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市场调查报告书
商品编码
1679393

美国医疗帐单外包市场规模、份额、趋势分析报告：按组件、最终用途、服务和细分市场预测，2025 年至 2030 年

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, Middle-end, Back-end), And Segment Forecasts, 2025 - 2030
出版日期: | 出版商: Grand View Research | 英文 120 Pages | 商品交期: 2-10个工作天内

价格

美国医疗帐单外包市场的成长和趋势

根据Grand View Research, Inc.的最新报告，美国医疗帐单外包市场规模预计到2030年将达到122.6亿美元，2025年至2030年期间的复合年增长率为12.0%。

医疗报销日益复杂以及索赔被拒的可能性较高预计将推动市场成长。疫情期间和疫情之后，患者群、病患资料和帐单量的负担不断增加，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。

疫情期间内部计费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 规范和应对报销额下降以及医疗成本上升方面，挑战重重。急诊医院和诊所等医疗保健提供者更愿意将其计费流程外包，以抑制和消除这些挑战。

医疗保健公司正在扩大其产品范围，以减轻计费和报销流程的负担。例如，2023 年 4 月，南佛罗里达州的行动诊断影像公司 Concierge Diagnostics Inc. 在其 100 多家宣布合作伙伴的组合中增加了医疗帐单和咨询服务。目的是减少医生的执业成本，同时增加收益并尽量减少索赔拒绝。

不同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，调度、编码、计费、患者登记和索赔处理比任何其他 RCM 应用程式更为普遍。外包医疗帐单服务的好处包括由于错误减少而改善帐单流程、缩短週转时间以及使医院和其他医疗机构的管理更加顺畅。

COVID-19 疫情对市场产生了重大影响。医院收入和患者数量的下降减缓了市场成长。疫情期间引入了新的计费代码和远端医疗代码。患者负担的增加和医务人员工作量的增加不仅对适应新规范提出了挑战，而且对在实践中实施新规范也提出了挑战。医疗帐单提供者在资源和技术上花费了大量资金，医疗保健提供者在外包帐单流程后可以利用这些资金。

美国医疗帐单外包市场报告重点

  • 从组成部分来看，外包部分预计成长最快，到 2024 年将占据最大收入份额，超过 58.90%。
  • 从服务来看，前端服务占据市场主导地位，2024 年的营收份额将超过 38.6%。
  • 预计中阶​​服务领域在预测期内将实现最快的复合年增长率。这是因为医疗保健专业人员对计费外包的认识不断提高，并且中阶服务的采用率不断提高。
  • 根据最终用途，由于索赔数量众多且患者共同支付费用增加，医院部门在 2024 年占据最大收入份额，超过 46.95%。此外，医疗帐单外包由于其无错误流程和最大限度减少付款造成的损失等优势，越来越多地被综合医院采用。

目录

第一章调查方法与范围

第二章执行摘要

第三章美国医疗帐单外包市场变数、趋势与范围

  • 市场体系展望
    • 母市场展望
    • 相关/辅助市场展望
  • 市场动态
    • 市场驱动因素分析
    • 市场限制因素分析
  • 美国医疗帐单外包市场分析工具
    • 产业分析—波特五力分析
    • PESTEL分析
  • 使用案例
  • 技术进步

第四章美国医疗帐单外包市场：组成部分、估算与趋势分析

  • 细分仪表板
  • 美国医疗帐单外包市场成分变化分析
  • 美国医疗帐单外包市场规模和趋势分析（按组成部分），2018 年至 2030 年
  • 内部
  • 外包

第五章美国医疗帐单外包市场：按服务、估计和趋势分析

  • 细分仪表板
  • 美国医疗帐单外包市场服务变化分析
  • 美国医疗帐单外包市场规模与趋势分析（按服务划分），2018 年至 2030 年
  • 前端服务
  • 中阶服务
  • 后端服务

第六章美国医疗帐单外包市场：按最终用途的估计和趋势分析

  • 细分仪表板
  • 美国医疗帐单外包市场的最终用途趋势分析
  • 2018 年至 2030 年美国医疗帐单外包市场规模及趋势分析（依最终用途）
  • 医院
  • 医生办公室
  • 其他的

第七章竞争格局

  • 公司/竞争对手分类
  • 战略地图
  • 2024年企业市场分析
  • 公司简介/上市公司
    • R1RCM Inc.
    • Veradigm LLC（Allscripts Healthcare, LLC）
    • Oracle（Cerner Corporation）
    • eClinicalWorks
    • Kareo, Inc.
    • McKesson Corporation
    • Quest Diagnostics
    • Promantra Inc.
    • AdvancedMD, Inc.
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 12.26 billion by 2030, registering a CAGR of 12.0% from 2025 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 58.90% in 2024 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 38.6% in 2024, 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 46.95% in 2024 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. Market Definitions
    • 1.2.1. Component Segment
    • 1.2.2. Service Segment
    • 1.2.3. End Use Segment
  • 1.3. Information analysis
    • 1.3.1. Market formulation & data visualization
  • 1.4. Data validation & publishing
  • 1.5. Information Procurement
    • 1.5.1. Primary Research
  • 1.6. Information or Data Analysis
  • 1.7. Market Formulation & Validation
  • 1.8. Market Model
  • 1.9. Total Market: CAGR Calculation
  • 1.10. Objectives
    • 1.10.1. Objective 1
    • 1.10.2. Objective 2

Chapter 2. Executive Summary

  • 2.1. Market Outlook
  • 2.2. Segment Snapshot
  • 2.3. Competitive Insights Landscape

Chapter 3. U.S. Medical Billing Outsourcing Market Variables, Trends & Scope

  • 3.1. Market Lineage Outlook
    • 3.1.1. Parent market outlook
    • 3.1.2. Related/ancillary market outlook.
  • 3.2. Market Dynamics
    • 3.2.1. Market driver analysis
      • 3.2.1.1. Increasing complexity of claims and reimbursement processes
      • 3.2.1.2. Increasing focus on patient engagement and reduce operational costs
      • 3.2.1.3. Technological advancements
    • 3.2.2. Market restraint analysis
      • 3.2.2.1. Ethical concerns related to data privacy
      • 3.2.2.2. Lack of Professionals to handle RCM processes
  • 3.3. U.S. Medical Billing Outsourcing Market Analysis Tools
    • 3.3.1. Industry Analysis - Porter's
      • 3.3.1.1. Supplier power
      • 3.3.1.2. Buyer power
      • 3.3.1.3. Substitution threat
      • 3.3.1.4. Threat of new entrant
      • 3.3.1.5. Competitive rivalry
    • 3.3.2. PESTEL Analysis
      • 3.3.2.1. Political landscape
      • 3.3.2.2. Technological landscape
      • 3.3.2.3. Economic landscape
      • 3.3.2.4. Environmental Landscape
      • 3.3.2.5. Legal Landscape
      • 3.3.2.6. Social Landscape
  • 3.4. Case Study
  • 3.5. Technological Advancement

Chapter 4. U.S. Medical Billing Outsourcing Market: Component Estimates & Trend Analysis

  • 4.1. Segment Dashboard
  • 4.2. U.S. Medical Billing Outsourcing Market Component Movement Analysis
  • 4.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Component, 2018 to 2030 (USD Million)
  • 4.4. In-house
    • 4.4.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 4.5. Outsourced
    • 4.5.1. Market estimates and forecasts 2018 to 2030 (USD Million)

Chapter 5. U.S. Medical Billing Outsourcing Market: Service Estimates & Trend Analysis

  • 5.1. Segment Dashboard
  • 5.2. U.S. Medical Billing Outsourcing Market Service Movement Analysis
  • 5.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Service, 2018 to 2030 (USD Million)
  • 5.4. Front-end Services
    • 5.4.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 5.5. Middle-end Services
    • 5.5.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 5.6. Back-end Services
    • 5.6.1. Market estimates and forecasts 2018 to 2030 (USD Million)

Chapter 6. U.S. Medical Billing Outsourcing Market: End Use Estimates & Trend Analysis

  • 6.1. Segment Dashboard
  • 6.2. U.S. Medical Billing Outsourcing Market End Use Movement Analysis
  • 6.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by End Use, 2018 to 2030 (USD Million)
  • 6.4. Hospitals
    • 6.4.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 6.5. Physician Offices
    • 6.5.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 6.6. Others
    • 6.6.1. Market estimates and forecasts 2018 to 2030 (USD Million)

Chapter 7. Competitive Landscape

  • 7.1. Company/Competition Categorization
  • 7.2. Strategy Mapping
  • 7.3. Company Market Position Analysis, 2024
  • 7.4. Company Profiles/Listing
    • 7.4.1. R1RCM Inc.
      • 7.4.1.1. Company overview
      • 7.4.1.2. Financial performance
      • 7.4.1.3. Product benchmarking
      • 7.4.1.4. Strategic initiatives
    • 7.4.2. Veradigm LLC (Allscripts Healthcare, LLC)
      • 7.4.2.1. Company overview
      • 7.4.2.2. Financial performance
      • 7.4.2.3. Product benchmarking
      • 7.4.2.4. Strategic initiatives
    • 7.4.3. Oracle (Cerner Corporation)
      • 7.4.3.1. Company overview
      • 7.4.3.2. Financial performance
      • 7.4.3.3. Product benchmarking
      • 7.4.3.4. Strategic initiatives
    • 7.4.4. eClinicalWorks
      • 7.4.4.1. Company overview
      • 7.4.4.2. Financial performance
      • 7.4.4.3. Product benchmarking
      • 7.4.4.4. Strategic initiatives
    • 7.4.5. Kareo, Inc.
      • 7.4.5.1. Company overview
      • 7.4.5.2. Financial performance
      • 7.4.5.3. Product benchmarking
      • 7.4.5.4. Strategic initiatives
    • 7.4.6. McKesson Corporation
      • 7.4.6.1. Company overview
      • 7.4.6.2. Financial performance
      • 7.4.6.3. Product benchmarking
      • 7.4.6.4. Strategic initiatives
    • 7.4.7. Quest Diagnostics
      • 7.4.7.1. Company overview
      • 7.4.7.2. Financial performance
      • 7.4.7.3. Product benchmarking
      • 7.4.7.4. Strategic initiatives
    • 7.4.8. Promantra Inc.
      • 7.4.8.1. Company overview
      • 7.4.8.2. Financial performance
      • 7.4.8.3. Product benchmarking
      • 7.4.8.4. Strategic initiatives
    • 7.4.9. AdvancedMD, Inc.
      • 7.4.9.1. Company overview
      • 7.4.9.2. Financial performance
      • 7.4.9.3. Product benchmarking
      • 7.4.9.4. Strategic initiatives

List of Tables

  • Table 1 List of abbreviations
  • Table 2 U.S. medical billing outsourcing market, by component, 2018 - 2030 (USD Million)
  • Table 3 U.S. medical billing outsourcing market, by service, 2018 - 2030 (USD Million)
  • Table 4 U.S. medical billing outsourcing market, by end use, 2018 - 2030 (USD Million)

List of Figures

  • Fig. 1 Market research process
  • Fig. 2 Data triangulation techniques
  • Fig. 3 Market formulation & validation
  • Fig. 4 U.S. medical billing outsourcing market: Market outlook
  • Fig. 5 U.S. medical billing outsourcing market: Segment outlook
  • Fig. 6 U.S. medical billing outsourcing market: Competitive landscape outlook
  • Fig. 7 Parent market outlook
  • Fig. 8 U.S. medical billing outsourcing market driver impact
  • Fig. 9 U.S. medical billing outsourcing market restraint impact
  • Fig. 10 U.S. medical billing outsourcing market: Component outlook and key takeaways
  • Fig. 11 U.S. medical billing outsourcing market: Component movement analysis
  • Fig. 12 In-house market estimates and forecasts,2018 - 2030 (USD Million)
  • Fig. 13 Outsourced market estimates and forecasts, 2018 - 2030 (USD Million)
  • Fig. 14 U.S. medical billing outsourcing market: Services outlook and key takeaways
  • Fig. 15 U.S. medical billing outsourcing market: Services movement analysis
  • Fig. 16 Front-end services market estimates and forecasts,2018 - 2030 (USD Million)
  • Fig. 17 Middle-end services market estimates and forecasts, 2018 - 2030 (USD Million)
  • Fig. 18 Back-end services market estimates and forecasts, 2018 - 2030 (USD Million)
  • Fig. 19 U.S. medical billing outsourcing market: End Use outlook and key takeaways
  • Fig. 20 U.S. medical billing outsourcing market: End Use movement analysis
  • Fig. 21 Hospitals market estimates and forecast, 2018 - 2030 (USD Million)
  • Fig. 22 Physician offices market estimates and forecast, 2018 - 2030 (USD Million)
  • Fig. 23 Others market estimates and forecast, 2018 - 2030 (USD Million)