due to denial of payments are benefits associated with medical billing outsourcing, which leads to rising adoption in multispecialty hospitals
Table of Contents
Chapter 1. Methodology and Scope
- 1.1. Market Segmentation & Scope
- 1.2. Research Methodology
- 1.3. Information or Data Analysis
- 1.4. Market Formulation & Validation
- 1.5. Model Details
- 1.6. List of Secondary Sources
- 1.7. List of Abbreviations
- 1.8. Objectives
Chapter 2. Executive Summary
- 2.1. Market Snapshot
- 2.2. Segment Snapshot
- 2.3. Competitive Landscape Snapshot
Chapter 3. Market Variables, Trends, & Scope
- 3.1. Market Segmentation and Scope
- 3.2. Market Lineage Outlook
- 3.2.1. Parent Market Outlook
- 3.2.2. Related/Ancillary Market Outlook
- 3.3. Market Trends and Outlook
- 3.4. Market Driver Analysis
- 3.5. Market Restraint Analysis
- 3.6. Business Environment Analysis
- 3.6.1. PESTLE Analysis
- 3.6.2. Porter's Five Forces Analysis
- 3.7. COVID-19 Impact Analysis
Chapter 4. U.S. Medical Billing Outsourcing Market: Component Estimates & Trend Analysis
- 4.1. U.S. Medical Billing Outsourcing Market: Component Movement Analysis and Market Share
- 4.2. U.S. Medical Billing Outsourcing Market: Segment Dashboard
- 4.3. In-house
- 4.3.1. In-house market, 2018 - 2030 (USD Million)
- 4.4. Outsourced
- 4.4.1. Outsourced market, 2018 - 2030 (USD Million)
Chapter 5. U.S. Medical Billing Outsourcing Market: Services Estimates & Trend Analysis
- 5.1. U.S. Medical Billing Outsourcing Market: Services Movement Analysis and Market Share
- 5.2. U.S. Medical Billing Outsourcing Market: Segment Dashboard
- 5.3. Front-end Services
- 5.3.1. Front-end services market, 2018 - 2030 (USD Million)
- 5.4. Middle-end Services
- 5.4.1. Middle-end services market, 2018 - 2030 (USD Million)
- 5.5. Back-end Services
- 5.5.1. Back-end services market, 2018 - 2030 (USD Million)
Chapter 6. U.S. Medical Billing Outsourcing Market: End-use Estimates & Trend Analysis
- 6.1. U.S. Medical Billing Outsourcing Market: End-use Movement Analysis and Market Share
- 6.2. U.S. Medical Billing Outsourcing Market: Segment Dashboard
- 6.3. Hospitals
- 6.3.1. Hospitals market, 2018 - 2030 (USD Million)
- 6.4. Physician Offices
- 6.4.1. Physician offices market, 2018 - 2030 (USD Million)
- 6.5. Others
- 6.5.1. Others market, 2018 - 2030 (USD Million)
Chapter 7. Competitive Landscape
- 7.1. Participant's Overview
- 7.2. Financial Performance
- 7.3. Company Market Position Analysis
- 7.4. Strategy Mapping
- 7.4.1. Expansion
- 7.4.2. Acquisition
- 7.4.3. Collaborations
- 7.4.4. New Product Launches
- 7.4.5. Partnerships
- 7.4.6. Others
- 7.5. Participant's overview
- 7.5.1. R1 RCM, Inc.
- 7.5.1.1. Overview
- 7.5.1.2. Financial Performance
- 7.5.1.3. Product Benchmarking
- 7.5.1.4. Strategic Initiatives
- 7.5.2. Veradigm LLC (Allscripts Healthcare, LLC)
- 7.5.2.1. Overview
- 7.5.2.2. Financial Performance
- 7.5.2.3. Product Benchmarking
- 7.5.2.4. Strategic Initiatives
- 7.5.3. Oracle (Cerner Corporation)
- 7.5.3.1. Overview
- 7.5.3.2. Financial Performance
- 7.5.3.3. Product Benchmarking
- 7.5.3.4. Strategic Initiatives
- 7.5.4. McKesson Corporation
- 7.5.4.1. Overview
- 7.5.4.2. Financial Performance
- 7.5.4.3. Product Benchmarking
- 7.5.4.4. Strategic Initiatives
- 7.5.5. eClinicalWorks
- 7.5.5.1. Overview
- 7.5.5.2. Financial Performance
- 7.5.5.3. Product Benchmarking
- 7.5.5.4. Strategic Initiatives
- 7.5.6. Kareo, Inc.
- 7.5.6.1. Overview
- 7.5.6.2. Financial Performance
- 7.5.6.3. Product Benchmarking
- 7.5.6.4. Strategic Initiatives
- 7.5.7. Promantra Inc.
- 7.5.7.1. Overview
- 7.5.7.2. Financial Performance
- 7.5.7.3. Product Benchmarking
- 7.5.7.4. Strategic Initiatives
- 7.5.8. AdvancedMD, Inc.
- 7.5.8.1. Overview
- 7.5.8.2. Financial Performance
- 7.5.8.3. Product Benchmarking
- 7.5.8.4. Strategic Initiatives
- 7.5.9. Quest Diagnostics
- 7.5.9.1. Overview
- 7.5.9.2. Financial Performance
- 7.5.9.3. Product Benchmarking
- 7.5.9.4. Strategic Initiatives
- 7.5.1. R1 RCM, Inc.
List of Tables
- Table 1 List of secondary sources
- Table 2 List of abbreviations
- Table 3 U.S. medical billing outsourcing market, by component, 2018 - 2030 (USD Million)
- Table 4 U.S. medical billing outsourcing market, by service 2018 - 2030 (USD Million)
- Table 5 U.S. medical billing outsourcing market, by end-use 2018 - 2030 (USD Million)
List of Figures
- Fig. 1 Market research process
- Fig. 2 Information procurement
- Fig. 3 Primary research pattern
- Fig. 4 Market research approaches
- Fig. 5 Value chain-based sizing & forecasting
- Fig. 6 Market formulation & validation
- Fig. 7 Medical billing outsourcing market segmentation
- Fig. 8 Market Snapshot, 2023
- Fig. 9 Market trends & outlook
- Fig. 10 Market driver relevance analysis (current & future impact)
- Fig. 11 Market restraint relevance analysis (current & future impact)
- Fig. 12 PESTLE analysis
- Fig. 13 Porter's Five Forces analysis
- Fig. 14 U.S. medical billing outsourcing market: component movement and market share analysis
- Fig. 15 U.S. medical billing outsourcing market component outlook: Segment Dashboard
- Fig. 16 In-house market, 2018 - 2030 (USD Million)
- Fig. 17 Outsourced market, 2018 - 2030 (USD Million)
- Fig. 18 U.S. medical billing outsourcing market: service movement and market share analysis
- Fig. 19 U.S. medical billing outsourcing market service outlook: Segment Dashboard
- Fig. 20 Front-end services market, 2018 - 2030 (USD Million)
- Fig. 21 Middle-end services market, 2018 - 2030 (USD Million)
- Fig. 22 Back-end services market, 2018 - 2030 (USD Million)
- Fig. 23 U.S. medical billing outsourcing market: end-use movement and market share analysis
- Fig. 24 U.S. medical billing outsourcing market end-use outlook: Segment Dashboard
- Fig. 25 Physician back offices market, 2018 - 2030 (USD Million)
- Fig. 26 Hospitals market, 2018 - 2030 (USD Million)
- Fig. 27 Others market, 2018 - 2030 (USD Million)
- Fig. 28 Strategy mapping
- Fig. 29 Company market position analysis
