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封面
市场调查报告书
商品编码
1404738

美国医疗申请外包市场规模、份额和趋势分析报告：2024-2030 年按构成、最终用途、服务和细分市场进行的预测

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
出版日期: | 出版商: Grand View Research | 英文 90 Pages | 商品交期: 2-10个工作天内

价格

美国医疗申请外包市场的成长与趋势：

Grand View Research, Inc.最新报告显示，到2030年，美国医疗申请外包市场规模预计将达到123亿美元，2024年至2030年复合年增长率为11.78%。

医疗保险报销的日益复杂性和索赔申请的高机率预计将推动市场成长。在大流行期间和之后，患者群、病患资料和申请量的压力增加，迫使医院产业外包服务。预计这将在预测期内推动市场成长。

疫情期间内部申请服务面临的挑战增加了对外包服务等替代服务的需求。在遵守 ICD-11 准则以及应对报销下降和医疗费用上升方面，挑战比比皆是。一些医疗保健提供者，包括急诊医院和诊所，更喜欢外包其申请流程，以限製或消除这些挑战。

医疗保健公司正在扩大其产品范围，以减轻申请和报销流程的负担。例如，2023 年 4 月，南佛罗里达州行动影像公司 Concierge Diagnostics Inc. 在其 100 多个推荐合作伙伴的投资组合中增加了医疗申请和咨询服务。目的是降低医生执业成本，同时增加收益并最大限度地减少申请拒绝。

各种医疗机构对收益週期管理 (RCM) 的接受程度因应用而异。在美国，与任何其他 RCM 应用程式相比，它更多地用于调度、编码、申请、患者登记和申请处理。与外包医疗申请服务相关的好处包括改进的申请流程、更少的错误、更快的周转时间以及更顺畅的医院和其他医疗机构的管理。

COVID-19大流行对市场产生了重大影响。医院收益和患者数量的下降减缓了市场成长。大流行期间引入了新的申请和远端医疗代码。病患负担的增加和医护人员工作量的增加不仅给适应新规范带来了挑战，而且在现场实施也带来了挑战。医疗申请提供者在资源和技术上花费了大量资金，在外包申请流程后，医疗保健提供者可以利用这一点。

美国医疗申请外包市场报告亮点

  • 从组成来看，预计到2023年外包产业将占最大收入份额，超过57%，成长最快。
  • 从服务来看，前端服务领域占据市场主导地位，2023年收益占有率将超过38%。
  • 预计中端​​服务业在预测期内复合年增长率最快。这是由于医疗保健专业人员对申请外包的认识不断增强以及中间端服务的采用不断增加。
  • 按最终用途划分，由于申请数量高和患者成本增加，2023 年医院部门的收入份额最大，超过 46%。此外，无错误处理和因付款拒绝而造成的损失最小化是与医疗申请外包相关的好处，这导致多学科医院越来越多地采用。

目录

第一章调查方法和范围

第 2 章执行摘要

第三章市场变数、趋势和范围

  • 市场区隔和范围
  • 市场体系展望
    • 母市场展望
    • 相关/附随市场展望
  • 市场趋势及展望
  • 市场驱动因素分析
  • 市场抑制因素分析
  • 营商环境分析
    • PESTLE分析
    • 波特五力分析
  • COVID-19感染疾病的影响分析

第四章美国医疗申请外包市场：构成预估及趋势分析

  • 美国医疗申请外包市场：构成变化分析及市场占有率
  • 美国医疗申请外包市场：细分仪表板
  • 公司内部
    • 内部市场，2018-2030
  • 外包
    • 外包市场，2018-2030

第五章美国医疗申请外包市场：服务估算与趋势分析

  • 美国医疗申请外包市场：服务差异分析与市场占有率
  • 美国医疗申请外包市场：细分仪表板
  • 前端服务
    • 前端服务市场，2018-2030
  • 中阶服务
    • 中阶服务市场，2018-2030
  • 后端服务
    • 后端服务市场，2018-2030

第六章美国医疗申请外包市场：最终用途估算与趋势分析

  • 美国医疗申请外包市场：最终用途变化分析和市场占有率
  • 美国医疗申请外包市场：细分仪表板
  • 医院
    • 医院市场，2018-2030
  • 检查室
    • 2018-2030年检查室市场
  • 其他的
    • 其他市场，2018-2030

第七章竞争形势

  • 参与企业概况
  • 财务绩效
  • 公司市场分析
  • 策略规划
    • 扩张
    • 获得
    • 合作
    • 新产品发布
    • 合伙
    • 其他的
  • 参与企业概况
    • R1 RCM, Inc.
    • Veradigm LLC（Allscripts Healthcare, LLC）
    • Oracle（Cerner Corporation）
    • McKesson Corporation
    • eClinicalWorks
    • Kareo, Inc.
    • Promantra Inc.
    • AdvancedMD, Inc.
    • Quest Diagnostics
Product Code: GVR-2-68038-824-4

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

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