PUBLISHER: The Business Research Company | PRODUCT CODE: 1727758
PUBLISHER: The Business Research Company | PRODUCT CODE: 1727758
Back-end revenue cycle management (RCM) encompasses the processes that take place after a patient receives care, focusing on billing, claims processing, payment collection, and reimbursement from insurance providers. It ensures that healthcare providers receive proper compensation for their services. Efficient back-end RCM helps optimize revenue, minimize errors, and enhance the financial performance of healthcare organizations.
The primary products and services in back-end RCM include services and software. Back-end RCM services involve managing claims processing, payment collections, denial management, and revenue reconciliation to ensure accurate and efficient financial operations for healthcare providers. It is available in different delivery modes, including on-premise and cloud-based solutions, and serves various end users such as healthcare payers and healthcare providers.
The back-end revenue cycle management market research report is one of a series of new reports from The Business Research Company that provides back-end revenue cycle management market statistics, including back-end revenue cycle management industry global market size, regional shares, competitors with a back-end revenue cycle management market share, detailed back-end revenue cycle management market segments, market trends and opportunities, and any further data you may need to thrive in the back-end revenue cycle management industry. This back-end revenue cycle management market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenario of the industry.
The back-end revenue cycle management market size has grown strongly in recent years. It will grow from $12.36 billion in 2024 to $13.39 billion in 2025 at a compound annual growth rate (CAGR) of 8.3%. The growth during the historic period can be attributed to rising healthcare costs, an increase in claim denials, regulatory compliance requirements, the shift to value-based care, and the growing adoption of healthcare IT solutions.
The back-end revenue cycle management market size is expected to see strong growth in the next few years. It will grow to $18.19 billion in 2029 at a compound annual growth rate (CAGR) of 8.0%. The growth during the forecast period can be attributed to advancements in AI and automation, increasing healthcare digitalization, the rising demand for outsourced RCM services, the expansion of telehealth services, and a growing focus on patient financial engagement. Key trends in this period include AI-driven claims processing, robotic process automation (RPA), blockchain for secure transactions, cloud-based RCM platforms, and the use of predictive analytics for revenue optimization.
The increasing number of patients is expected to drive the expansion of the back-end revenue cycle management market. Patient volume refers to the total number of individuals seen, treated, or admitted by healthcare facilities, providers, or systems within a given timeframe. This rise is attributed to factors such as an aging population, the growing prevalence of chronic diseases, improved healthcare access, advancements in medical treatments, and heightened awareness of healthcare services. As patient numbers grow, the need for efficient back-end revenue cycle management systems becomes crucial to handling complex billing and insurance processes, ensuring accuracy, reducing administrative burdens, and maintaining seamless healthcare operations. For instance, in August 2024, the National Health Service England (NHS England), a UK-based government department, reported that approximately 75.2% of patients visiting accident and emergency departments in UK hospitals were admitted, transferred, or discharged in 2023, up from 74.6% in 2022. This upward trend in patient volume continues to fuel the demand for back-end revenue cycle management solutions.
Leading companies in the back-end revenue cycle management market are focusing on developing secure SaaS solutions to enhance billing efficiency, optimize claims processing, and improve overall operational performance. Secure Software as a Service (SaaS) solutions for revenue cycle management provide cloud-based platforms designed to streamline and protect billing, coding, payment collection, and insurance reimbursement processes. In July 2023, Telcor Inc., a US-based laboratory revenue cycle management company, introduced version 21.3 of TELCOR revenue cycle management (RCM), a secure SaaS platform. This latest version improves laboratory productivity and collections by offering expanded access to the report designer, an executive module, web application programming interfaces (APIs), and other advanced features.
In January 2024, R1 RCM Inc., a US-based revenue cycle management company, completed the acquisition of Acclara from Providence for $675 million. This acquisition strengthens R1 RCM's revenue cycle management services and establishes a 10-year agreement with Providence for comprehensive revenue cycle management solutions. Acclara, a US-based revenue cycle management company, specializes in back-end revenue cycle management services.
Major players in the back-end revenue cycle management market are McKesson Corporation, Optum Inc., Oracle Health, Cognizant Technology Solutions, GE Healthcare, Quest Diagnostics, Access Healthcare, Guidehouse, GeBBs Healthcare Solutions, Ensemble Health Partners, R1 RCM Inc, Veradigm LLC, Athenahealth, Conifer Health Solutions, Eclinicalworks, FinThrive, CureMD, CareCloud, The SSI Group, AdvantEdge Healthcare Solutions, DST Systems, Context 4 Healthcare, Cerner Corporation, Allscripts Healthcare Solutions Inc.
North America was the largest region in the back-end revenue cycle management market in 2024. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in back-end revenue cycle management report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa.
The countries covered in the back-end revenue cycle management market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA, Canada, Italy, Spain.
The back-end revenue cycle management market consists of revenues earned by entities by providing services such as medical billing and coding, claims submission and processing, denial management and appeals, payment posting and reconciliation, accounts receivable (A/R) management, patient collections, and compliance with healthcare regulations. The market value includes the value of related goods sold by the service provider or included within the service offering. The back-end revenue cycle management (RCM) market also includes sales of routers, switches, and firewalls. Values in this market are 'factory gate' values, that is, the value of goods sold by the manufacturers or creators of the goods, whether to other entities (including downstream manufacturers, wholesalers, distributors, and retailers) or directly to end customers. The value of goods in this market includes related services sold by the creators of the goods.
The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD unless otherwise specified).
The revenues for a specified geography are consumption values and are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.
Back-end Revenue Cycle Management Global Market Report 2025 from The Business Research Company provides strategists, marketers and senior management with the critical information they need to assess the market.
This report focuses on back-end revenue cycle management market which is experiencing strong growth. The report gives a guide to the trends which will be shaping the market over the next ten years and beyond.
Where is the largest and fastest growing market for back-end revenue cycle management ? How does the market relate to the overall economy, demography and other similar markets? What forces will shape the market going forward? The back-end revenue cycle management market global report from the Business Research Company answers all these questions and many more.
The report covers market characteristics, size and growth, segmentation, regional and country breakdowns, competitive landscape, market shares, trends and strategies for this market. It traces the market's historic and forecast market growth by geography.
The forecasts are made after considering the major factors currently impacting the market. These include the Russia-Ukraine war, rising inflation, higher interest rates, and the legacy of the COVID-19 pandemic.